MYOFASCIAL PAIN THERAPY

MYOFASCIAL PAIN THERAPY ASSOCIATES
JAMES FLOOD BUILDING
870 MARKET, Suite 1175
SAN FRANCISCO, CA 94102
Tel: 415/397-5087

MARY ST. JOHN LARSON
KATE WORTHINGTON

Certified Trigger Point Myotherapists

WHAT IS A TRIGGER POINT?

A Trigger Point (TrP) is a sore and irritable area in tissue such as muscle that can either be "latent" or "active" and feels like a small nodule when palpated. When latent, it makes muscles stiff and restricts free motion of the affected muscle. When active, it is sore at the area touched, but also "refers" pain to a distant locale that is specific to that muscle (For instance, a Trigger Point in your pectoral (chest) muscle may refer pain to the chest region, the front of the shoulder, and to the inside of your elbow. This referred pain feels usually like a deep ache.

HOW CAN I RELIEVE REFERRED PAIN FROM A TRIGGER POINT?
The first thing to remember with referred pain is that the point responsible for the pain is not always in the area that pain is felt. Therefore, you must find the areas that are sensitive to pressure and reproduce the pain felt in the distant area. First, use your thumb, elbow, or a tool to apply pressure to the Trigger Point in a slow, steady manner to create only enough reaction to identify it. Continue to apply steady light pressure (do not rub around it ) until the area begins to project less pain and until it feels as though it is dissolving. It is imperative that you do not create so much pain from the pressure that you have to tense against it; you cannot flex and relax a muscle at the same time. The more you can relax a muscle while you are applying pressure, the more able it will be to release the Trigger Point and stop referring pain.

HOW LONG WILL THE RELIEF LAST?
A Trigger Point is created when a muscle is either overused, or left in too shortened or lengthened a position for too long. The circulation is compromised and it develops a tending nodule as a result. Therefore, to both prevent formation of TrPs and to lengthen the period of relief following direct compression and release of the Trigger Point, you must follow an exercise and stretching regimen each day to ensure proper muscle tone. Proper posture and use of your body mechanics also serves to promote lasting comfort.

WHAT DOES MYOFASCIAL MEAN?
Our clinic's specialty is myofascial pain and dysfunction. Myo means muscle - Fascia is the membranous connective tissue that binds tissue together and separates and identifies various muscle groups.
Through overuse, chronic shortening of muscles by remaining in an unusual position (sitting, hunching shoulders, repeated reaching, or craning neck to look at a VDT, etc.), or sudden trauma such as a blow or jerk, irritable spots called Trigger Points are developed. These Trigger Points (TrPs), when latent, are responsible for stiffness and inflexibility. When flare-ups occur from psychological stress or repetitive overuse or misuse, these TrPs become active, meaning that they cause pain to travel or "refer" to a predictable zone. For instance, a TrP flaring in your pectoral or chest muscle may cause pain in your chest, shoulder and the inside of your elbow. Compression to a TrP may recreate the referred pain pattern, the source of which had been previously frustrating and mysterious. Trigger Point Myotherapy has proven very successful in the alleviation or chronic muscular pain when other modalities used were not.

WHAT IS TRIGGER POINT MYOTHERAPY?
Therapists Mary St. John Larson and Kate Worthington apply deep compression, massage, passive stretches and movement, postural and ergonomic retraining, and kinesthetic awareness to reduce chronic pain and to facilitate a return to normal activity. Nutrition, medication and other therapies are considered to work in an integrated fashion.
Emphasis is on patient involvement, education and self-care. Stretching and exercise programs are tailored for individual capacity and use, as well as training in self-application of manual pain-relief techniques. Use of compression tools, aqua exercise, and creative interaction with environment (e.g., chair/car/pool exercise) may be used. Attention to individual lifestyles and professions receive careful consideration. Goals are set at your initial evaluation and are periodically reassessed. Patient participation, insight and creativity are highly encouraged.

WHAT SHOULD I EXPECT FROM TREATMENT?
Your rate of improvement depends on many conditions:

Response to treatment varies; some patients experience superficial soreness the day after treatment. This usually resolves after the first few treatments. You may experience fatigue as the chronically held musculature is allowed to relax and return to normal tone. Some patients experience an increase in energy.
As the "work load" of the musculature shifts and returns to a normal balance, pain patterns may change. This is a temporary and normal stage of recovery from chronic pain. It is suggested that patients keep activities to a minimum after treatment for maximum benefit.
Return to normal activities without pain is most often accelerated by adherence to the self-care program given to you by your therapist. Minimizing stress, pacing your activities and avoidance of overexertion (with a focus on what you can do instead of your limitations) are very important. Patience and a positive attitude are essential.
We encourage you to talk freely with your therapist all changes, questions and concerns.

WELCOME TO MPTA!

specializing in muscular pain and limitation