After reading this article you’ll know the basic techniques and principles of deactivating trigger points (which can be self-implemented).
The cover of the book by Donna Finando “Trigger Point Self-Care Manual. For Pain-Free Movement”
The core of trigger point deactivation is so-called ischemic compression. In plain English, it is a pressing a trigger point firmly and long enough to deprive it of some blood (ischemic pressure).
So, most of the manual approaches to deactivating trigger points basically boil down to flushing trigger points with fresh blood. However, this simplicity doesn’t mean that it can be done easily.
How To Deactivate Trigger Points
Below method has proven to be highly effective. It was developed by Leon Chaitow and combines three manual deactivation techniques. It’s called INIT which stands for:
Integrated Neuromuscular Inhibition Technique. For most of the people, it is not important to know what every word means here.
Despite this method was developed for manual therapists, understanding its principles will build a solid foundation for success in self-deactivation of trigger points.
INIT = ischemic compression (1) + positional release (2) + gentle muscle contraction (3) + stretching (4).
You can jump down to the last video and see the whole procedure in action.
Below is the gist. The full method can be found here.
(1) Ischemic compression sequences
Choose one from the two methods.
1) Apply firm digital compression to the trigger point sufficient to produce localized discomfort/pain as well as symptoms in the target area. Maintain this compression for 5 seconds. Release for 2-3 seconds. Reapply pressure (same level) and keep repeating the 5 seconds on and 2‐3 seconds off until the patient reports a reduction in local or referred pain OR an increase in pain
(which is rare) OR until 2 minutes have passed with no change in the pain levels.
2) Apply firm digital pressure to the trigger point sufficient to produce localized discomfort/pain as well as symptoms in the target area. Maintain the pressure for approximately 10 seconds. Increase the degree of pressure slightly and maintain for a further 10 seconds Increase the
degree of pressure once more and maintain for approximately 10 seconds. Slowly release pressure and the INIT sequence then moves to the positional release component.
(2) Positional release sequence
Theory: putting muscle in the position of maximum ease is often “resetting” it.
Usually one has to passively shorten the muscle housing a trigger point to find a position of maximum ease (when the painful sensation reduces significantly).
A lengthy 60‐90 seconds are recommended as the time for holding this position of maximum ease ‐ although some experts suggest just 20 seconds if an additional facilitating input can be achieved ‐ for example by ‘crowding’ or ‘folding’ the tissues to reduce sensitivity further
Method to make a step (2)
• Apply sufficient pressure to the point to cause mild discomfort and then slowly position the area in such a way as to reduce or remove the tenderness from the point.
• If the painful point is on the anterior of the body consider flexion and sidebending and/or rotation towards the side of pain as the likeliest directions for creating ease.
• If the painful point is on the posterior surface consider an extension and turning away from the side of pain as the likeliest direction towards ease.
(3)+(4) Muscle Energy sequence for stretching a muscle housing a trigger point.
Don’t be scared by the words. This is a method to stretch a muscle effectively.
Usually, it is used by manual therapists but it also can be self-implemented. If you know what is PNF-stretching, then, Muscle Energy Technique is almost the same but differing in details.
In a nutshell. To stretch a muscle effectively you place it in a most stretched position, then you have to slightly contract it (10-15% of maxim force), hold 7-15 seconds and relax – it will give you some more length. Repeat 3 times.
Muscle energy technique explained for nerds:
The end.
Important takeaway: pressure + positional release + gentle stretching.
All steps above have to be replicated for self deactivating. Not easy to do sometimes. Need to play with such variables.
The Variables In Self Deactivating Trigger Points And General Rules
Do several 2–6 minutes therapy sessions per day. But do rest days between session days.
Relaxation. Don’t use an awkward and inconvenient position. Emotional relaxation is critical.
Find the right spot. The right spot can be only just one-two millimeter away of the wrong spot. Charts can be misleading. There are primary trigger points and secondary. You have to find the first ones.
Experiment with the dosage of pressure. It can be quite painful but it is not necessarily needed to be painful.
Experiment with the timing of pressure. 15 sec, 30 sec, 90 sec, several minutes – all can work for you. Several reps * X seconds with several seconds pause in between usually works great. Phase (1) can be, for example, six repetitions of 30-second ischemic compression.
Gently press, gently release.
As a rule of thumb do sessions every other day.
As a rule of thumb: {press, wait for changes, unpress} – repeat few cycles.
Breathe! Read this article. Don’t skip it. Implement this approach to breathing while playing with trigger points. You’ll be surprised how much it can add to the therapy. Trigger points will literally start melting away with proper relaxed breathing.
Keep trying regularly. Don’t give up.
Example Of Trigger Point Deactivation
Tools for trigger point deactivation
There are some tools which can be useful for many to self deactivate trigger points.
However, don’t be surprised if you end up with the understanding that your own hands are the best tools.
Lacrosse balls – made of resin, loads of video in the Internet demonstrating the technique with those.
Tennis balls – it is sometimes better then lacross ball but much cheaper.
Trigger point back massager – helps to get hard to get points and engage a leverage to get force needed with least efforts. This version is quite rigid (unlike famous Thera Cane) which is important.
Jacknobber – useful.
The Knobble II – very useful.
Foam Rollers – so many of them. It’s not possible to make a review on foam rollers in this article.
The Thumper – this is quite expensive, but is worth its money for many. They don’t help directly with trigger points but can relax muscle tissues very fast. Unfortunately, other competing alternatives lack the weight which is critical for this tool, and this particular brand is guaranteed to be effective. Pricey but excellent.
Spiky balls are not useful for trigger point deactivation. They doesn’t work (while just good for massage) for this purpose.
Further Reading on Trigger Points
The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief
by Clair Davies
Easy to read, still can be written much more concise. Also the author will try to make you believe that his ideas are the ones to solve every problem anyone has. Just not true. Many examples of work with different muscles. This book may be the best option for lay person.
Trigger Point Chart is a kind of useful. Still, as it was mentioned before charts can be misleading.
Be Careful: What You Have To Know About Trigger Points
Now let’s talk seriously about trigger points. Tackling them is not a panacea!
It’s highly recommended, but it’s symptomatic treatment which doesn’t eliminate the real cause of suffering.
A person has lived many years with bad postural habits, deteriorating mobility, lack of regular movements, faulty breathing patterns, misaligned joints and bones, muscles imbalances… If these are not to be changed then any treatment, including trigger points deactivation, will be just temporal improvement of the situation.
And the problem is that there is no economic mechanism which would make trigger points specialists explain that to their clients.
It’s better to have a client who regularly comes back.
Second, if all you have is a hammer, everything looks like a nail…
Be happy and don’t forget to share this post if you like it :).
