trigger point therapy + yoga asana

[dianneg]

Peace to you Mukunda-

I am wondering what you have to say about combining trigger point therapy and yoga asana?

In your opinion, how would a teacher need to be trained in order to work in this capacity with a client?

Thanks for any input you may have.

in peace,
Dianne Germain

[timfm]

Hi Dianne,

While I'm not a yoga teacher, therapist, or LMT, I can tell you what I know about trigger point therapy and yoga based on my understnding of Mukunda's SYT approach.

Firstly, I would highly recommend that you get a hold of Muknda's SYT book as well as Clair Davies' "The Trigger Point Therapy Workbook."

Trigger points are essentially areas of bound up muscle fibres that usually exist in the belly of the muscle and REFER pain to other areas of the body. They can be as tiny as a pinhead or as large as chestnut. They restrict blood flow, alowing toxins and scar tissue to build up, as well as shortening and weakening the muscle. Over time, they can cause a structuaral imbalance. They are "exquisitely tender," that is to say when you find one, you'll know because it hurts and refers pain. There are primary and secondary trigger points. It's necessary to work out the primary trigger points in order to find relief. Often times, working on secondary trigger points can exacerbate the problem, as can over-working a trigger point.

Davies' basic hypothesis is that one can work through and release trigger points through a specific protocol, involving specific, frequent massage strokes (see book for details).

Davies also says that stretching a muscle that is impaired with trigger points will make the situation worse. Similarly, Mukunda says that stretching is usually contraindicated for people in pain and that they need to focus on strenghtening and relaxation.

From my personal experience, I believe both of these views are correct. I have been dealing (incorrectly) with acute sciatic pain caused by a piriformis in spasm for nearly three years before understanding these concepts. I continued a contraindicated yoga asana practice that was not healing my pain. Aside from yoga, I had an LMT work through a number of trigger points in my lower back and gluteal areas. Currently I have one or two trigger points on my piriformis that I'm gentlly working through. I have begun a yoga therapy routine that involves litlle or no stretching, and focuses on stregthening, balancing, breathwork, and relaxation. I've only been at it for a couple of weeks, so it's too soon to vouch for its effectiveness, but I can say that I've had less nerve pain flare ups since I began.

As regards to combining yoga asanas with trigger point work, I would be very cautious. I do my trigger point work while in a very relaxed position and usually after a hot shower or having warmed up the muscles in the area with movement and/or essential oils. One needs to be able to relax completely and breath deeply with the muscle being worked on in a relaxed (non-stretched) state to access the trigger points effectively.

I hope this information is of some help to you.

Namaste,

-tim

[dianneg]

Tim-
Thank you for your advice. Ironic, I have just begun to read Mukunda's book. On your request I have checked out the trigger point therapy book from the library as well. So far, I like the concise nature of the the anatomy and points in Davies' book. I look forward to exploring this at length.

"As regards to combining yoga asanas with trigger point work, I would be very cautious. I do my trigger point work while in a very relaxed position and usually after a hot shower or having warmed up the muscles in the area with movement and/or essential oils. One needs to be able to relax completely and breath deeply with the muscle being worked on in a relaxed (non-stretched) state to access the trigger points effectively"

Is a non- stretched state a large component of this or being relaxed? Because isn't this attainable in certain postures that accentuate the muscles action while releasing with mild application of pressure? Supine twist is a great example for accessing certain muscles that act on the spine while twisting as well as the IT band of the outer thigh.
Or while doing a sphinx pose couldn't you access the pectoralis major?

Let me know what you think.

thanks,
in peace,
dianne

[timfm]

"Is a non- stretched state a large component of this or being relaxed?"

From my limited understanding of Trigger Point Therapy, I would say that both are improtant. Davie's really empahsizes not stretching (AT ALL) a muscle that has trigger points as it tends to aggravate the problem. The belly of the muscle should be in a completely relaxed state while working on the trigger points. Sometimes they're so tender that just touching them causes the muscle to engage, so one has to relax, breath deeply, and find just the right amount of pressure. It very easy to overwork a point. You'll know you've done this if it gets worse. In which case you should give it a couploe of days to calm down and then try again with less vigor/force.

Ironically (as mentioned in his book) the traditional thrapuetic methods involve either trigger point injection or spraying the muscle with a refridgernt and then stetching it out. These methods require a qualified third party and have their drawbacks as well.

-t