Trigger points are hyperirritable spots in the muscles that can cause pain and discomfort. They are typically formed due to muscle overuse, trauma, or stress. When a muscle is repeatedly contracted or held in a shortened position, it can develop knots or tight bands of muscle fibers. These trigger points can restrict blood flow and cause the muscle to become sensitive and painful. Additionally, trigger points can refer pain to other areas of the body, making it difficult to pinpoint the source of the pain.
Trigger point therapy has shown promise in helping with chronic pain conditions such as fibromyalgia. Fibromyalgia is a disorder characterized by widespread musculoskeletal pain, fatigue, and tender points. Trigger point therapy aims to release the tension and knots in the muscles that may be contributing to the pain. By applying pressure to the trigger points, therapists can help alleviate pain and improve muscle function. However, it is important to note that trigger point therapy should be used as part of a comprehensive treatment plan for fibromyalgia, which may include other therapies and lifestyle changes.
Erson follows up with the difficult lumbar lateral shift patient from this episode a few weeks back. As in the past, he's doing much better and this time Erson takes care not to flare him up! Interestingly enough using the Activforce 2 handheld dynamometer reveals some significant hip and trunk rotation strength percentage differences that could be key to better prevention. Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded IndividualCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practicesKeeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-05-04
Introduction SummaryLow back pain (LBP) is a prevalent and costly health problem that affects a significant portion of the global population. Pain developers (PDs) are individuals who are considered a pre-clinical LBP population at risk of developing clinical LBP, which can exact great social and economic costs. Prolonged standing has been identified as a risk factor for LBP, and it is necessary to investigate the risk factors of standing-induced LBP in PDs comprehensively. By identifying these risk factors, appropriate preventive measures can be planned, which may reduce the incidence of standing-induced LBP and its associated costs.This study1 used a systematic review and meta-analysis approach to investigate the distinctive characteristics and risk factors of standing-induced LBP in PDs. The study aimed to identify statistically significant differences between PDs and non-pain developers (NPDs) in demographics, biomechanical, and psychological outcomes and to determine the pooled effect sizes of these differences. The study’s findings have important implications for preventing and managing standing-induced LBP in PDs and for future research investigating the association of these distinctive characteristics to standing-induced LBP and interventions that may modify them.Characteristics of Pain Developers and Non-Pain DevelopersThe systematic review and meta-analysis identified 52 papers and theses involving 1070 participants (528 PDs and 542 NPDs) that were eligible for inclusion. The studies used a prolonged standing duration greater than 42 minutes to classify adult PDs and NPDs without a history of LBP.Significant differences were found between PDs and NPDs in terms of movement patterns, muscular, postural, psychological, structural, and anthropometric variables. PDs exhibited altered motor control in the anterior hip abduction (AHAbd) test and displayed higher lumbar lordosis in individuals over 25 years old. These factors were found to have a statistically significant association with standing-induced LBP.Muscular differences were also identified between PDs and NPDs. PDs had a higher level of co-activation between gluteus medius and the erector spinae muscles, which can lead to increased lumbar loading and potentially contribute to the development of LBP.In terms of postural characteristics, PDs had less trunk control and increased trunk sway during standing compared to NPDs, which may suggest a lack of postural stability.Psychological characteristics were also found to differ between PDs and NPDs. PDs had higher levels of pain catastrophizing, which is the tendency to magnify the threat value of pain and to feel helpless in the face of it, and is associated with increased pain intensity and disability.Finally, anthropometric and structural differences were found between PDs and NPDs. PDs tended to have higher body mass index (BMI) and shorter stature compared to NPDs, which may result in altered spinal loading during standing.These findings suggest that PDs have distinct biomechanical and psychological characteristics that may predispose them to standing-induced LBP. Altered motor control displayed in AHAbd test and higher lumbar lordosis in individuals over 25 years seem to be probable risk factors for standing-induced LBP. The study’s findings have important implications for preventing and managing standing-induced LBP in PDs and for future research investigating the association of these distinctive characteristics to standing-induced LBP and interventions that may modify them.Risk Factors for Standing-Induced Low Back PainThe systematic review and meta-analysis identified several factors that were found to have a statistically significant association with standing-induced LBP:Lumbar fidgets – Participants with PDs displayed more lumbar fidgets, defined as small voluntary or involuntary movements of the lumbar spine, which are indicative of discomfort or pain. This factor was found to have a significant negative effect size (Hedge’s g − 0.72).Lumbar lordosis in participants over 25 years – Participants with PDs had higher lumbar lordosis, defined as the natural curvature of the lumbar spine, in individuals over 25 years old. This factor was found to have a significant positive effect size (Hedge’s g 2.75).AHAbd test – Participants with PDs displayed altered motor control in the AHAbd test, which measures the ability to control the hip and pelvis while lifting one leg. This factor was found to have a significant positive effect size (WMD 0.7).Gluteus medius co-activation – Participants with PDs had higher levels of co-activation between the gluteus medius and erector spinae muscles. This factor was found to have a significant positive effect size (Hedge’s g 4.24).Pain catastrophizing – Participants with PDs had higher levels of pain catastrophizing, which is associated with increased pain intensity and disability. This factor was found to have a significant positive effect size (WMD 2.85).These risk factors suggest that altered motor control, higher lumbar lordosis, increased gluteus medius co-activation, and pain catastrophizing may predispose individuals to standing-induced LBP. The findings may help identify individuals at risk of developing standing-induced LBP and plan appropriate preventive measures.Future research should investigate the association of the reported distinctive characteristics to standing-induced LBP and whether they are manipulable through various interventions. Such interventions may include physical therapy, posture correction, and mindfulness-based stress reduction, among others. Identifying modifiable risk factors may lead to the development of effective interventions for preventing and managing standing-induced LBP in individuals with pre-clinical LBP.Implications for Future ResearchThe systematic review and meta-analysis identified several distinct characteristics and risk factors for standing-induced LBP in PDs compared to NPDs. However, the study authors note that the identified risk factors do not necessarily prove causality or provide a complete understanding of the mechanisms underlying standing-induced LBP. As such, future research should investigate these factors in greater detail, and identify modifiable risk factors that can be targeted for preventive interventions.The study authors recommend that future research should investigate the following areas:Association with standing-induced LBP – Further research should investigate the association of the identified distinctive characteristics and risk factors to standing-induced LBP. Studies should investigate whether these factors are predictive of standing-induced LBP and whether they are specific to standing-induced LBP or generalizable to other types of LBP.Mechanisms underlying standing-induced LBP – Future research should also investigate the underlying mechanisms of standing-induced LBP, such as the interplay between motor control, muscle activation, and posture. Understanding the mechanisms underlying standing-induced LBP can help identify modifiable risk factors and develop effective interventions.Intervention strategies – Future research should investigate the efficacy of various interventions for preventing and managing standing-induced LBP in individuals with pre-clinical LBP. Such interventions may include physical therapy, posture correction, mindfulness-based stress reduction, and other strategies aimed at reducing risk factors identified in this study.Generalizability of findings – Finally, future research should investigate the generalizability of the study findings to other populations, such as individuals with clinical LBP or those with different occupational or lifestyle factors. This will help to determine the applicability of the findings to a broader population and inform the development of preventive measures for standing-induced LBP.ConclusionIn summary, this systematic review and meta-analysis found that pain developers (PDs) – individuals with a history of low back pain (LBP) – have distinct characteristics compared to non-pain developers (NPDs) when exposed to prolonged standing. These characteristics include altered movement patterns, muscular, postural, psychological, structural, and anthropometric variables. The study also identified several risk factors associated with standing-induced LBP, including lumbar fidgets, higher lumbar lordosis in participants over 25 years, AHAbd test, GMed co-activation, and higher scores on the Pain Catastrophizing Scale.These findings have important implications for preventing and managing standing-induced LBP, particularly in individuals with a history of LBP. The study suggests that altered motor control displayed in the AHAbd test and higher lumbar lordosis in individuals over 25 years old are probable risk factors for standing-induced LBP. Therefore, future interventions may focus on improving motor control and reducing excessive lumbar lordosis. Additionally, the study highlights the importance of addressing psychological factors, such as pain catastrophizing, as a potential risk factor for standing-induced LBP.Overall, the study emphasizes the need for a comprehensive approach to preventing and managing standing-induced LBP, including a focus on biomechanical, psychological, and other factors. Future research should investigate the association of these distinctive characteristics to standing-induced LBP and whether they are manipulable through various interventions. By identifying and addressing these risk factors, it may be possible to reduce the prevalence of LBP and improve the quality of life for individuals with a history of LBP.This study emphasizes the importance of developing appropriate preventive measures for standing-induced low back pain (LBP) in pain developers (PDs). PDs are individuals with a history of LBP and are considered a pre-clinical population at risk of developing clinical LBP, which can lead to significant social and economic costs. The study found that PDs have distinct characteristics compared to non-pain developers (NPDs) when exposed to prolonged standing, which suggests that targeted interventions may be necessary to prevent standing-induced LBP in this population.The development of appropriate preventive measures requires a thorough understanding of the risk factors associated with standing-induced LBP in PDs. This study identified several risk factors, including lumbar fidgets, higher lumbar lordosis in participants over 25 years, AHAbd test, GMed co-activation, and higher scores on the Pain Catastrophizing Scale. These risk factors suggest that interventions targeting motor control, lumbar lordosis, and psychological factors may be effective in preventing standing-induced LBP in PDs.In addition to identifying risk factors, the study highlights the importance of comprehensive interventions that address biomechanical, psychological, and other factors associated with standing-induced LBP. These interventions may include postural education, physical therapy, and cognitive-behavioural therapy. By addressing these factors, it may be possible to reduce the prevalence of LBP and improve the quality of life for individuals with a history of LBP.Overall, the study underscores the importance of developing appropriate preventive measures for standing-induced LBP in PDs. Identifying risk factors and developing targeted interventions may help reduce the burden of LBP in this population and improve their overall health and well-being.Dynamic Disc DesignsDynamic Disc Designs offers dynamic anatomical models that musculoskeletal healthcare workers (chiropractors, medical doctors, physiotherapists, osteopaths) can use to help explain how the spine is impacted when one stands, for example. The models are designed to simulate the spinal movement dynamically, allowing various spinal specialists to better illustrate to patients the impact that standing can have on the spine.Using the dynamic disc model, a healthcare worker can demonstrate how the intervertebral discs are compressed when standing due to the force of gravity on the spine. They can show how the discs lose water content and height throughout the day, resulting in reduced shock absorption and increased pressure on the spinal nerves. This can lead to various symptoms, including low back pain, stiffness, and numbness or tingling in the legs. In this particular research highlighted in this post, a practitioner can explain dynamically what excessive lordosis means and how the facets are approximated in this case. Explore.Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!Learn more online - new online discussion group included!Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion GroupLive caseswebinarslectureLive Q&Aover 600 videos - hundreds of techniques and more! Check out MMT InsidersKeeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
![[RESEARCH REVIEW] The High Cost of Standing: Uncovering Risk Factors for Low Back Pain](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXTsCQGpK-PEaVaLh2d-4MDJt3iZYFUMfzgmUKypDoGEjgXskP71pa-s8bMk_XOK-iWRrL8pLt-vIE6tD_i8NbsgluTbBpfCrbP80CWO3oFOoSZauwQ7U375LUV9hsBh7bwaSz6BJiYSFJfEniuRnDbSGa6swxPr0DzfpYmpWkljZ5TeS2P6031Ioh/s16000/Low%20back%20pain.png)
Posted by on 2023-04-27
Trigger point therapy differs from other forms of massage therapy in that it focuses specifically on identifying and treating trigger points in the muscles. While traditional massage therapy may involve general relaxation techniques, trigger point therapy targets specific areas of pain and discomfort. Therapists trained in trigger point therapy use their hands, fingers, or specialized tools to apply pressure to the trigger points, helping to release tension and alleviate pain. This targeted approach allows for a more precise and effective treatment of muscle knots and trigger points.
Like any form of therapy, trigger point therapy does carry some risks and potential side effects. During the treatment, some individuals may experience temporary discomfort or pain as the therapist applies pressure to the trigger points. In rare cases, trigger point therapy can cause bruising or soreness in the treated area. It is also important to note that trigger point therapy may not be suitable for everyone, especially those with certain medical conditions or injuries. It is always recommended to consult with a qualified healthcare professional before undergoing any form of therapy.
Yes, trigger point therapy can be used to treat sports injuries and improve athletic performance. Sports injuries often involve muscle strains, sprains, or overuse, which can lead to the formation of trigger points. By targeting these trigger points, therapists can help reduce pain, improve range of motion, and enhance muscle function. Additionally, trigger point therapy can help prevent future injuries by addressing muscle imbalances and promoting proper muscle activation. Athletes can benefit from incorporating trigger point therapy into their training and recovery routines to optimize performance and reduce the risk of injury.
There are several common techniques used in trigger point therapy. One technique is direct pressure, where the therapist applies sustained pressure to the trigger point using their fingers, knuckles, or elbows. This pressure helps release the tension and knots in the muscle. Another technique is stretching, where the therapist gently stretches the muscle to relieve tension and improve flexibility. Additionally, some therapists may use tools such as foam rollers or massage balls to apply pressure to the trigger points. These tools can help target specific areas and provide a deeper release of tension.
Trigger point therapy has been found to be effective in relieving tension headaches and migraines. Tension headaches are often caused by muscle tension and trigger points in the neck, shoulders, and head. By applying pressure to these trigger points, therapists can help relax the muscles and alleviate the pain associated with tension headaches. Similarly, migraines can also be triggered by muscle tension and trigger points. Trigger point therapy can help reduce the frequency and intensity of migraines by addressing the underlying muscle tension and promoting relaxation. However, it is important to note that individual results may vary, and trigger point therapy should be used as part of a comprehensive treatment plan for headaches and migraines.
Older adults who are at risk of falls can benefit from a variety of effective balance exercises. One such exercise is the single-leg stance, where the individual stands on one leg while maintaining their balance for a certain period of time. This exercise helps improve stability and proprioception. Another effective exercise is the heel-to-toe walk, also known as the tandem walk, which involves walking in a straight line with the heel of one foot touching the toes of the other foot. This exercise challenges balance and coordination. Additionally, the sit-to-stand exercise, where the individual repeatedly stands up from a seated position, helps improve leg strength and balance. Other beneficial exercises include the standing leg lift, side leg lift, and the backward leg lift, all of which target specific muscle groups and improve overall balance. It is important for older adults to consult with a healthcare professional or a qualified exercise specialist to determine the most appropriate balance exercises for their specific needs and abilities.
Anterior cruciate ligament (ACL) injuries are often caused by a combination of biomechanical factors. These factors include excessive valgus stress, internal tibial rotation, and anterior tibial translation. Excessive valgus stress refers to the inward angulation of the knee joint, which can put strain on the ACL. Internal tibial rotation occurs when the tibia rotates inward, causing the ACL to twist and potentially tear. Anterior tibial translation refers to the forward movement of the tibia relative to the femur, which can also strain the ACL. To manage ACL injuries, various approaches are employed. Non-surgical management may involve physical therapy to strengthen the surrounding muscles and improve stability. Surgical management may involve ACL reconstruction, where a graft is used to replace the torn ligament. Rehabilitation following surgery is crucial and typically includes a combination of exercises, bracing, and gradual return to activity to ensure proper healing and prevent re-injury.
Electrical muscle stimulation (EMS) has been shown to have potential benefits in enhancing muscle recovery after orthopedic surgery. EMS involves the use of electrical impulses to stimulate muscle contractions, which can help improve blood flow, reduce muscle atrophy, and promote tissue healing. By targeting specific muscle groups, EMS can help activate dormant muscles and prevent muscle loss during the post-surgical immobilization period. Additionally, EMS can aid in reducing pain and inflammation, improving range of motion, and accelerating the rehabilitation process. Studies have demonstrated the effectiveness of EMS in various orthopedic surgeries, such as knee and shoulder surgeries, by facilitating muscle recovery and enhancing overall functional outcomes. However, it is important to note that EMS should be used under the guidance of a healthcare professional and tailored to individual patient needs to ensure optimal results and minimize potential risks.
Yoga therapy has been shown to have a positive impact on flexibility and pain reduction in individuals with fibromyalgia. Research studies have demonstrated that practicing yoga can lead to improvements in joint range of motion, muscle flexibility, and overall physical function in patients with fibromyalgia. The gentle stretching and strengthening exercises involved in yoga help to alleviate muscle stiffness and improve joint mobility, thereby reducing pain and discomfort. Additionally, yoga incorporates relaxation techniques and mindfulness practices, which can help individuals with fibromyalgia manage stress and enhance their overall well-being. Overall, yoga therapy can be a beneficial adjunctive treatment for individuals with fibromyalgia, providing them with a holistic approach to managing their symptoms and improving their quality of life.
Aquatic therapy has been found to be highly beneficial for individuals with rheumatoid arthritis. The buoyancy of water helps to reduce the impact on joints, providing a low-impact environment for exercise. This can help to alleviate pain and stiffness associated with rheumatoid arthritis. Additionally, the resistance of water provides a gentle form of resistance training, which can help to improve muscle strength and joint stability. The warmth of the water also helps to relax muscles and increase blood flow, promoting healing and reducing inflammation. Overall, aquatic therapy offers a holistic approach to managing rheumatoid arthritis symptoms, improving mobility, and enhancing overall quality of life for individuals with this condition.