What is a trigger point?
A trigger point is a hyper-irritable spot located in a tight band of skeletal muscle. If you’d had an active trigger point, you know how painful they can be. They can produce pain locally and radiate out into seemingly other unrelated parts of the body. Inactive trigger points which often cause stiffness and decreased range of motion without pain are far more common. While trigger points can accompany many chronic musculo-skeletal disorders, they are caused by an muscle overload either by acute trauma (fall, injury etc) by sustained, prolonged activity or by repetitive micro trauma. Nerve compression and the decreased flow of blood and oxygen further injure the muscle. This dysfunction of the muscle then creates further complication in the tendons, ligaments and skeleton of the horse. The persistent pain associated with trigger points results in both a decrease function in the muscles of locomotion and in the postural muscles. This is why it’s so important to address trigger points.
While factors that increase the formation of trigger points are numerous and sometimes hard to detect, they are important. Without the proper attention they can spell the difference between success and failure in treatment.
- Mechanical stress
- skeletal & postural asymetry
- poor fitting tack compressing nerves in the paravertebral muscles
- rider imbalance
- lack of warmup
- overuse of muscles causing fatigue
- Nutritional imbalances
- Metabolic and endocine disorders
- Cushings Syndrome
- Low Thyroid
- Insulin Resistance
- Equine Metabolic Syndrome
- Psychological Problems
- Chronic disease and infections
- respiratory disease
- liver and kidney dysfunction
- heart murmurs
Types of Trigger Points
Central tigger points are located in the most electrically excitable area of the muscle, also called the motor point of the muscle. These points are usually found over the body of the muscle and dysfunction causes contraction knots, nodules and taut fibers.
Attachment trigger points are located at the attachment of the muscle onto fascia, tendons or bone. The strain on the muscle at these attachments causes swelling, tenderness and pain.
Key trigger points is the main trigger point responsible for the activity of additional trigger points. Clinically this becomes apparent when the release of one trigger points also causes the release of additional trigger points called satellite trigger points. For long term affects, both the key and satellite trigger points need to be released.
Trigger Point Treatment
There are many ways to release trigger points and different modalities of alternative medicine address them even if they don’t aknowledge them as such. However, Janet Travell, author of the Trigger Point Manual, recognized the following successful treatments for trigger points.
- vapocoolant spray during stretching
- isometric contractions and voluntary contraction and relaxation of the muscle
- percussion during stretching
- range of motion exercises that fully lengthen and shorten every muscle treated
- ischemic compression (best on central trigger points)
- deep stroking massage
- myofascial release
- dry needling/acupuncture
Acupuncture and Trigger Points
Research has shown acupuncture to be effective in treating muscle pain and releasing trigger points. We also know that acupuncture speeds healing of injured tissue and brings blood and oxygen to the local area. Interestingly, The Tri State College of Acupuncture calls the study of Acupuncture in the release of trigger points: Acupuncture Physical Medicine. They have a great quote related to this very study. “Acupuncture Physical Medicine or dry needle release of a trigger point is safer than trigger point hypodermic needling and far easier than manual trigger point release, yet as effective as either”. Trigger point treatment via acupuncture combines Japanese meridian therapy techniques along with current knowledge in trigger point therapy. While trigger points are (according to Travell) very persistent most of the medical community focuses instead on the injury to tendons, ligaments and joints. We all know that acupuncture was meant to be preventative. This is one area where it rings true. Why not address the trigger points with acupuncture and body work before they impact the fascia, tendons, ligaments and skeletal system?
I’ve done this before, but wanted to try it again. Dancer, my own horse, has been working really hard this spring. He’s been doing great but hasn’t felt quite as good in his back as I know he can feel. He’s NOT lame nor does he palpate to be sore. Everything looks and feels as it should but he’s just not flowing in his trot. In response, I begin the experiment.
Over a 3 week period Dancer got 4 acupuncture treatments. About every 5 days. WOW, what a difference it made. He felt better after the first treatment but by the fourth he was really supple. He is swinging over his back, easy to connect and easy to engage. The best news… it’s been 10 days since the last treatment and he still feels wonderful. I’m so amazed at how powerful this medicine is.
Prepping for Competition
How can this benefit you? Think about your training. Is there something your horse is struggling with? Would it help if your horse felt better in his body? Preparing for a big clinic, event or show? Wouldn’t it be great to walk into that competition with your horse feeling amazing?
Think on this.
Scenario #1 is the routine client. I have many “routine” clients that get me out to work on their horse on a regular basis to ensure their horse feels it’s best. This routine is usually about once a month. I’m not advocating treating a horse every week for the rest of it’s life but too often I see us rely on acupuncture as a one time treatment. I don’t think we are truly utilizing the power of this medicine. Let’s try something different…Instead of once a month for several months, let’s try twice a week for 2 weeks every 3 months. It ends up being the same amount of money but I think you will see better results.
Scenario #2 is the client who calls me up to prepare for a big event. What if instead of calling me out every 3-6 months for one treatment, we really make a big impact on the horse by doing 4-5 treatments right in a row. Really give the horse the boost he needs. Again, I think you will be extremely pleased with the result and you will be setting the horse up for success.
Research has proven that frequent treatment back to back is very effective even with long standing problems. My horse just helped prove this. As usual, when I listen to my horse I learn. Dancer is teaching me an important lesson. Frequent treatment is the key to success. Let’s try it on your horse and see the great results.