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This requires considerable palpatory skill and it is important not to slip off of the center of the trigger point because this causes needless pain. 38 It is crucial to apply the pressure to the nidus of the trigger point. If the pressure is too painful, the patient will respond with muscle tightening in the area. Care must be taken not to exceed the patient's tolerance, and if the patient tenses or pulls away, then a lighter pressure should be applied. Specific pressure is applied directly to the center of the trigger point to the patient's tolerance. Pressure can be applied with a thumb, finger, knuckle, or elbow depending on the size, depth, and thickness of the muscle being compressed. These changes correspond to circulatory changes in the underlying muscle, which is subjected to the same pressure.
#TRAVELL AND SIMONS TRIGGER POINT TECHNIQUES SKIN#
Travell and Simons 8 termed this therapy “ischemic compression” because, on release of pressure, the skin is at first blanched and then shows reactive hyperemia. Ischemic compression is a mechanical treatment of myofascial trigger points that consists of application of sustained pressure for a long enough time to inactivate the trigger points.
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This approach to patient-centered care of muscle pain syndromes encourages patients to contribute to their own rehabilitation rather than be party to passive therapy alone that encourages patients to be dependent on others for their recovery. 37 In addition to the application of ischemic compression, the patient is encouraged to actively stretch the involved muscles. 9 Chiropractic therapy has been reported to be among the most effective measures in the treatment of muscle pain syndromes. Ischemic compression is one of the least invasive trigger point therapies and has been employed by chiropractors since 1957. McDowell, in Whiplash, 2012 Ischemic Compression