The majority of the clients who visit me for Neuromuscular Therapy (NMT) treatment have a build up of trigger points, causing the symptoms, with which they are suffering. In addition to the specific techniques of NMT there are many ways that people can help themselves to deactivate trigger points in between treatments and thus achieve faster results. This article provides some information about these methods.  

What are Trigger Points?

Trigger points are tiny contraction knots in the muscles fibres (and sometimes other body tissues), where blood flow is compromised, causing a build up of metabolic wastes and casuing the nervous system to become over-reactive. Trigger points can cause pain, aching, weakness, reduce the mobility of joints and, in fact, can reproduce any sensation of which your nervous system is capable. Frequently trigger points cause symptoms in another area (referred symptoms), e.g. trigger points in your shoulders can cause headaches. 
 
How to Alleviate Trigger Points

There are many things you can do to help yourself, if you have trigger points causing you pain and/or dysfunction.

Neuromuscular Therapy treatment is very effective at helping your body get rid of trigger points. However, there are many factors which perpetuate these points and they will return if you do not make changes to these factors.

Stretching: Since trigger points involve a contraction of the muscle tissue, regular stretching of the problem muscles is one of the most important things that you can do. Your therapist will show you how to do the stretches which will be most beneficial to you. 

Stress and Relaxation: This refers to either an overuse of a specific area of the body, which can make it prone to developing trigger points or the common problem of mental/emotional stress that most of us are prone to. When you are stressed your nervous system switches in to the “fight or flight” state. This is OK short-term and is essential for fighting tigers, etc. but when it carries on long-term, your body suffers. Your nervous system becomes more reactive to even little stressors and consequently you are more likely to be troubled by trigger point symptoms.

There are many ways to counter “bad” stress. You have to find what works for you. One useful way if you find it hard to “let-go” is progressive muscle relaxation. This works on the principle that it is easier to relax a muscle after it has been contracted. You sit or lie in a quiet, comfortable place, then progressively move from your toes to your face, contracting each muscle group, then relaxing it, ideally as you exhale.
 
Exercise: Blood flow to muscles is essential to help with their healthy functioning. Exercise not only increases circulation, but lubricates the joints, causes the release of “feel-good” hormones such as endorphins and reduces emotional stress. If you don’t already exercise, you need to find something you enjoy – remember you don’t need to be sweating away in a gym to be exercising; dancing or yoga are just as good for you.

Nutrition: Since trigger points are associated with an imbalance of chemicals, what you put in to your body in the way of nutrients, plays a part in whether you have trigger points or not. If you think your diet is deficient in nutrients, you may want to visit a nutritionist or dietician for expert advice.

It is also important that you look at what you are consuming that are nerve stimulants, because they will make your trigger points more active. Nerve stimulants include coffee; tea (not herbal tea); chocolate; sugar and not forgetting energy drinks. 

Making sure you have enough water (at least 8 glasses a day) is also important. Remember your body is over 80% water. Alcohol, tea and coffee are diuretics – they cause you to lose water and essential nutrients are lost at the same time.

Perpetuating Factors: Try to take note of any factors that make your trigger points more reactive. It could be your work-station, your sleeping position, the position you sit when driving. Discuss these observations with your therapist, to find solutions to alleviate these stresses on your body.

Emotional Factors: Positive thinking can go a long way to changing what is going on in your body. Research has shown that a positive attitude can reduce the amount of pain experienced and help the body heal more successfully.
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Temporomandibular Joint (TMJ) pain and dysfunction often result from imbalances in the soft tissues (muscles and fascia); both those crossing the jaw itself and those in other regions of the body. In this article I want to give a brief overview of how they can be treated effectively using Neuromuscular Therapy (NMT).

A rather bad tempered woman, whom I’ll call Sue, came to our clinic hoping that a massage would relax her and help get through a stressful week. During the pre-treatment interview she mentioned many problems, including almost constant jaw pain, frequent headaches and most recently, toothache. Initially she did not expect me to be able to help with any of these symptoms, only seeing massage as a way to relax. However, after explaining further about the way trigger points in muscles could cause the type of symptoms she was experiencing, I persuaded her to give NMT a try. It was good to see her whole demeanour change when gentle palpation of various parts of the temporalis muscles was able to reproduce all her most debilitating symptoms. 

Neuromuscular Therapy has its origins in bodywork, incorporating the best skills of massage therapists, together with trigger point therapy, stretching, mobilisation, heat and ice. NMT therapists, differ from other body-workers in that they work intra-orally (with gloves obviously), to make lasting changes in the muscles, alleviating pain and helping correct faulty movement patterns. We take a holistic approach to find out the actual causes of symptoms and identify any perpetuating factors, such as bruxism, low nutritional status, postural imbalance and stress (often associated with jaw tension). 

Postural analysis is an essential part of our assessment of TMJ disorders. Forward head posture increases the downward pull on the mandible, thus placing additional stress on the elevators - masseter and temporalis - as well as causing increased intra-articular pressure in the TMJs.  Overworked muscles tend to develop trigger points (see below). The head may be forward as a result of peering at a computer screen, or bad driving position, or can stem from a forward or backward rotated pelvis. While it is not immediately obvious that short hamstrings or quadriceps could cause TMJ pain, I often find that this is the case.

Trigger points are often the cause of TMJ dysfunction. Trigger points are hypersensitive taut bands within muscles, which when compressed cause referred symptoms, often far removed from the site of the trigger point. Pain is not the only effect of trigger points; they can, for example, cause weakness in the affected muscles. Thus if the jaw muscles on one side only are involved, trigger points can alter the biomechanics of the TMJ. Headaches and dizziness are some of the many other symptoms of trigger point activity, which are commonly seen in our TMJ patients.

So how did I treat Sue? What NMT tries to achieve is a balance between the nervous and muscular systems. Four years previously, Sue had been involved in a car accident and sustained whiplash. Such trauma can often cause the receptors in the nervous system to send confused signals to the brain. If this does not resolve itself, the person may be left with over-short muscles and/or pain, despite the initial injuries having healed. 

Sue’s whiplash-related neck pain had resolved itself within six months of the accident. It was only when she was several months into a new high stress office job that the jaw pain started, followed by headaches. This is often the type of history that I see with TMJ cases. The whiplash was an underlying precipitating factor, which when added to the postural and emotional stresses of the new job, triggered the symptoms. NMT seeks to put together the pieces of the puzzle to find the appropriate approach to treatment.

Although Sue was initially too tender to get deep into the muscles housing the trigger points, ice and gentle stretching were employed. As she improved, I was able to work deeper, working intra-orally on the trigger point-laden pterygoids and masseter. Meanwhile, work to lengthen short muscles at the front of her neck helped to reduce Sue’s forward head posture, which was aided by changes at her computer workstation. The treatment was enhanced by ‘homework’ consisting of stretches and mobilisations, together with relaxation techniques to aid in a more relaxed stance with her jaw. It was really rewarding to work with Sue over the next few weeks: to see the positive changes in her body and perhaps more dramatically, the change in her personality from grumpy to light-hearted as the pain receded.

The bottom line is that Neuromuscular Therapy gets very successful results, often when many other treatments have failed. NMT therapists recognise the importance of a multidisciplinary approach to treatment, so work with other health professionals where appropriate. If you suffer from jaw pain or other problems, it would be in your interest to seek treatment from a Neuromuscular Therapist and see the results for yourself.
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Although I treat about equal numbers of men and women, I thought I’d give an insight in to how I help with two women’s issues: pregnancy and menstrual pain.

Pregnancy and Child Birth

 I have worked for many years with women at all stages of pregnancy using massage therapy. At later stages this involves lying on the massage table being comfortably supported in a side-lying position. The bodily changes during pregnancy can lead to various complaints, including back or sciatic pain. More general therapeutic touch is a great way to relax and enjoy this special time and many women have massage throughout their pregnancies. 

Although giving birth is one of the most natural processes in the world, it has a reputation of being extremely painful, with most mothers resorting to medications to help with the process. The good news is that there is another option. By learning easy self hypnosis techniques, the labour process can be made much easier and more enjoyable. There are also hypnotic techniques for self anaesthesia, to remove painful sensations, which can be learned by mums to be. 
 
"I would like to acknowledge the help I received from Marianne Macdonald of Advanced Body Mind Therapies in preparing for the birth of my son (first child). I was able to achieve a natural labour and birth without interventions of any kind, and without any pain relieving medications. My labour was also shorter than the average for first time childbirths. Marianne’s coaching on relaxation and hypnotherapy techniques gave me the tools to keep focused and very relaxed when coping with contractions. This enabled me to labour at home for the most part, and I was met by a pleasantly surprised midwife on arrival at the hospital, who on initial examination assessed me as being 8 centimetres dilated. This was coupled with a comment along the lines of “aren’t you a good manager then”. My grateful thanks to Marianne, and I would recommend her sessions to other expectant mothers." 

 Fiona Blackmore

 Another common ailment is pain and discomfort associated with menstruation. Again, many women have come to rely on pain-killers to get them through this monthly cycle. However, the majority of menstrual pain is caused by trigger points in the deep abdominal and back muscles. For those of you that have had treatment with me, you will know that Neuromuscular Therapy (NMT) is a highly effective method for alleviating and even getting rid of the trigger points that cause pain and those techniques work just as well on getting rid of menstrual pain. So if you, or someone you know, suffers in this way, give me a call.

 “I first began seeing Marianne (Advanced Body Mind Therapies) a few months ago. I had been suffering from upper back, shoulder and neck pain for years which was also affecting my sleep. After my initial session I felt a lot better within a few days, I am now virtually pain free, I have more flexibility in my neck and am able to get a full night’s sleep. I also used to experience bad period pain every now and again which I told Marianne about, she started treating me for the pain and I no longer have any painful periods - which is fantastic. I would not hesitate in recommending Marianne!”

Monique Facon

 
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