How many theories do we have about Trigger points? And, how many theories do we have on solving the problem? I believe that many vague, and sometimes strange theories are served to our patients and athletes when it comes to soft tissue disorders in general. If you deal with soft tissue disorders in general, please do the following:
1. Compare the peripheral nerve chart with the trigger point chart. Check also the radiation/distribution areas. What do you find?
2. Ask yourself, would you like someone to compress (squeeze) and twist, or needle your ex. median nerve by the pronator teres muscle?
3. Now, let’s say we are pretty much sure that a nerve is involved in the picture. How can you determine the cause of the nerve symptoms?
4. Entrapment by adhesions? Entrapment by muscle tonus? Friction? Loss of gliding capacity? Blood Nutrition? Damage to myelin? etc.
Differentiate! How you solve the issue is of course up to you. I would pretty much focus on releasing the nerve and surrounding structures + introduce nerve- and tissue gliding by treating neighboring entrapment sites + nerve gliding exercises etc. I would also always make sure to address the underlying biomechanical cause to avoid “backfires”.
KNOW YOUR NERVES
Carpal Tunnel Syndrome – Median Nerve – Peripheral Nerves