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I would like to learn more about trigger points and their application in Podiatry. Can anyone tell me where is a good place to start in learning about them? Those of you who use trigger points in treatments, where did you learn about them and how to use them? Any help would be very much appreciated :)
I have found a place in Edinburgh which does courses in trigger point therapy and myofascial release. I have sent an enquiry as to whether or not their courses would be suitable for Pods. Thank you again :)
La Trobe University website has some good stuff (images and basic application for Podiatry) from Travel and Simons book. (Vol 2. Good book but pricy, I think mine was £70 for volume 2)
Trigger points (TrP) can be useful things to work but generally, in my experience, they would form part of an overall soft tissue mob treatment (STM). Equally it is not always necessary to take active trigger points out directly. I was doing soft tissue mobs (STM) on a physio's calf muscles Friday (competitive runner who completed last years Brighton Marathon in 2:45) and there was a clear trigger point issue. It resolved, without specific treatment of TrP work, to good massage. Another time I have treated TrP's in the calf for some heel pain issues, again as part of an STM treatment.
Useful skill to eventually develop as part of over all palpation skills.
I've been infrequent in the Arena lately but the tag was close to my heart.
On references, the true master resource is Travell and Simons, Myofascial Pain and Dysfunction, The Trigger Point Manual and for us pods we want Vol 2 The Lower Extremities. You will find it at Amazon and elsewhere. This reference is so thorough about the trigger points (TrP's) and anatomy - it educates you to a new level.
While there are numerous ways to release TrP's the most effective is with a technique commonly called Dry Needling, which is an acupuncture technique.
Dry needling and manual techniques are practical skills to master and as such are learnt as Ian has advised from those experienced in the techniques i.e. in workshops.
There may be some visual aids out soon as well but nothing beats hands on training.
I've been teaching these skills for quite a few years in Australia and have presented in UK and Ireland as well.
For the UK you need to do a SOCAP approved workshop to gain insurance cover for dry needling.
We have now incorporated this content into our Clinical Masters programme at UWA. The intention as always is to provide skills required to use these techniques in the treatment of conditions being commonly presented to Podiatrists.
The Following User Says Thank You to Shane Toohey For This Useful Post:
Fantastic info Shane, thank you. I am hoping to do a course in podiatric accupuncture either at the end of this year or start of next, depending on funds and timing! The more you read about the more you want to learn, I currently have a course wish list as long as my arm!
I am hoping to do a course in podiatric accupuncture either at the end of this year or start of next, depending on funds and timing! The more you read about the more you want to learn, I currently have a course wish list as long as my arm!
I've had numerous conversations with Pods who say that they have found a new lease on their careers, that they are now excited again and want to learn more.
These comments are driven by the outcomes they are now achieving that were not even considered possible.
One of my personal imperatives is that practical training for new skills being hands on and undersupplied. You can make far more difference to your outcomes with practical hands on training more so than sitting alongside hundreds of others listening to presentations (although they are important for other reasons). It is difficult to do practical at universities. I think that you can't do too much training, that you can learn something from everyone, and that it never ends.
Lastly, once you start producing enhanced outcomes you will find that your practice changes and gets busier. The training will pay for itself in no time.
Is there any evidence base for the effectiveness of dry needling over ischemic pressure in trigger point therapy? Just wondered.
Good question, thanks
There is good evidence for the existence of myofascial trigger points (MTrP's) including histological differences from surrounding tissue and also the ability of blinded examiners consistently and reliably achieving correlation in locating them.
I'd refer you to another very good text " An Introduction to Western Medical Acupuncture" , White, Cummings and Filshie, Churchill Livingston, 2008, chapter 7 for a full exploration.
"Needling is not the only way to treat MTrP's, but it is quick and effective", p73
Quite simply the effort involved to achieve a release is minimal with needling but using ischemic pressure (compression) using hands, elbows and various tools can be destructive in the long term to the therapist. It takes far more contact time which can become a real problem when treatment of more than a few MTrP's is required.
I still use I.C. sometimes for isolated points or when they are located in places I don't want to go for one reason or another.
Overall, you need to look after yourself. Many therapists (physio, remedial etc) have to change their treatment modalities as their body parts wear out. It is one of the reasons that dry needling has become so popular - it has prolonged the careers of worn out therapists.
As useful as it may appear that page is a summary of the literature (mostly Travell and Simons) - so really an overview. Good for context. Once you have got that under your belt it makes it easier to go into the literature and practice with more depth.
Just reviewing the year on Arena, so seemed worth adding a last note to the thread you started.
I have two workshops coming up in April. As advised earlier you need to do a SCP approved workshop to use acupuncture needles with insurance cover in podiatric practice. The workshop is developed by myself as a podiatrist and acupuncturist for the treatment of commonly presented conditions - so it has a podiatric perspective.
The workshop includes 'dry needling' for trigger point release but also includes other acupuncture techniques that are useful when treating joint pain and nerve dysfunction. More info is available on the website.
The first workshop is in Dublin, 20-22nd April and the second is at the University of Huddersfield on 22-29th April.