Trigger Point Massage Therapy
Part 1

The Myth of "No Pain, No Gain"

In order to understand Trigger Point Massage Therapy, it's essential to deconstruct the pervasive myth of, "No Pain, No Gain."

While it's totally appropriate for athletes during training to push themselves, the "no pain, no gain" concept has no place in a therapeutic context, especially when individuals are experiencing significant pain.

A frequent comment I hear from clients in my private practice is, "I can take a lot. Push as hard as you need to in order to get the job done."

This comment arises from a pervasive mindset that many of us have. We believe deep down that more is better. Push harder and you fix it faster. Right?


I probably spend more time explaining this point to my clients than any other.

It's not their fault. It's the "no pain, no gain" mindset of American culture.

Often I will add to my verbal instructions to my client, "if you're starting to think it might be too much pressure, it's already too much."

The Reason "Less is More"

Massage therapy which adheres to the Arndt-Shultz Law will be the most effective application of this technique. This neurological principle states that…

Weak stimuli activate physiological processes. Strong stimuli inhibit them.

What that means in this context is that therapeutic pressure by a therapist which is too heavy-handed — a strong stimuli — will interfere with the release of trigger points.

On the other hand, a lighter pressure — a weak stimuli — a pressure that is just enough to produce the referred sensation, will be the optimal amount of pressure.

For the best, fastest, most lasting results, please follow these steps carefully and thoroughly...

Proper Steps for this Type of Massage Therapy

1. Apply pressure to localized trigger points with the smallest amount of pressure necessary in order to reproduce the referred sensation.

2. Only hold the point for 8-12 seconds, monitoring for when the sensation in the referred area begins to diminish.

  • IMPORTANT NOTE: If the sensation in the referred area increases rather than diminishes it means that you're using too much pressure.

3. Release pressure when the referred sensation begins to diminish or after 12 seconds have elapsed, whichever comes first.

4. If the muscle can tolerate it and myofascial trigger points are not extremely tender, a one-direction stroking technique may applied.

Impact of this Type of Back Pain Therapy

This technique accomplishes several things…

• It stimulates blood flow to the muscle without causing more inflammation

• It interrupts the feedback loop between the muscle and the nervous system which otherwise keeps the muscle chronically contracted

• It decreases pain in the referral areas by stopping it at its source (as opposed to "chasing the pain," a common mistake when a therapist isn't familiar with this type of referral pathway).

The technique described in Part 2 for the quadratus lumborum can be applied to any muscle in the body.

Continue to Part 2 >>>

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Stephen O'Dwyer, cnmt

Neuromuscular Therapist & Pain Relief Researcher

Stephen O'Dwyer, CNMT


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