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will generally include the following:

  • Myofascial Trigger Point compression-release therapy
  • Connective Tissue and Neuromuscular massage
  • Travell Stretch and Spray Protocol (as needed)
  • Muscle Energy Techniques (MET)
  • Therapist-assisted Stretching (PNF, PIR, Lewit)
  • Patient Education 



The Travell Stretch and Spray Protocol - application of a vapocoolant spray on the target muscle group/s while the Myofascial Trigger Point therapist introduces a gradual, fully supported, passive stretch to the patient’s involved musculature.  Voluntary relaxation of the muscle being stretched is essential.  The application of the vapocoolant spray helps to block reflex spasm and the muscle guarding response, thereupon allowing the gentle restoration of the muscle to its full stretch range of motion.  The patient is also instructed on facilitative breathing techniques to help further and optimize relaxation as the stretch is being attained.  Immediately following the Stretch and Spray, moist heat is applied, and the muscle is moved through its full, active range of motion. 


THERAPIST-ASSISTED Proprioceptive Neuromuscular Facilitation (PNF) 

Stretching is ALWAYS utilized in Myofascial Trigger Point Therapy treatment sessions.  Alternate/additional stretch methods, the LEWIT Stretch Technique, Post-Isometric Relaxation (PIR), Muscle Energy Techniques (MET) may also be performed.




The Myofascial Trigger Point therapist demonstrates to, and instructs the patient on Therapeutic stretching exercises to be performed regularly by the patient--at home and at work--to facilitate neuromuscular retraining, restore muscle length, and minimize postural/environmental stressors.  Developing flexibility and strength is essential for continued relief from muscular pain and dysfunction.


The prescribed therapeutic stretch exercises are to help the patient to regain his/her normal level of physical activity.  Once recovery is obtained, the exercises may be expanded and developed into a program for maintaining an effective level of fitness.
Identification and correction/modification of postural and positional activities which may be perpetuating factors that can impede the patient’s rehabilitation process.  The Patient is instructed with, and educated on, correct biomechanical behaviors and positions to adopt while conducting his/her work and daily routines.   Ergonomic changes to the Patient’s home/work environment are also facilitated.  

A thorough history of the patient is necessary to develop a plan of treatment related to his/her condition and lifestyle.  Initial evaluation of the patient will include pain-mapping of the Primary Trigger Point sites and their referral/satellite zones, range of motion/muscle testing, and postural analysis.  Postural analysis of the patient may also involve evaluation for LLLI (Lower Limb Length Inequality), small hemipelvis, Morton’s foot, gait dynamics, short upper arms, and the ASIS-PSIS relationship.