Canine Triggerpoint Myotherapy
The use of Trigger Point Myotherapy (“TPM”; also known as Myofascial Release) involves a non-invasive, hands-on method of locating pressure points in the muscle bodies through palpation. It then includes the relief of these pressure point(s) through specific compression techniques and the re-education of muscle tissue through the use of passive stretching routines. Increased range of motion is facilitated by the passive stretching and by the assignment of specific exercises/movements that will encourage the muscle tissue to return to as much of its normal flexibility as possible.
There are many conditions that respond favorably to this technique including lameness, roaching, hip dysplasia and arthritis, spinal misalignment and many post-operative circumstances. In 1977, it was found that there is a 100% correlation of trigger points (“TP’s”) to acupoints. This allows TPM to enhance the overall muscle treatments by also balancing meridians (effecting circulatory, lymphatic, muscular and nervous systems) and positively effecting internal organs via the meridian networks.
When the therapist applies compression, blanching occurs in the tissue under pressure. In other words, blood leaves the area. Lactic acid and other waste products are “loosened”. When the compression is released, blood flows back into the tissue and picks up the wastes for elimination through the circulatory and lymph systems.
Muscle Dysfunction
Before we can appreciate the healing capabilities of TPM, we need to understand how muscles become dysfunctional. While nearly half the body’s weight is muscle tissue, it is often the most ignored system! There are several ways that TP’s are created including over-exertion, chronic fatigue, chilling, metabolic disturbances, decreased circulation, under-exertion and direct trauma.
Once a muscle is injured, there is a natural tendency to continue to protect it from inducing pain. Even after full healing has occurred, muscles will tend to “remember” the original discomfort and react by not using itself to its fullest potential. Range of motion is diminished along with flexibility. While it’s an easy matter to tell humans how they can overcome these issues, dogs obviously cannot understand verbal instructions from us for self-rehabilitation! Therefore, therapists must be familiar with various passive stretching techniques and exercises that will reinforce the nervous system’s ability to re-educate the muscle tissue.
Another problem in working with non-verbal clients is that there are two types of trigger points, latent and active. Only the active TP’s elicit pain. Latent TP’s were once active, but were neglected and have “settled” into the muscle tissue without causing a direct pain source. Therapists must then be vigilant for signals from their patient that would indicate pressure has uncovered the active TP. They must also be familiar with areas that harbor common latent TP’s so that treatment can be applied there as well. Finally, active TP’s refer pain distally from their source. Since the animal cannot point out the referred pain, it is important to have a full understanding of anatomy in order to achieve a satisfactory treatment outcome.
Common sites of trigger points, both latent and active.Sometimes it is difficult to accurately assess muscle dysfunction in dogs as they instinctively cover pain. In the wild, a distressed or weak animal is left behind the pack. This natural survival instinct still exists in the domesticated animal. One could say their dog has a high pain tolerance. I’ve often treated dogs that were 3-legged lame at home, but able to run on all fours in their yard! Determining the exact cause of muscle trauma can be difficult as too often, direct trauma goes unnoticed. Hopefully, through in-depth questioning during the pre-treatment interview, along with movement analysis, some clues will be offered that can direct the therapist to the correct area(s) of concern.
Muscles that are fatigued or injured will require other muscle groups to take over their primary functions until healing occurs. This transference of “muscle loading” is called “compensation” and can have long term and devastating effects. For example, assume the right rear has been injured. Typically, the dog will transfer weight and balance diagonally, in this case to the left front leg. Those muscles can help for a while, but will quickly fatigue as they are being asked to do work they’re unsuited to handle.
Another muscle group will be “asked” to conduct compensatory work for the left front. It soon becomes a vicious cycle, compounded by the muscle memory factor that tries to keep the original injured part free from pain. This is the main reason why treatment must include the whole body and not just the site of dysfunction. The dog is the sum of all its parts and to be whole, all parts must be in good working order.
Another consideration is that areas left untreated become more susceptible to renewed injury. Muscle tone weakens, atrophy sets in and compensation continues to unravel the whole system. Initial treatments include the evaluation of tone and atrophy to assist the therapist in developing appropriate treatment protocols.
Stretching Techniques
Stretching will accomplish many things. Used before exercise, passive stretching will “awaken” muscle tissue to action through the increase in circulation. It also stimulates proprioceptors in the brain improving balance and footing. By encouraging range of motion, flexibility is geared up to meet the demands of the exercise or training routine.
Used after exercise, stretching will help to eliminate the build up of lactic acid in the muscle bodies, a leading cause of developing TP’s. You will also stimulate the natural range of motion, helping to reduce post-exercise stiffness.
We also use passive stretching at the conclusion of our treatment sessions to:
- erase muscle memory;
- increase range of motion and,
- improve flexibility.
Our purpose at that time is not to exceed the animal’s current level of flexibility. This process is to be non-threatening and never painful.
Examples of the common stretches are: Click an image for a larger version.
 |
 |
 |
| Front Flexion | Extension | Rear Flexion |
 |
 |
 |
| Front Flexion | Extension | Rear Flexion |
Treatment Conventions
From the therapist’s perspective before any physical contact is made, several objectives must be achieved. First, we need to be certain that the animal has recently seen a veterinarian to assure there are no underlying medical reasons for the muscle problem. Second, a complete and thorough history needs to be taken to identify a variety of factors:
- Age, Breed and Sex
- Years owned by current guardian
- Vet name and number
- Handler’s name and number (if any)
- Height/weight
- Vaccination history
- Medication(s), feed and supplements
- Routine exercise program
- Usage (i.e., show/companion/therapy dog, etc.)
- Any and all known history re: illness/surgery/injury etc.
- Experience with any other therapeutic modality
- Unusual habits (chewing, licking, biting, etc.)
- Noting their presenting condition
- Setting a measurable, realistic goal for the therapy with the owner. “I want him to feel better” is not measurable. “Be able to perform a straight sit in class” would be more specific.
Treatment Routine
Prior to any hands-on work, it is necessary to perform a movement assessment and range of motion testing. This is done on four levels, including assessment of body conformation and breed.
- The dog is observed turned out and moving freely on its own.
- The dog is assessed while being leashed to observe controlled movement in all directions.
- The dog is assessed participating in whatever sport they do, if possible.
- Flexion and extension is conducted on all extremities and the neck to determine baseline condition.
Treatments consist of palpation, compression, various massage strokes and passive stretching. While some massage strokes are considered compression, they are not as intense as the compressions used for TPM. Normal treatment time is about 45-60 minutes long. An additional benefit of treatment is the release of endorphins allowing for natural pain relief.
For additional information or to schedule an appointment or consultation, please contact Sue Olmos, CTPM of Midstates Myotherapy, Inc. at 630-205-WELL (9355); email info@midstatesmyotherapy.com , or visit her website at www.midstatesmyotherapy.com .
Certification in Canine Myotherapy is offered through Harper College in Palatine, IL. Check out the “News” section in the website above for more information.
Sue Olmos, CTPMCertified Trigger Point Myotherapist