Massage Therapy Should be Proactive, not Reactive

Today’s healthcare system is locked in a methodology that tends to be reactive rather than proactive.  Physical therapy is notably done after an injury and there are few, if any, modes of prevention that aren’t equipment-oriented.  As advanced as medicine is today, the focus is still treatment, not prevention.

Massage therapy is one of those professions that have the ability to break the mold and overlap into prevention.  Travell and Simone – two well-known researchers who published the first trigger point hypothesis in 1981 – introduced the notion of trigger points and their latent and active nature.  They researched composition and regionalized the effects and location of trigger points. Basically, they found that repetitive stress could be labeled as latent (that area of sensitivity which is not felt until palpated or if left untreated would in time become active) and active, which has need for some clinical intervention.

In today’s medical model, those professions, which can consistently and reliably assess and treat with consistent results are welcome to join the western medical model. Travell and Simone opened the door and made it possible for massage therapy to assess injury in the latent stage.  Since, they were not body workers, they didn’t identify how trigger points felt or give terminology to describe the feel to the practitioners. They also never researched whether there are an infinite or finite number of trigger points.

In 1996, after studying Travell and Simone, I began working to identify the myriad of textures involved in trigger points. To my amazement, I could only identify 13. I began focus groups on the subject, which included 175 people in all. Thirteen seemed to be the most we could identify. The tricky part was labeling according to how they felt.

In my studies of interrater reliability, I found that the reliability of a methodology is based on consistent and reliable assessment and treatment through standardized labeling.  Therefore, my job was clear: I must assist the massage community in creating a consistent language to describe differing trigger points so that any practiced massage therapist could unilaterally identify the same trigger point on the same person.

This has led me to begin to study and develop core material to identify trigger points in the latent stage and create specific descriptors. In effect, I’ve had the opportunity to create a delivery system for injury prevention for use with teams and in corporations. Providing practitioners with consistent and reliable assessments, will open massage to more mainstream use in Prevention.


Ron Mc Knight

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