Some of you may associate Activator exclusively with the treatment of spinal and extremity pain.
However, doctors are increasingly turning to instrument adjusting for treating trigger points. In the last 10 years, we have developed more than 20 diagnostic tests to quickly screen whether a problem is related to muscle involvement or subluxation of the spine.
I had my first experience years ago when I fell asleep on an airplane, and I am sure many of you can relate. Your head goes off to one side and when you awake you have a knot in your upper trapezius that feels like someone stuck a knife in it.
At my clinic upon my return, I showed a “hot” trigger point in my upper trapezius. While trigger points may be found in any skeletal muscle, a large number are found in the upper trapezius. That was my impetus to investigate trigger points.
There were two clinical trials using my instrument for trigger point therapy published in 2008, co-authored by Hugh Gemmell, DC, from the Anglo- European College of Chiropractic. The trials compared instrument-assisted trigger point therapy to ischemic compression and instrument-assisted trigger point therapy to myofascial band therapy, using sham ultrasound as the control.1-2
The results suggested that both ischemic compression and trigger point therapy with my instrument have an equal, immediate, and clinically
important effect on upper trapezius trigger point pain. Furthermore, the results suggested that patients treated with instrument-assisted trigger point therapy are seven times more likely to improve than a patient treated with myofascial band therapy or sham ultrasound.
Gemmell treated the active trigger point using as many as 10 thrusts from an instrument at a rate of one thrust per second. After we learned how effective this was on trigger points, we began treating them clinically more often.
We found that it often doesn’t take 10 thrusts on each trigger point; in fact, an active trigger point often releases with just one thrust. Simply repeat the diagnostic test and look for leg-length reactivity or palpate to confirm release.
As my interest increased, I also began to hear that the average practice life of a massage therapist is approximately three years. Their thumbs simply give out from using deep pressure to compress trigger points.
In chiropractic literature, it is shown that chiropractors who have been in practice for more than 15 years tend to have some health problems of their own. A young DC I know who just completed his 10th year of practice approached me to ask if I would adjust him for carpal tunnel syndrome. He loves his practice, but he’s simply starting to wear out and looking for an easier way to deliver a thrust.
The diagnostic test for an upper trapezius trigger point is quite simple. Instruct the patient to turn the head to the opposite side of the affected trapezius, and tip the back of the head toward the shoulder. If the short leg goes shorter in the extended position, locate and adjust the trigger point on the upper trapezius trigger point. (See photo)
Let the instruments do the work. This might help you stay in practice for many years to come.
Arlan W. Fuhr, DC, is the co- founder and CEO of Activator Methods International. A practitioner and researcher for more than 40 years, Fuhr is widely acknowledged for bringing instrument adjusting to the chiropractic profession.
1 Blikstad A, Gemmell H. Immediate effect of activator trigger point therapy and myofascial band therapy on non-specific neck pain in patients with upper trapezius trigger points compared to sham ultrasound: A randomized controlled trial. Clin Chiropr. 2008;11(1):23-29.
2 Gemmel H, Allen A. Relative Immediate Effect of Ischaemic Compression and Activator Trigger Point Therapy on Active Upper Trapezius Trigger Points: A Randomized Trial. Clin Chiropr. 2008;11(4):175-181.