Let me tell you about Mary Biancalana and the value of myofascial trigger point therapy. A lifelong fitness expert and personal trainer, in her early thirties Mary found herself with chronic headaches. First, she was told they were ‘psychological,’ then a manifestation of a little understood term called “trigger points” and another condition she’d never heard of called Myofascial pain syndrome (a lesser problematic, distant cousin of fibromyalgia). She wanted to use holistic medicine, so first she consulted me as a patient in 1993 and started her personal quest for wellness. That lead her to study and become an expert in the treatment for eliminating myofascial pain syndrome and fibromyalgia and we have referred patients to each other ever since.
In 1999 she discovered myofascial trigger point therapy and knew her life would never be the same. After just a few myofascial trigger point treatments and simple lifestyle changes her headaches were gone! Mary worked for 7 years at the holistically oriented Fibromyalgia Treatment Centers of America with integrative physician Dr. Mike McNett but soon saw her mission was not only to treat patients but to teach physical therapists and massage therapists how to expand their professional skills by learning myofascial trigger point therapy. So, she has been teaching advanced courses one weekend per month all over the country since 2007.
In 2014 she founded The Chicago Center for Myofascial Pain Relief incorporating wellness education, personal training, and myofascial trigger point therapy on the far northwest side of Chicago.
Since opening WholeHealth Chicago in 2000 (initially named Chicago Holistic Center in 1993), I realized I am now reaching my third decade of referring patients to Mary Biancalana. Then, when I published my own books on fibromyalgia, “The Triple Whammy Cure” and “Healing Fibromyalgia”, that kept a steady flow of traffic between Mary’s office and WholeHealth Chicago. We are now especially happy to have found a myofascial trigger point therapist of her skills to now be on our staff. But it’s not just Mary Biancalana, she has brought with her two of her highly trained colleagues, Mike Pilney and Sue Dimbert. Together they make up one of the most highly trained and skilled group of practitioners ready to eliminate muscle problems and restore full, pain-free function.
What Are Trigger Points And What Is Their Relationship To Fibromyalgia And Chronic Pain Or Muscle Problems?
By themselves, myofascial trigger points are a very common cause of pain and usually localized to one or two areas of the body. They have an interesting property in that they can refer pain to an area not necessarily where they are located, a trigger point in your neck can refer pain all the way down your arm or to your upper back. Picture Myofascial Trigger Points as a tight, highly contracted area in your muscles and fascia stuck in a feedback loop of pain which tries to protect itself by more tightness, the result being more pain. As you can imagine, Trigger Points are not only painful, but the efficiency of muscles nearby are impaired. A golfer notices a change in his swing, a dentist has difficulty using her hand, a professional violinist starts worrying about his career. The list goes on and on, and the pain can be every day. Just to clarify; “myo” means muscle, and “fascia” is the three-dimensional connective tissue matrix that surrounds and interpenetrates all soft tissue areas of the body. This modality is not myofascial release per se. This modality addresses the fascia as well as the muscle. The two cannot ever be separated nor can one be treated without the other, thus the name Myofascial Trigger Point Therapy.
Myofascial Trigger Points Are A Message From The Rest Of Your Body That Something’s Not Quite Right.
In addition to treating the actual ‘stuck’ Trigger Points, a good myofascial trigger point therapist will review your lifestyle, stresses, nutrition, posture, how you once held your violin in comparison to the way you are holding it now, the weight of that backpack (or that child you’re carrying), the posture in which you sleep or drive and any number of other “perpetuating factors” or things we all may do that keep the muscles in this “stuck” state.
Fibromyalgia is definitely real. We’re learning more about Fibromyalgia every year but there are several things we do know for sure, including that there is a direct relationship with myofascial trigger points.
- Its main manifestation is PAIN, the slow but steady appearance of myofascial trigger points over your body spread equally above and below your waistline and on the left and right halves of your body.
- Although for years, patients were told “not a disease, no blood tests”, indeed there is a blood test to measure inflammatory cytokines which are very high in fibro patients.
- Virtually all the prescription medications (antidepressants, muscle relaxants, Lyrica, pain meds) are “Band-Aids” improving symptoms but not curing.
- To reduce dependence on medications, myofascial trigger point therapy, massage, home-care activities and acupuncture as well as Cognitive Behavioral Therapy and diet changes have all been shown very effective.
- At this point, we don’t have a cure for Fibromyalgia, but treatment can bring your level of pain from a 9-10 to a 1-2.
Now That We Know Trigger Point Therapy Will Help Both Trigger Points And Fibromyalgia, What Exactly Is It?
The Team: Mary Biancalana, Mike Pilney and Sue Dimbert.
Myofascial Trigger Point Therapy (MTPT) is a muscle-specific type of massage therapy that is goal-oriented. It’s goal is to restore full, pain-free function to areas of your body. While Mary, Mike and Sue are all licensed massage therapists, they also have taken a 130 hours of post graduate training in anatomy, kinesiology (the function of muscles) and myofascial trigger point therapy.
Mary has been providing MTPT full time for 23 years. Mike and Sue have studied MTPT and worked in-clinic alongside Mary full time for the past three years.
What is “Myofascial Trigger Point Release”? Trigger point pressure release is a firm, steady pressure applied to an area of muscle identified as more painful than surrounding ones. Your specific trigger point areas are mapped, pressure is applied, that pressure is held, then released, then you and the practitioner slowly use movement and stretching to relax and normalize the muscles, then the whole process is repeated (and repeated) as needed. Your Pain Scale is checked constantly, and the pressure discomfort is kept at a level you are happy with. The trigger point therapists will then address other muscles that can be contributing to the pain in other areas of the body (referred pain). Rather than describe it, here’s a magazine article with photos of Mary at work.
What does a Trigger Point feel like? Your trigger points can feel like dense, irritable areas inside a muscle or group of muscles. Did you ever have a significant other (or a massage therapist) say something like, “It feels like you’ve got really tight muscles in your back and shoulders?”. Those are likely muscles held tight by trigger points. A trigger point can feel quite painful when it is being pressed, but it’s a “hurts so good” pain in that you know the area will feel better when the pressure is released and the area is able to finally relax! There’s also the unique quality called referred pain caused by myofascial trigger points. For example, press the tender area on the top of your shoulder near your neck, in your trapezius muscle, and you might feel pain or sensation radiating upward into the side of your neck and into your head.
What Causes Trigger Points? Generally, it’s chronic mechanical overload, something you’re doing unconsciously. Your chair at work puts a strain on your upper back, your car seat needs a lumbar support, you’re a hairdresser who uses the shoulder muscles all day while styling hair. Something habitual, some pain you’ve felt nagging at you, but you have ignored.
Or, it could be acute; you were rear ended in an auto accident and the whiplash, neck pain and headaches never went away (x-rays were all normal, of course), or that too heavy suitcase you tried to lift into the overhead bin, and your upper or lower back was never right again.
Muscles go out of balance and stay that way; trigger points develop; pain becomes a daily event; you find yourself taking Advil virtually every day.
Or (and you know who you are), there’s a change in weather and all your fibro tender points feel like you’re on fire.
You don’t have to suffer in silence. We now have a proven modality to help you eliminate your pain. We will even teach you home care activities, so you are empowered to prevent your muscle problems yourself!
Call WholeHealth Chicago at 773-296-6700 and schedule a trigger point consultation. If you’re new to trigger point therapy, we will schedule you with one of our trained Nurse Practitioners, Jordan Neumann, DNP or Mark Hagerty, NP. They will assess your symptoms and decide with you if trigger point therapy is the best next step. If so, you will most likely get a trigger point injection on that same day and head upstairs to Mary, Mike or Sue for a myofascial trigger point therapy session. Get started. Feel better.
David Edelberg, MD