Tandem Point

Tandem Point(SM) Therapy:
An integrated acupressure approach for myofascial pain

by Rena K. Margulis
Presented to Rehabilitation Medicine Grand Rounds
Institutes of Health
March 17, 2000


This paper includes comments and questions from the lecture audience, as well as descriptions of the demonstrations. The comments, questions, and descriptions are presented in brackets [ ]. New data added after the lecture are also presented in brackets.

Thank you for inviting me to speak here today. I appreciate the opportunity to describe an acupressure approach that combines western and eastern pressure point therapy, an approach that offers an exciting option for treating myofascial pain.

Janet Travell made an enormous contribution to our understanding of myofascial pain. With her discoveries, we expanded the model of myofascial pain to include trigger points. I hope that today you will come to believe that it is once again time to expand the model.

Travell proved that a major cause of myofascial pain is one or more trigger points in the muscle. A trigger point can (a) shorten and or (b) weaken the muscle. A trigger point usually lies within a taut band of a muscle, which prevents the muscle from achieving full length. Achieving full muscle length is key to the release of a trigger point.

I find that the best way to release a trigger point, and therefore end a patient's myofascial pain, is to hold a trigger point with an acupuncture point, and to have the patient stretch through the trigger point, an approach I call Tandem Point therapy. It is a fast, effective, reproducible method of releasing trigger points. This approach also provides some intriguing insights into why acupuncture might be effective. From time to time I will demonstrate techniques, so if any of you have upper body pain issues, I would appreciate your volunteering to be a model.

The great advantage of Tandem Point therapy over acupuncture is that the clinician holds the trigger point throughout the approach and can determine immediately whether applying pressure to an acupuncture point is helping to release the trigger point. If the trigger point is releasing, it will soften and frequently heat. If the trigger point is not releasing, another acupuncture point can be held. Dozens of likely points can be tried in one session. The clinician can experiment to determine what works clinically. Tandem Point therapy works when other manual approaches fail. It works even when a pain pattern involves integrated agonist-antagonist syndromes that are problematic for techniques such as strain/counterstrain.



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