Trigger-Point Acupuncture for Posture Alignment (Pt. 1)

Sport acupuncture is a lot more than just trying to treat a patient’s pain. Pain is the symptom, while the cause is not often obvious. Dysfunctional movement, bad posture and/or an overly sensitized nervous system stemming from ergonomic issues, poor postural habits, and old injuries will alter a person’s mobility and stability (motor control).

As a practitioner, you don’t want to find yourself always chasing pain; you want to look at the person as a whole and begin to correct the cause of the pain and not just the source.

The best place to start is by looking at the patient’s overall posture and those bad habits altering their biomechanics and movement strategies. Our bodies become those bad posture and movement habits because of the daily repetitiveness of those habits.

Poor Posture and Resulting Compensations

As many of us know, good posture refers to the alignment of the spine with the head, shoulders and hips. The tough part is keeping these parts of the body in a straight and relaxed position that minimizes stress on the muscles. Poor posture throws one or more areas of the body out of alignment, leading to a chain reaction of tissue compensation, pain and a host of problems that can significantly impact an individual’s quality of life.

There are a handful of common bracing strategies people will develop to accomplish everyday tasks like standing, bending, walking, and sitting. These bracing strategies aren’t always healthy to begin with and at some point,everyone will develop compensation patterns when the body needs to keep moving after an injury and/or poor repetitive movement habits.

They might not even realize they’ve developed these compensations. They might be able to operate without pain or issue. However, the compensatory motor pattern becomes ingrained over time, leaving them vulnerable to injury.

Again, just because they can do the task does not mean that they do it well. Poor posture and movement strategies will lead to persistent areas of tension in a person’s body and will likely be responsible for the loss of any gains that you, the practitioner, may have made by just chasing and treating the pain.

I highly recommend that a treatment plan for correcting a patient’s posture involve not only needling, but also other modalities such as manual therapy and corrective exercise.

Assessing Patient Posture

In your assessment of posture, you want to get a sense of a patient’s bracing patterns – where they hold most of their tension. This bracing is usually done on a subconscious level. You’ll often see patients bracing their buttocks, or their back, neck and shoulders; others may brace their chest, or even their jaw.

Many people have what is called protective spasming or muscle guarding. This is when the sympathetic nervous system elicits protective muscle spasm when there is no injury; the body thinks there is threat of injury due to postural and movement deviations. The muscles are easily triggered and often form new patterns to compensate.

Basically, the nervous system is taught over time to fire on all cylinders, globally tensing everything. I like to think of it as the “new” book (which quickly gets old) your nervous system has written in the attempt to fix a problem or potential problem. Even after the injury has healed, the “new” book, a workaround, is still being utilized to keep the body ambulatory and functioning.

The body is smart and has this wonderful ability to develop these workarounds, but it also relies on you, its partner, to stay aware, understand and have the knowledge to correct these compensatory faults, keeping the body healthy, strong, balanced, and conditioned.

I know it’s a lot to ask nowadays; that’s why we’re in business as practitioners to help our patients and their bodies. Too bad the body can’t just as easily go back to the “original” book written in its healthy youth.

Unfortunately, the bracing strategy a person develops is strongly rooted in their nervous system and based on their life experience. It is presented in their muscular system for you, the practitioner, to find and help rewrite the book, putting the previous book on the shelf to gather dust. Then it’s the patient’s job to adhere to this new version and not reopen the old book.

Treatment Goals / Strategy

Acupuncture and its many variations allow you to treat through a person’s nervous system and mechanically through their muscular system. The idea is to inactivate or inhibit tissue areas that are short and tight, and activate those areas that need to wake up and do their job on a local and global scale. As mentioned earlier, treat the symptoms locally at the source while tending globally to the cause.

When I have a new patient come into my practice, during the initial meeting I have found value and long-term success by setting the expectations in line with my intentions of treating the whole body. Yes, I start by focusing on their local issue and begin to build the understanding on how that issue is likely connected to a more global problem related to their posture and movement.

In doing this, I use assessment tools such as the Functional Movement Screening (FMS), Selective Functional Movement Assessment (SFMA) and Y-Balance Test [see www.functionalmovement.com for more information]. Using these tools not only gives me an objective direction on treating the patient globally, but also helps instruct the patient on the need for a global treatment.

I then tap into my toolbox and use trigger-point (TrP) acupuncture for the most obvious areas of pain and tension; those areas that will make an immediate and profound change. It provides the patient with relief, trust and confidence to continue treatment. Even if the effects don’t last more than a week, the patient feels confident that they have been heard. It’s good for them to feel the difference and see how their body responds over that week.

It’s a step-building process whereby you must form a trusting work relationship, which transitions into broadening your treatment more globally away from the painful areas.

I have many athletes visit my practice whose chief complaint is simply that they feel tight and stiff all over. The training they recently did shouldn’t have translated this way. They weren’t expecting that strange stiffness and don’t understand why they’re tight.

Others come in for an “overhaul” to help with performance and recovery. In these cases, I often assess the athlete, their alignment, and movement. This is where we can get ahead of the ball and provide preventative maintenance, taking a global TrP acupuncture approach and making the tweaks where necessary.

Key Muscles to Target

When providing a postural “overhaul” or just looking for a place to start, I go to groupings of musculature that often tend to hold a lot of stress and tension. Nine times out of 10, these areas will demonstrate a mobility or motor-control issue. These groups also have an integral role in a person’s posture and often are all in proximity to one other.

Treating some of the major muscle groups in the shoulder girdle and hips can improve a client’s pain, posture and overall body tension. I like to call these two major areas of focus the two motors of the body; the shoulder complex being the upper motor, driving the movement of the upper limbs, and the hips being the lower motor, driving the lower limbs. In between the two motors is the chassis or spine.

Treating these two muscle groupings with TrP acupuncture will by default help relieve tight necks, shoulders, backs, hips, and knees, reaching out to the periphery through its fascial, muscle and nervous connections. It’s a great platform to work from. You can then build out from here and become more focused on a particular area.

Editor’s Note: Part 2 of this article appears in the July issue, and includes a resource list for both installments.