Myofascial Pain Syndromes: The Travell Trigger-Point Tapes.

Videotape

Myofascial Pain Syndromes: The Travell Trigger-point Tapes Daitz B, writer, producer, and director; Travell J, presenter. Baltimore, MD 21298, Williams & Wilkins, 1990, Tape 1: Introduction to Myofascial Pain Therapy (VHS), 38 min; Tape 2: Myofascial Pain Syndromes of the Head, Face, Neck, and Shoulder Girdle (VHS), 61 min; each tape, $87; 6-tape set, $395.

The purpose of these tapes is to present an overview of myofascial pain syndrome: what it is, how to evaluate it, and how to treat it. Tape 1, "Introduction to Myofascial Pain Therapy," is 38 minutes long and rather slow moving. This is somewhat discouraging, as the remaining tapes, which explain how to evaluate and treat specific how areas for this syndrome, are very well done and paced. if you were to just view Tape 1, however, you might not want to continue with the series.

Dr Janet Travell's expertise in the area of myofascial pain syndrome has been well established. In Tape 1, she makes some fine points about how important the evaluation process is in working with myfascial pain syndrome. The practitioner and the patient become one in the ongoing evaluation process, and Travell explains that patients must listen to their muscles; when something does not feel right, they, must adjust their movement habits. The process of evaluating and treating myofascial pain syndrome emphasizes stretch, use of a vapor-coolant spray, and use of heat.

This definition of myfascial pain sydrome seems to be directed to an audience consisting mainly of physicians, although there is some mention of physical therapists. Some good points are made regarding mechanical factors contributing to this condition and how improper seat length or arm-rest height on a chair can he modified to match the imbalances that appear in a postural evaluation. Improper positioning in a work setting and other issues that may contribute to this condition are also discussed.

The weaknesses of Tape 1 are that it moves slowly; some explanations are excessively long; and the information, although comprehensive, is poorly organized. Camera angles are sometimes poor, and unless the camera pulls back, it is not clear, at times, what part of the body you are seeing. Inappropriate breakaways and poor music do not encourage the viewer in this 38-minute tape. Some of the information, However, is very, good. If the introductory tape were shortened and edited to create smoother transitions, it might be more effective.

Tape 2, Myofascial Pain Syndromes of the Head, Face, Neck, and Shoulder Girdle," deals with the evaluation and treatment for the paraspinal, posterior cervical, sternocleidomastoid, scalenus, levator scapulae, trapezius, temporalis, splenius, and suboccipital muscles.

This tape is 61 minutes long and covers in depth how to treat and evaluate each of the above muscles or muscle groups. Graphics are excellent and presented with narration before each demonstration session for a given group. This offers a great review of anatomy. A demonstration with Travell and tile patient follows the initial anatomical graphics. Travell evaluates, stretches, sprays with a vaporcoolant, and reassesses the muscle group. The muscle groups demonstrated are again represented graphically, with narration. An outline of spray patterns over the muscle groups is also graphically represented. The use of the vapor-coolant spray on the temporalis muscle was questionable, as the spray hit many areas of the face, and many practitioners would not use the spray in this area of tile body.

The techniques for evaluating and treating myofascial pain syndrome on the body areas mentioned in this tape and the ongoing need to assess the patient was demonstrated very well. Again, the tape appears to be addressing mainly physicians, although physical therapy is mentioned. The reinforcement with graphics and narration before and after Travell's demonstration is very effective.

This tape would be a wonderful learning aid for educators and is a helpful review of anatomy and technique for practitioners. I recommend this tape as an excellent educational training tool for physical therapists.

The consistent elements in this tape and in the other tapes are the sensitivity and expertise of Travell as she demonstrates the techniques. The patient used in these tapes is very "believable' her responses appear both authentic and valid. Barbara S Oremland, PT Lyndhurst, Ohio