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40: Wesley Lai, Physiotherapist – Trigger Points and Yoga

Have you ever had a “knotted” muscle? Well, this episode is for you. We invited physiotherapist Wesley Lai to get into the physiology of trigger points, nerve referral pain and how stretching and yoga can impact the knots in our muscles. Wesley lays out the current theories about trigger points and fascia, release techniques and the surprising limitations and advantages of yoga when it comes to deeply knotted tension. As always, we intersperse personal anecdotes throughout the episode, and learn a bit more about one another. This episode is one of our favourite interviews!

In This Episode

  • Wesley introduces himself and his background in genetics, Rett syndrome in children and his transition into physiotherapy (2:43)
  • Nat shares her surprising physio experience while she was a student in university (7:21)
  • Wesley tells us about active and latent trigger points:
    1) active trigger points refer pain locally as well as elsewhere; can also cause spontaneous pain
    2) latent trigger points don’t refer pain. Both types can reduce range of motion; can shorten the muscles and hence weaken them also. Both types can lead to autonomic nervous system dysfunction – changes in your fight and flight response (15:25)
  • We don’t actually know what a trigger point really is; we only have hypotheses: The Cinderella Hypothesis (metabolic theory); slow-twitch (type 1 muscle fibers), low load get recruited and de-recruited first during any load; they get overused so less blood flow, so under ischemia (low oxygen), makes the environment more acidic which changes the way calcium gets re-uptake into muscle cells. The Neurogenic Theory  suggests that trigger points have more nerve activity that’s spontaneous; this creates more muscle tone and hence creates the metabolic environment as we see in the Cinderella Theory (18:08)
  • If you use a muscle you’ll develop it; the beauty of the body is that it’s highly adaptable (21:14)
  • Wesley explains how nerves exit the spine and the fascial dysfunction model as it helps explain referral pain (25:13)
  • Can we stretch a trigger point out? (31:39)
  • For Wesley, he usually sees low back injuries from yoga; either as a lack of education as to when to back off from an exercise, or a physical hands-on adjustment (like a forced anterior pelvic tilt within downward dog) (49:39)
  • Wesley’s final words of advice for yoga instructors (53:48)

Resources & Links

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