A cooling method in combination with Spray and Stretch technique

Almost everyone knows the very cool Spray, which has the ability to bring the athlete back into the game in the event of an unpleasant injury. Although Spophy Coolant Spray is primarily used to quickly relieve pain in acute injuries, such as ankle sprain, muscle strain, or tear, it’s extremely strong cooling effect can also be used to successfully perform a lesser-known therapeutic technique called Spray and Stretch. Unlike immediate pain relief and severe swelling in acute structural injury, in which Spophy Coolant Spray is most commonly used, the Spray and Stretch technique works primarily to remove the trigger point from the muscle, which in turn reduces chronic pain and increases muscle tension.

What are the trigger points in the muscles?

Trigger points the muscles are a common source of pain in the musculoskeletal system. They create the typically transmitted pain, which is often difficult to diagnose because it can occur outside the area of a given trigger point. For example, the trigger point in the anterior tibialis muscle occurs in the area below the knee, but the transmitted pain is created only in the area of the ankle and toe. The trigger point often arises in the muscles due to incorrect movement stereotypes, due to muscle “overloading” or due to chaining of muscle tension. Physiotherapists often have to make a lot of effort to successfully remove trigger points from a muscle when working with a patient. Various techniques are used for this purpose, such as the ischemic compression technique, the application of continuous ultrasound, or the Spray and Stretch technique.

How does the Spray and Stretch technique work?

Now you may be wondering how a cooling spray can effectively remove a triggerpoint from a muscle. The Spray and Stretch technique works primarily at the spinal level. According to Travell and Simons, Coolant application causes severe irritation of cold receptors in the skin, resulting in a strong influx of impulses in a given spinal cord segment. The predominance of damping interneurons occurs, which leads to a reduction in cell irritation in the anterior corners of the spinal cord, with a consequent reduction in muscle tension. The authors consider that the subsequent stretching of the muscle by the therapist can remove the source of increased muscle tension from the muscle – trigger point – with much greater success than it would be without the application of cold because under normal circumstances the muscles in which active trigger points are located stretching painful. The mutual combination of the application of Spophy Coolant – Spray and muscle stretching – stretch leads to the removal of the triggerpoint from the muscle and to the resulting reduction of muscle tension, to the removal of transmitted pain and better function of the muscle and surrounding joints.

Put simply, using the Spray and Stretch technique, the “stretch” part is the main therapy, while the “spray” part is a distraction for the body. Extreme cold serves as a source of “proprioceptive confusion”, which then allows for better and especially easier stretching of the muscles to greater lengths.

How to perform the Spray and Stretch technique correctly?

The technology itself is not difficult to implement and does not require any special equipment. To properly perform the Spray and Stretch technique, as taught by Travell and Simons, at least a basic knowledge of anatomy, primarily the muscular system, is required for a therapist to be able to apply Spophy Coolant Spray to the right area. It is also important to know the basic location of common trigger points and reference zones, at least for the most common muscle trigger points. However, after mastering this basic knowledge, the modified Spray and Stretch technique is relatively simple.

How to apply the Spray and Stretch technique using Spophy Coolant Spray?

1. Place the patient in a stable position in a warm room. Place the muscle you are going to treat in a very gentle position. Excessive muscle strain could irritate the trigger point and activate the tension reflex
2. Apply Spophy Coolant from one end of the muscle to the other end. Apply several times over the entire width of the muscle, or 2 to 5 parallel strips next to each other. Apply from a distance of 15 to 30 centimeters. Application from close range can damage the top layer of the skin and subjectively cause a burning sensation. The long-distance application reduces the cooling effect.
3. Gently stretch the muscle to the limit without pain. It must be a passive stretch, which means that the patient remains relaxed throughout the stretch.
4. Hold this Stretch for a minimum of 30 seconds to make sure the patient is breathing slowly and deeply.
5. After stretching, repeat the technique again, if similar.