Biography:

Past Medical Director for Chicago Center for Myofascial Pain Relief

Retired Cardio/Thoracic Surgeon

Dr. Hartz has spent over 40 years in Medicine (now semi-retired), began incorporating myofascial trigger point therapy concepts to her medical practice over 10 years ago.   She is a passionate and engaging speaker, providing us with research data and science. Dr Hartz's lecture information will also be based on over 10,000 trigger point injections she has performed together with myofascial trigger point therapists.

Dr Hartz is the primary author of over 100 Pub-Med, peer-reviewed, citated papers.

Topic:  Trigger Point Treatment Alone is Inadequate Therapy for Myofascial Pain and Dysfunction   (1 NCBTMB Approved CE Hour)

Dr. Hartz will describe the Myofascial Unit (MFU) as a sophisticated and highly innervated organ system each of whose components must be treated in order to restore myofascial health. She will use the most recent terminology available in order to dispel many of the myths that persist in this specialty and she will encourage use of the terms “enthesitis” and “enthesopathy” rather than myositis, myopathy, and tendonitis which are often misleading (eg. plantar fasciitis is  really an enthesopathy disorder NOT a fascia disorder).

The tendons and ligaments of the MFU are aneural, avascular, and are resistant to stretching. The epimysium, perimysium and endomysium are highly innervated, extremely vascular, and amenable to lengthening using myofascial trigger point release techniques. These 3 fascial layers  are most abundant at the myoneural junctions, and knowledge  of the origin and insertion of each MFU allows them to be identified easily in its most bulky portion of the unit. (This knowledge allows the manual therapist to identify the most important muscle segment to be treated).

In Dr. Hartz’s opinion, trigger points (TrPs) are not "mysterious" as described in recent national pain meetings by prominent leaders in the field. TrP's are ischemic areas formed at the myoneural junctions of the MFU caused by overuse or improper positioning. When  the ischemia is extreme the TrPs will “twitch" when palpated and the patient will feel (referred) pain or sensation at the INSERTION (enthesis ) of the MFU on movable bone or joint structures. Dr Hartz hypothesizes that the  pain is caused by traction of the MFU on the insertion!

Ischemic areas in other organ systems lead to fibrosis, (angina to heart attack and claudication to gangrene), but trigger points do not undergo fibrosis even when the sarcomeres are locked in the shortened position. This feature affords myofascial therapists the opportunity to resolve pain in almost all dysfunctional units. The therapist must have knowledge of each MFUs origin and insertion because the trigger points form at the neuromuscular junctions which are near the center of the unit where the muscle is bulkiest. Dr. Hartz recommends treatment of the trigger points with compression or injection, even before the trigger points twitch, and / or  if "referred' pain occurs. 

Dr. Hartz also recommends the use of 3-D anatomy apps for patient education.

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