This isotonic eccentric effort - designed to reduce contractions and break down fibrotic tissue - should target precisely the tissues in which the trigger point being treated lies buried.

Following the isolytic stretch the tissues could benefit from effleurage and/or hot and cold applications to ease local congestion. An instruction should be given to avoid active use of the area for a day or so.

Summary and Comment
The integrated use of inhibitory pressure, Strain/counterstrain and a form of Muscle Energy Technique - applied to a trigger point or other area of soft tissue dysfunction involving pain or restriction of range of motion (of soft tissue origin), is a logical approach since it has the advantage of allowing precise targeting of the culprit tissues.

Clearly the use of an isolytic approach as part of this sequence will be more easily achieved in some regions rather than others - upper trapezius posing less of a problem in terms of positioning and application than might quadratus lumborum.

No claim of absolute originality is made for this integrated approach which has evolved out of years of teaching the elements separately in the USA and Europe.