In this conversation, Dr. Beau and Steven Capobianco discuss the complex topic of trigger points and their role in manual therapy. They explore various theories and mechanisms behind trigger points, including the soft tissue milieu, neurogenic inflammation, and peripheral and central sensitization. They emphasize the importance of considering the broader context of the patient and adopting a synergistic approach to treatment. The conversation also touches on the interrater reliability of palpation and the role of experience in improving accuracy. In this part of the conversation, the subjectivity and objectivity of palpation are discussed, highlighting the challenges of accurately locating trigger points. Advancements in technology, such as MSK ultrasound, elastography, and T1Q mapping, are explored as potential tools for identifying trigger points and dysfunctional tissue. The role of hyaluronan in the extracellular matrix and its impact on tissue mobility and sensitization is examined. The concept of peripheral sensitization and neurogenic inflammation is introduced, emphasizing the importance of addressing cutaneous nerve entrapments in treatment approaches. In this conversation, Steven Capobianco and Dr. Beau discuss the role of touch and movement in addressing pain and dysfunction. They explore the influence of peripheral and central structures, such as trigger points and the limbic system, on the experience of pain. They also delve into the importance of the therapeutic alliance and the need for open-minded discussions in the field of musculoskeletal therapy. Overall, the conversation highlights the complexity of pain and the need for individualized approaches that consider both physical and psychological factors.