What are trigger points?
Trigger Points are thought to be tiny knots that develop in a muscle when injured or overworked. Commonly thought to be a cause of most joint pain, they are thought to cause some headaches, neck, and jaw pain, lower back pain, tennis elbow, and carpal tunnel syndrome.
Based on the discoveries of Drs. Janet Travell and David Simons found the causal relationship between chronic pain and its source, Myofascial trigger point therapy is used to relieve muscular pain and dysfunction through applied pressure to trigger points of referred pain and through stretching exercises. These points are defined as localized areas where the muscle and connective tissue are susceptible to pain when compressed. Pressure on these points can send referred pain to other specific parts of the body.
What can trigger point therapy do for you?
Trigger Point Therapy can relieve muscular aches and pains associated with these areas. It can also assist with redeveloping muscles and/or restoring joint motion. Trigger Point Performance products are specifically designed to support the massage associated with Trigger Point Therapy. Trigger points are described as hyper-irritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers.
Trigger point researchers believe that palpable nodules are tiny contraction knots and a common cause of pain. Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response. The local twitch response is not the same as a muscle spasm. This is because a muscle spasm refers to the entire muscle entirely contracting, whereas the local twitch response also refers to the entire muscle but only involves a slight twitch, no contraction.
Trigger points have a number of qualities. They may be classified as potential, active/latent and also as key/satellites, and primary/secondary.
How many trigger points do I have?
A few more than 620 potential trigger points are possible in human muscles. When they become active or latent, these trigger points appear in the same places in muscles in every person. That is, trigger point maps that are accurate for everyone can be made.
Active or latent… what’s the difference?
An active trigger point actively refers to pain either locally or to another location (most trigger points refer to pain elsewhere in the body along nerve pathways). A latent trigger point exists but does not yet refer to pain actively but may do so when pressure or strain is applied to the myoskeletal structure containing the trigger point.
Latent trigger points can influence muscle activation patterns, resulting in poorer muscle coordination and balance. For obvious reasons, active and latent trigger points are also known as “Yipe” points.
A key trigger point is one that has a pain referral pattern along a nerve pathway that activates a latent trigger point on the pathway or creates it. A satellite trigger point is one which is activated by a key trigger point. Successfully treating the key trigger point will often resolve the satellite and return it from being active to latent or thoroughly treating it.
In contrast, a primary trigger point, in many cases, will biomechanically activate a secondary trigger point in another structure. Treating the primary trigger point does not treat the secondary trigger point.
Potential causes of trigger points
Activation of trigger points may be caused by a number of factors, including acute or chronic muscle overload, activation by other trigger points (key/satellite, primary/secondary), disease, psychological distress (via systemic inflammation), homeostatic imbalances, direct trauma to the region, accident trauma (such as a car accident which stresses many muscles and causes instant trigger points) radiculopathy, infections and health issues such as smoking.
Trigger points form only in muscles. They form as a local contraction in a small number of muscle fibers in a larger muscle or muscle bundle. These, in turn, can pull on tendons and ligaments associated with the muscle and cause pain deep within a joint without muscles. When muscle fibers contract, they use biochemical energy and depletion of these biochemicals leads to the accumulation of fatigue toxins such as lactic acid.
The tightened muscle fibers constrict capillaries and prevent them from carrying off the fatigue toxins to the body’s recycling system (liver and kidneys). The buildup of these toxins in a muscle bundle or muscle feels like a tight muscle—a slippery, elongated bundle.
When trigger points are present in muscles, there is often pain and weakness in the associated structures. These pain patterns in muscles follow specific nerve pathways and have been readily mapped to allow for the identification of the causative pain factor. Many trigger points have pain patterns that overlap, and some create reciprocal cyclic relationships that need to be treated extensively to remove them.
Diagnosis of trigger points
Trigger points are diagnosed by examining signs, symptoms, pain patterns, and manual palpation. A 2009 review of nine studies examining the reliability of trigger point diagnosis found that physical examination could not be recommended as reliable for diagnosing trigger points.
Usually, there is a taut band in muscles containing trigger points, and a hard nodule can be felt. A twitch response can often be felt in the muscle by running your finger perpendicular to the muscle’s direction; this twitch response often activates the “all or nothing” response in a muscle that causes it to contract. Pressing on an affected muscle can often refer pain.
Clusters of trigger points are common in some larger muscles, such as the gluteus group (gluteus maximus, gluteus medius, and gluteus minimus). Often, there is a heat differential in the local area of a trigger point, and many practitioners can sense that. In 2007, a paper describing images of trigger points taken by modified MRI was presented.
Treatment of Trigger Points
Treatment by a qualified professional such as a Graduate Sports Therapist, Physiotherapist, or Massage Therapist may choose manual therapy as a treatment, or we can use self-administered treatments such as TP Therapy The Grid, TP Therapy Massage Ball, TP Therapy Quadballer, and or TP Therapy Starter Kit.