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Trigger Points - An Introduction
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Muscles are fantastic structures within the body – supple, elastic and powerful. When they are in a healthy condition, movement is fluid and easy as joints move freely to their full range of motion without any discomfort. When touched, they feel soft and there is no tenderness.
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Simplistically, muscles can be thought of as individual bands of muscle fibres lying parallel to each other. When the muscle contracts, these fibres work together to move the relevant joint. Any injury or muscular strain can lead to a restriction of one or more of the fibres which can lead to a taut band within the muscle.
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The function of the muscle may appear to be almost normal but it is likely that the range of motion of the joint will be restricted to some extent. The joint may appear to be stiff. The muscle feels tight to the touch and there may well be a deep dull ache and/or tenderness.
A trigger point will be located within the taut band of the muscle fibre and it is a point that produces a predictable pain pattern that is reproducible when the trigger point is pressed. Quite often, the pain does not manifest itself at the site of the trigger point and the ‘referred’ pain is felt at location away from the trigger point.
Trigger points normally arises from either overuse or overloading a muscle. Overuse occurs when a muscle is used in a similar way, over and over again. Repetitive work tasks or sporting activities are frequent culprits for developing trigger points through overuse. As the muscle contracts in the same way over and over again they become shortened and develop taut bands/trigger points. Poor posture can also play a role as muscles are forced to overwork to compensate, a classic example is rounded shoulders leading to tightness and trigger points in the upper back, in particular the trapezius and rhomboid muscles.
There are different types of trigger points including latent, active and satellite. Latent trigger points are probably the most common and develop from poor posture, strains, overuse, etc. Latent trigger points restrict the range of motion of the joints without the individual being aware of any significant pain patterns other than some general tightness. Latent trigger points can build up over years and easily persist for extended periods of time and are only released with direct techniques.
With extra overuse or sudden overload, the latent trigger point can become an active trigger point. These are the trigger points that have the predictable pain referral pattern that is specific to that muscle and that trigger point. The muscles located within the pain pattern may well be tender to the touch and the tenderness will only be removed after the trigger point has been deactivated. Pain from the active trigger point can increase with use of the muscle, rapid stretching or with prolonged shortening or repetitive contraction of the muscle. However, pain may reduce when the muscle is allowed to rest or undergoes slow passive stretching (particularly when in conjunction with the application of moist heat to the trigger point).
When a muscle lies within the pain pattern produced by other active trigger points then a flow-on effect can occur. Trigger points can develop in that muscle as well and these are often referred to as satellite trigger points.
How can trigger points be treated?
The trigger point is first located by palpation, feeling with the fingertips. Once the trigger point is located there are a number of methods available to deactivate the point. These include dry needling, ultrasound, muscle-energy techniques or even an analgesic. A massage therapist will use direct pressure to the trigger point, holding the pressure for up to 90 seconds until the trigger point releases and the pain is completely gone. After working on the trigger point it is important to stretch and then apply moist heat to restore normal muscular suppleness and to enable the muscle to return to it’s normal resting length.
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Any information, advice, recommendations, statements or otherwise contained herein, or in any other communication made by or attributed to Eastern Suburbs Massage and its representatives, whether oral or in writing, is not intended to replace or to be a substitute for medical advice trained by a trained physician or healthcare practitioner.
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