When a client says “muscle knot,” a trained massage therapist often hears “trigger point.” The medical community is still uncertain about their exact physiology, but trigger points are behind many daily aches and pains. For those suffering from chronic or persistent pain, finding a massage therapist that is skilled in trigger point therapy can be the first step to pain relief.
So, What Exactly Are Trigger Points…?
While there is no absolute definition, most agree that trigger points are hypersensitive nodules formed by myofascial tissue in a chronic spasm. They are often tight, hard and either warmer or cooler to the touch than surrounding tissues. Pressing on one can cause the whole muscle to twitch, and more than one can be present in a single muscle belly.
Trigger points can also be classified as “active” or “latent”:
- Active trigger points create persistent symptoms and are constantly “activated”.
- Latent trigger points become “activated” when a stimulus (such as pressure) is applied. They also frequently cause decreased range-of-motion and muscle weakness.
Trigger Point Symptoms
The hallmark of a trigger point is the palpable “knot” or band of tight tissue in the belly of a skeletal muscle. It will often produce a “jump sign,” a client’s sudden and obvious reaction to stimulus. Other common symptoms of trigger points include:
- Dull aching and tenderness
- Temperature differences in the affected area
- Involuntary muscle contraction
- Localized weakness and fatigue
- Delayed muscle relaxation
Many trigger points refer pain to other areas of the body. In fact, some clients will feel their worst symptoms in an area near but not at the site of the the point itself. This is especially common when a trigger point has entrapped a nerve bundle or causes a chain reaction of dysfunction through several muscles.
Trigger points can even activate other nearby points, causing a chain reaction or “domino effect”, which can lead to chronic pain and be more difficult to treat. These are known as satellite trigger points.
It is important to note that trigger point symptoms often overlap with those of other medical conditions, which only a medical doctor can diagnose. Always check with your primary care physician if you are experiencing pain or any of the symptoms above.
Causes Of Trigger Points
Trigger points can often be linked to stress, postural imbalance, repetitive motion, or the lasting effects of an old but healed injury. They can also be caused by muscular atrophy or holding a muscle in an awkward position for repeated or extended periods. Latent trigger points can become active due to overuse, overstretching or exposure to cold.
On a physiological level, it is thought that the dysfunction is caused by a small group of muscle cells unable to purge the calcium that triggers muscle flexion. Some report that women are more likely to develop trigger points than men, and some people seem more susceptible to them than others. Chronic, widespread trigger points are a common symptom of chronic pain disorders like fibromyalgia.
Trigger Point Therapy
Treatment may include of a variety of methods (such as “spray and stretch” or dry needling) but in the context of massage therapy, manual treatment using direct pressure is commonly referred to as “trigger point therapy“.
During trigger point therapy, a massage therapist uses concentrated, rhythmic pressure directly on a trigger point using a tool, hand, thumb or elbow. It is believed that the alternating pressure encourages rushes of blood flow that helps muscle fibers relax and purge waste products. Gentle stretches and deep but broad effleurage can also help alleviate the spasms and re-train the muscle to move in a more healthy way.
Trigger point therapy must be performed with care. The affected muscle should be warmed up first, and pressure should start light and gradually increase, staying within the client’s tolerance level for pain. If the client cannot tolerate a direct approach, applying pressure nearby or from an angle can help.
Focused trigger point therapy and regular therapeutic massage is a very safe and effective way to address and prevent trigger points, but maintaining an active and healthy lifestyle with regular exercise, proper hydration, and adequate sleep can dramatically reduce pain caused by trigger points as well.
Trigger Point Video