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Bodywork Blog

Trigger Points 

1/8/2016

2 Comments

 
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What are they?  How are they treated?  Why do they matter? 
Most of my massage therapy sessions include the treatment of at least one or two trigger points.  But many of my clients don’t know what trigger points are or why they are important.   Trigger points are “a highly irritable localized spot of exquisite tenderness in a nodule in a palpable taut band of muscle tissue.”¹ Pain from trigger points ranges from a vague ache to debilitating pain. 

​As a therapist, trigger points usually feel like small knots or very tight bands of muscle.  To clients, trigger points are tender, often feeling like a bruise when pressed.  When I locate a trigger point, the response of the client is usually, “That’s the spot!”  One client calls them “hot spots”.  While trigger points are tender, pressure within your individual pain tolerance usually feels good (in a hurts so good way). 

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​We believe trigger points are caused by shortening of sarcomeres, microscopic components of muscles that control a muscle’s ability to contract and relax.  A trigger point forms when a cluster of sarcomeres are chronically contracted.  Chronic contraction prevents the normal exchange of oxygen and nutrients within the muscle fibers, which perpetuates the tightness and pain.  Trigger points are notacupuncture/acupressure points, muscle spasms, reflexology points, or fibromyalgia tender points.
 
Trigger points are triggered by chronic muscle tension, overuse of a muscle, or chronic overstretching.  Culprits include distorted posture, poor ergonomics, repetitive motions (including sports), nutritional deficiencies, falls and injuries, and medical and metabolic problems.  Psychological factors such as chronic tension, anxiety, and playing through the pain can all perpetuate trigger points.


Often trigger points refer pain to nearby areas of the body.  The reason for referred pain is not well-understood but likely results from confused nerve signals caused by the chronic contraction of muscle fibers.  Referred pain occurs in predictable patterns with only minor individual variation.  It can feel like a stabbing pain, dull ache, numbness/tingling, or even muscle weakness.   The pictures to the left and right show common trigger points as "X" with referral patterns in red. 

During a massage session, trigger points are treated with sustained pressure (compression) and/or small motions (friction), which help stimulate greater circulation and nutrient exchange.  Thus, it helps break the cycle of pain, tightness, and more pain to help relax your muscles.   The intention of massage is not to force the muscle to relax (what a contradiction!); rather the goal is to use massage to increase nutrient supply to the muscle.  Movement and careful stretching can also help relieve trigger points.

Keep an eye out for an upcoming blog on treating trigger points at home!

 
¹Travell, J., and D. Simons. 1983.  Myofascial Pain and Dysfunction:  The Trigger Point Manual.  Vol. 1.  Baltimore:  Williams and Watkins.
2 Comments
Melissa link
3/14/2016 08:53:28 pm

Great blog on trigger points! Thankyou for posting this! Indepth information for people to understand it.

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Melissa link
3/30/2016 06:29:35 pm

Great detailed blog on trigger points! Thankyou for sharing! Your clients need to know this stuff. Very good !:)

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