What are Trigger Points?

Trigger points are found as extremely sore points occurring in ropy bands throughout the body. They can also be felt as painful lumps of hardened fascia (a sheet or band of fibrous connective tissue enveloping, separating, or binding together muscles, organs, and other soft structures of the body).

Trigger points can be either latent or active. An active trigger point is one that actively refers pain either locally or to another location (most trigger points refer pain elsewhere in the body along nerve pathways). A latent trigger point is one that exists, but does not yet refer 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. Activation of trigger points may be caused by a number of factors, including acute or chronic muscle overload, activation by other trigger points, disease, and psychological distress.

If you stretch a muscle about 2/3 of the way out, you might be able to feel them. Sometimes the muscles get so tight that you can’t feel the lumps, or even the tight bands. The muscle just feels like ‘concrete’.

Myofascial (of or relating to fascia surrounding muscles) trigger points can entrap the nerves, blood and lymph vessels, causing a variety of symptoms that confuse doctors and patients alike. Often nerve damage is incorrectly suspected which can result in many unnecessary tests.

Trigger points occur when multiple microscopic areas cause segments of the muscle fibres (called sacromeres) to become distorted. Eventually, a contraction knot forms as well as a taut band. When you have triggers points, your muscle strength becomes unreliable, stiff, and lead to muscle tightness and weakness.

Trigger Point Therapy

There are many different types of treatment which come under the umbrella of trigger point therapy. The ones which I find the simplest and often the most effective are;

  • Trigger point pressure release
  • Voluntary contraction and release methods
  • Myofascial release

Trigger point pressure is known to be effective at central trigger points where there is rationale for its use. A therapist lengthens the muscle to the point of increasing resistance within the comfort zone and then applies gentle, gradually increasing pressure on the trigger point until the finger encounters a definite increase in tissue resistance. This pressure then can be increased when the muscle has released. This is repeated for each band of taut muscle.

Voluntary contraction and release methods (PNF – Proprioceptive Neuromuscular Facilitation), employ degrees of voluntary (active) contraction followed by relaxation. A reduction in muscle stiffness (tension) following the contraction provides an increase in range of movement. This approach is the basis of the simplest, most available, most popular, and most effective techniques for inactivating Myofascial trigger points.

Myofascial release is a form of soft tissue therapy intended for pain relief and increasing range of motion. Techniques include manual massage for stretching the fascia and releasing bonds between fascia, muscles, and bones are applied. The fascia is manipulated, directly or indirectly, to allow the connective tissue fibers to reorganize themselves in a more flexible, functional fashion, and therefore making them more efficient once again.

The fascia is a seamless web of connective tissue that covers and connects the muscles, organs, and skeletal structures, located between the skin and the underlying structure of muscle and bone. Muscle and fascia form the myofascia system. The fascial system is totally one structure that is present from your head to foot without any interruption.

Injuries, stress, inflammation, trauma, and poor posture can cause restriction to fascia. Since fascia is an interconnected web, the restriction or tightness to fascia at a place, with time can spread to other places in the body like a pull in tights. The goal of myofascial release is to release fascia restriction and restore its tissue health.

There are two different approaches to Myofascial release:

  1. Direct myofascial release (or more commonly known as deep tissue work) and:
  2. Indirect myofascial release (soft tissue work)

Personally I am more favour of the indirect approach though each therapist will have their own preferences.

If you have any further questions with regards trigger points or trigger points therapy, please do not hesitate to get in touch.