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 be the cause of some headaches, neck and jaw pain, low back pain, tennis elbow, and carpal tunel syndrome.
Based on the discoveries of Drs. Janet Travell and David Simons in which they 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 in which the muscle and connective tissue are highly sensitive to pain when compressed. Pressure on these points can send referred pain to other specific parts of the body.
Trigger Point Therapy can relieve muscular aches and pains in association with these areas. It can also assist with the redevelopment of muscles and/or restore motion to joints. 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 small 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 small 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.
There are a few more than 620 potential trigger points possible in human muscles. These trigger points, when they become active or latent, show up in the same places in muscles in every person. That is, trigger point maps can be made that are accurate for everyone.
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, which can result in poorer muscle coordination and balance. Active and latent trigger points are also known as “Yipe” points, for obvious reasons.
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 often will resolve the satellite and return it from being active to latent, or completely treating it too.
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.
Above Picture is of The TP Therapy Starter Set being used on the Soleus and Calf area.
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 can cause pain deep within a joint where there are no muscles. When muscle fibers contract, they use biochemical energy, and depletion of these biochemicals leads to 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 elongate 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 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 the diagnosis of trigger points.
Usually there is a taut band in muscles containing trigger points, and a hard nodule can be felt. Often a twitch response can 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 not uncommon in some of the 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 was presented describing images of trigger points taken by modified MRI.
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 now we can usr self administered treatments such as TP Therapy The Grid , TP Therapy Massage ball, TP Therapy Quadballer and or TP Therapy Starter Kit.