If you've ever had a massage it is more than likely you've heard your therapist mention trigger points (TrP), but what exactly does that term mean? The definition of a TrP is a hyper-irritable nodule in a taut band. When a muscle is strained, overused, or even injured the muscle fibers in the tissue create "knots" that can restrict blood flow, oxygen, nerve signals and even nutrients; causing the fibers to stay contracted which in turn close down pathways in the muscle and myofascial system that also transport metabolic waste, resulting in pain and inflammation.
So how do you know if you have a hyper-irritable nodule? Let's see first what a TrP is not.
TrP's are often confused with adhesions, which is basically a scar that has formed over microtears in the muscle fiber. Adhesions usually have localized pain, but do not radiate to other areas of the body and can be treated with friction techniques used to induce blood flow and break them down.
Pain that is poorly localized, or hard to pin point, and seems to be more regionally located and achy in the subcutaneous tissues, fascia, and including the muscles and joints are more likely to be a TrP. If a point in the body is more sensitive to touch with evenly distributed pressure is also most likely a TrP.
But what are some signs that the body gives you that tell if you may have a TrP? Well, you might have a trigger point if you experience chronic pain of any sort :
Headaches
Neck Pain
Jaw Pain
Low Back Pain
Carpel Tunnel Syndrome
or even Joint pains like:
tendinosis/ tendinitis
bursitis
ligament injury
and if you have experienced painful conditions such as, but not limited to:
Frozen Shoulder
Radiculopathy
Myofascial Pain Dysfunction
Occipital Headaches
Thoracic Outlet Syndrome
TMJ
Tennis Elbow
Tension Headaches
Epicondylitis
A TrP can also create motor dysfunction w/out pain. For example stiffness in the body and/or restricted range of motion (ROM). They can create muscle spasms as it interferes with the signal sent through the nerves to and from the brain. Because the signal becomes "jammed" in the nodule it can create weaknesses in the involved muscles and decrease the tolerance to work loads, creating more strain on the muscular skeletal system.
Once the TrP has been treated it can activate what is called a satellite TrP , that is to say, you could feel pain in a completely different area of the body after working on a TrP. They also rarely occur in isolation and you will most likely find a group of them in the same muscle.
TrP's can also create disturbances in the autonomic function. For example, abnormal sweating, excessive salivation, and not to mention proprioceptive disturbances that distort perception of weight of lifted objects, create imbalances, dizziness, and even tinnitus.
So what is the best way to treat a TrP you may ask? Finding a trained professional that has learned certain techniques to "release" TrPs is key. But, if you cannot afford to seek professional help from a trained bodyworker then you can try applying contrast therapy or even self massage. Contrast therapy is an alternating therapy of heat and cold for a total of 20 min. If you decide to self massage know that compression is key, pushing down on the TrP for approximately 30 seconds or until the pain lessens.
Often times compression of a TrP can be very painful, it helps to focus on the breathe and imagine that with each inhale you are directing oxygen to the TrP and with each exhale you are pulling the pain out of the TrP and releasing it out of the body. If you continue to focus your breathe while compressing the TrP you will generally feel warmth and a subsiding of the pain as it is released and blood begins to flow.
Tools for self massage can include a foam roller, massage balls, massage canes, and handheld massage guns. Please be careful when applying these tools to self massage as there are areas of the body that are contraindicated and you can cause severe damage to the tissues if you are not in tune with your body. Ask your massage therapist to demo any tools you may be interested in trying to make sure that you are applying proper technique.
Benefits of TrP therapy include:
Improved circulation
Enhanced ROM
Promoted activity of the Parasympathetic Nervous System
Quicker recovery
