Trigger Point Release - What, Why and How

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Trigger Point Therapy written by Chartered Physio - A significant part of Physio's work is based around working with muscles and its interaction. This is a short guide explaining how Trigger point (TrP) is formed, how it affects muscle action and performance, and what to do to minimise its effect.  

Trigger Points, also known as muscle knots, are described as hyperirritable spots in muscles that are associated with palable nodules in taut bands of muscle fibres. When these TrP is pressed, a local twitch response with local sharp pain occurs, whilst frequently a referred pain also accompany.

There are 2 main types of TrP, Active and Latent. An Active trigger point is one that actively refers pain either locally or to another location. 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 muscle structure that contain the TrP.

Activation of TrP may be caues by a number of factors, including acute or chronic muscle overload, disease, psychological distress, homeostatic imbalance, direct trauma to the region or infection. TrP form only in muscles. They form as a local contraction in a small number of muscle fibres in a large muscle bundle. The TrP is formed from excessive release of acetylcholine which produces sustained deploarization of muscle fibres (muscle spasm). These sustained contractions of muscle compresses local blood supply restricting the energy needs of the local region. This crisis of energy produces sensitising substance that interact with the local nerve which produces localised pain and pain pattern that follow the particular nerve pathway.

TrP are found by palpation and usually there is a taut band or hard nodule in muscle. A twitch response can also be felt when running your finger perpendicular to the muscle's direction. Pressing on active and latent TrP will always produce pain.   

Active TrPs cause an active pain complaint. Latent TrPs while still in the muscle don't cause an active pain complaint but need to be treated to prevent pain symptoms from becoming active down the road. Latent TrPs will also be tender when pressure is applied so that's why we recommend searching the muscle thoroughly and treating all tender areas.

Once located the TrPs, apply a direct, sustained pressure to release the TrP. The duration held need to be correct as too short a hold can cause TrP not releasing or actually activating latent TrP, if held too long you can be brusing your muscle, causing unnecssary pain and damage. The key is to feel the release of the Tautness under your skin during pressure and together with the release of the localised pain. Trigger point massage tools are very helpful self-help aid for inactivating trigger points within the muscles.

Here are some tips  

1/ People who suffer back or thoracic pain, they are impossible to reach with your own hands, so use of a Backnobber would be crucial to help release your back TrP.

2/If you have Plantar Fasciitis, massaging your sole of foot is crucial, so use of plantar massage balls would be a great aid. 

3/As a novice, one of the common problem is incorrect use of part of your hand to press the TrP, hence causing unnecessary bruising. So the use of massage tools like Jacknobber, Indexnobber, Palmassager would have a rounded end that will allow user to ascertain the contact point is correct and not cause any unneeded trauma

4/For someone who need to perform TrP release daily like sports athletes, one of the problem that one encounter is thumb/finger pain due to the prolong pressure placed during the TrP release. Therefore the use of TrP aid like Pro Tec Roller massager, Tiger Tail massager, Foam Roller, would not only save your hands but also gives you the maximum input of force into the area intended.

5/ Use of agent like sports massage oil/lotion is also highly recommended to avoid friction burn on the skin whilst performing the TrP release technique

 

Finally, Don't be afraid to experiment and find out what works best for you.

Our therapist are always here to help your need and give you medical advice. Just send us a message.

VitalPhysio

 

Please note: The above information should not be used as medical diagnosis or treatment, please consult with your doctor or qualified health professional for your specific condition.

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