Understanding Trigger Points
It is common for individuals to think of their muscle tension as literal “knots”, tight hard lumps that feel sore, stiff, or tender to touch. However, knots may be actual trigger points. Trigger points are specific, hyperirritable spots within a taut band of skeletal muscle. They are typically sensitive to touch as they are painful when compressed and can also refer to pain in other areas of the body.
There are two classifications of trigger points based on their characteristics: active and latent. An active trigger point would cause spontaneous pain symptoms, and identify the referred pain as familiar. A latent trigger point is a sensitive or tender nodule that is unfamiliar and is not recognized to be responsible for the individual.
Referred pain occurs when pain travels to other body areas. It is sometimes common to not have pain at the site of trigger-point origin but in regions of the body remote from it. Individuals may describe the pain as spreading or radiating. Most muscles have a unique referral pattern that gives clinicians clues on where the root problem is.
There are many causes of trigger points including overuse or repetitive strain on muscles, poor posture, stress, dehydration and lack of proper nutrition, lack of physical activity, or overtraining. They can develop in any muscle, but they are commonly found in overused areas such as the neck, shoulders, back, hamstrings, and quadriceps. If left untreated, these tension points can lead to reduced mobility and contribute to further movement impairments.
Physical therapists (PTs) are extremely knowledgeable in anatomy and muscle function. Palpation, the use of touch to examine the body, is a key way PTs are able to locate taut muscle bands or trigger points. Physical therapists can treat trigger points through manual therapy techniques such as myofascial release, soft tissue massage, and dry needling which is only legal in some states. PTs can provide strengthening and postural correction exercises to prevent trigger points from developing.
However, there are some ways that individuals can self-relieve trigger points. Two simple ways are to stay hydrated and add stretching to their everyday routine. Other ways include using massage balls and foam rolls. By using one’s body weight, moving in small movements, or staying on the spot for 20-30 seconds, a trigger point can slowly be relieved. There are numerous resources on how to do this properly online.
Increased muscle tension is common, as we constantly strain and stress our bodies through our everyday lives and tasks at work, home, and activities. However, please remember to be mindful of sedentary activity and posture. The best way to combat this is through staying active and healthy.
Written by Kennedy Hardemion, SPT
References:
Alvarez DJ, Rockwell PG. Trigger points: diagnosis and management. American family physician. 2002;65(4):653-660.
Bron C, Dommerholt JD. Etiology of myofascial trigger points. Curr Pain Headache Rep. 2012;16(5):439-444. doi:10.1007/s11916-012-0289-
Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L. Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R. 2015;7(7):746-761. doi:10.1016/j.pmrj.2015.01.024