Myofascial Trigger Points

A trigger point is described as a hyperirritable spot in a muscle, commonly known as a ‘knot’. They can develop in skeletal muscle when it has been injured or overworked.
The spots are often tender when palpated, and cause what is called ‘referred pain’ to other areas of the body. They can often feel like a small bump buried beneath the muscle.

Trigger points can occur in all soft tissue such as skin, ligaments, tendons and even scar tissue, but are most commonly found in the thin wrapping that covers and protects the muscle, known as ‘fascia’; these are called myofascial trigger points. If a trigger point is left untreated, the length of the muscle is shortened, and the chance of injury can be increased. There are many types of trigger points such as; active, associated, attachment, central, key, latent, primary, and satellite. All of these can produce pain and weakness in the muscle, and even may impinge on nerves, causing neurological pain.

What is referred pain?

Referred pain is pain that is felt at a distance to where the actual cause is located. The pain usually feels like a deep, dull and steady ache. It can occur on movement or at rest, and it can vary from not that painful, to severe and incapacitating.

How do I get tripper points?

•    General emotional stress ( this is a major cause, producing severe neck and back pain, and even headaches)
•    Running on a hard surface for the first time
•    Prolonged standing or sitting (such as driving for a long period of time)
•    Poor sleep position
•    Holding phone between shoulder and head
•    Poor skeletal alignment
•    Impingement of nerves from abnormal muscle contraction
•    Overtraining, doing exercise that is to strenuous or excessive
•    Not warming up before exercise or not cooling down after
•    Any repetition at work or at home, such as typing
•    Incorrect use of the body when lifting
•    Excessive strain placed on muscles through lifting
•    Strain to a certain body part, such as carrying a school bag over one shoulder
•    Overuse of other muscles to compensate for injury
•    Prolonged shortening of muscles
•    Surgery, trauma, muscle adhesions, various pathological conditions, viral or bacterial illnesses.

What are the signs and symptoms?

The signs and symptoms can vary depending on the location of the trigger point as well as the severity. They produce a deep, dull pain on palpation. Trigger points cause referred pain that can produce headaches, neck and jaw pain, lower back pain, also joint pain. Some other common symptoms are:

•    Stiffness
•    Tightness and weakness of muscles
•    Localised sweating
•    Eye tearing
•    Increased salivation
•    Poor balance
•    Dizziness
•    Nausea
•    Tinnitus
•    Nausea
•    Goose bumps
•    Weak ankles
•    Staggering gait
•    Muscle cramps

Other signs and symptoms that can be found are often nerve related such as pain, numbness and tingling, also weakness and a decrease in range of movement.  Dizziness, sinus congestion and nausea have also been reported.

Myotherapy and Trigger points:

Myotherapy is a form of treatment aimed specifically at illuminating trigger points, and preventing them from reoccurring. With the use of deep tissue massage, dry needling, electrical stimulation, heat and other techniques the trigger point can be released.

Deep tissue massage and myofascial release helps to break into the self-sustaining vicious circle that has kept the muscle in the contracted state. Massage also helps to increase the circulation, which has been restricted in the immediate area by the contracted fibers. This enables regenerative properties such as oxygen and nutrients to flow to the spot. Lactic acid is a waste product that can collect in the muscle from spasm which causes pain; massage will promote circulation and remove this waste. Stretching and direct massage with friction will help to break up the trigger points knotted muscle fibers. Massage also promotes relaxation which can help to relieve stress and pain.