What are trigger points?
Have you ever experienced a shooting pain or sensation that travels? If you have, you may have encountered a Myofascial trigger point. Most often, people will refer to these points as “knots” or adhesions. You may usually find them within a taut band of skeletal muscle or its fascia. It tends to be tender to touch, and exhibits pain referral patterns that cause the affected muscle to shorten.
Myofascial trigger points are very common to everyone regardless of age and condition. Our bodies go through constant changes and adaptations to fit our needs and lifestyles.
For example, an individual who sits at a desk eight to ten hours a day, for many years, will show a neck-forward posture with shoulders rolled forward. Without any postural exercises and other preventative measures, that body will slowly adapt and change to that positioning which yields muscle imbalances. These imbalances indicate that there are muscles that have shortened and some that have lengthened and lost its strength. To add to the postural changes, some people may experience referral pain. Tension headaches are one of the most common examples that can indicate a trigger point is present in your upper trapezius.
Figure 1. Poor posture creating imbalances in the neck and shoulders
Some signs and symptoms of trigger points will include: 
- local point tenderness
- decreased range of motion in the affected muscle
- referral pain pattern
- painful passive stretching
- painful contraction of the muscle
- imbalance of posture
Trigger points are often treated a variety of different ways. The most common is a technique known as ischemic compression. A static compression is applied to the affected muscle which creates a local ischemic point. While applying pressure, the referral pattern will reveal itself and the therapist begins to treat. After treating, the result is a reactive hyperemia that follows. In simpler terms, we are suffocating the muscle “knot” and then allowing re-circulation into the tissue to flush metabolites and release any built-up pressure. This is then followed up with heat and stretch.
Figure 2. Myofascial trigger point present in upper trapezius (marked by x) showing red referral patterns.
Although it may be a painful technique, your massage therapist should always inquire about your pain tolerance and make sure that you are comfortable. We are here to make sure we provide the most safe and effective treatment for you.
If you ever feel that you are struggling with trigger points, your local massage therapist will be able to treat those trigger points and provide a full analysis of postural imbalances as well as remedial exercises to prevent further injury and trigger points forming.
By: Jonathan Chang, RMT, SMT(cc)
References:
http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-8
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