- Dori Nissenson
Let's Get To The Point
What Are Trigger Points?
I often get asked what trigger points are and honestly, I have trouble answering the question! This is because the science behind trigger points is only half-baked and their nature is controversial.
Essentially, trigger points are muscle knots or sensitive spots. Too many bad trigger points is myofascial pain syndrome. Trigger points are usually described as micro-cramps and are very common around injuries or in weak and or overused muscles. Trigger points are a major factor in back and neck pain as well as headaches including migraines and cluster headaches… and they are both a cause and a complication.
Although the topic of trigger points is just now becoming more popular, I see and treat trigger points regularly in my practice and eliminating them is essential for full recovery and from pain and injury.
What makes trigger points clinically important and fascinating as well as challenging for the physical therapist, is their triple threat.
Trigger points can cause pain problems, complicate pain problems and mimic other pain problems…. 1. Trigger points are a muscle spasm that causes pain in the belly of the muscle and may or may not radiate pain to other areas. 2. Trigger points very commonly complicate the recovery from a muscle or bony injury by developing around the injury site. 3. Trigger points mimic other problems and may feel like something else. For example, many health care professionals often misdiagnose a trigger point as some other musculoskeletal problem such as: a repetitive stress injury, arthritis, or a disc bulge when, in fact, it is muscle pain due to a trigger point. IN FACT…” MOST OF OUR COMMON ACHES AND PAINS ARE ACTUALLY CAUSED BY TRIGGER POINTS.” Claire Davies
What Are The Causes Of Trigger Points?
Repetitive overuse injuries from sports related issues, activities of daily living, and occupational factors
Sustained loading of the muscle such as heavy lifting, carrying babies or briefcases, boxes, and wearing heavy uniforms
Habitually poor posture due to sedentary lifestyles, occupational factors, and poor ergonomics at home or at the workstation
Direct trauma to the muscle
Inactivity or severe muscle weakness
How Do You Know If You Have Trigger Points
Many people often wonder why their pain isn't going away. As I stated above, they may have trigger points in their muscles that are delaying the healing process. Symptoms of trigger points are: 1. A dull achy sensation in the muscle 2. A burning sensation in the muscle 3. Fatigue in the muscle 4. Pain that radiates either up or down from the muscle Unfortunately, chronic pain is a relatively unstudied epidemic and many doctors don’t even know what to do with it. They are often inclined to inject the trigger point, but as I heard someone once say, “Would you use a bazooka to kill a mouse”?
ENTER THE PHYSICAL THERAPIST...
What Can Your Physical Therapist Do For Your Trigger Points?
1. Hands On!!! An experienced physical therapist will know how to locate and mobilize trigger points. Manual mobilization of trigger points is the most effective treatment to release the tightened muscle tissue. Since a trigger point is the contraction point of a muscle locked in a shortened position, the treatment involves unlocking that contraction mechanism.
2. Maintain Change: Your physical therapist will give you exercises at home to keep the muscle long and unlocked.
3. Get Strong! Your physical therapist will give you strengthening exercises for the affected muscles ANDyour postural muscles, as they are prone to the development of trigger points.
4. Get Long!! Your physical therapist will give you stretches that will maintain your muscle flexibility to prevent the development and/or recurrence of trigger points.
5. Posture: Your physical therapist will evaluate and treat your biomechanical alignment to re-establish muscle length throughout the body and to prevent the development and/or recurrence of trigger points.
6. Ergonomic Evaluation: Your physical therapist will evaluate your work station, car and any other space that may contribute to overuse injuries and poor postural alignment... both of which can cause the development of trigger points.
7. Support the problem: Your physical therapist may use tape, braces, sleeves or orthotics to help support the healing muscle for a better recovery.