Trigger Points.....those 'ouchy' points

As a massage therapist releasing trigger points is an important part of my treatments for reducing client’s pain and promoting muscles to regain their full function. So what are they and how do they work… here I’ll try to explain my understanding of them….

What is a Trigger Point?

Below is a great explanation given by one of the leading founders of trigger point therapy and also quoted by my excellent teachers at Jing Massage Training school in their recent book: 

A trigger point is described as a “A hyper irritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is painful on compression and can give rise to characteristic referred pain, referred tenderness and autonomic phenomena (Simons et al 1999, P.5, Quoted In Fairweather and Mari, 2015)

These trigger points form when muscles are used repetitively for extended periods of time or the muscle is held in a shortened position for too long, such as sitting for long periods of time. As the muscle is held in this shortened position for too long, these tight areas form and they are no longer able to release themselves in the usual way. These trigger points can be as tiny as a grain of sugar or rice, they are usually found in the belly of a muscle or at their attachment point and can cause excruciating pain. This pain can be felt as deep, aching, sharp or stabbing in quality. When a trigger point is present in a muscle, there will often be other areas of tension around that muscle too, so releasing the whole area is needed. 

Primary trigger points are active and cause pain when pressed and then secondary trigger points often occur due to the primary trigger point. Latent trigger points can also be present and these sit in the muscle but do not cause any pain, but do still cause a restriction in the muscle fibre due to the tightness that is present and these can later become re-activated following a trauma or injury. 

Trigger point pain patterns

When trigger points were first fully researched by Dr Janet Travell who was a pioneer in her field, it was discovered that each trigger point has its own unique pain pattern. This means that when pain is present in a certain area of the body, by using this knowledge you have a good indication of where a trigger point may be present. In more recent years scientific studies have taken place to further underpin the knowledge on trigger point pain patterns. 

Here are some examples of common trigger points found in the body and their resulting pain pattern….. 

Trigger points in the trapezius muscle can cause pain into the back of the neck and also around the side of your head. Often people experiencing headaches will have trigger points in their Trapezius muscle. 

Trapezius side view

Trapezius back view

The muscles in the side of the neck, called the Scalenes, can cause pain down your arm and into your thumb and first two fingers very much like carpel tunnel syndrome. 

Scalenes

Lower back pain can be a result of trigger points deep into your side, in your Quadratus Lumborum (QL for short) which can result in pain felt in your lower back and is the number one muscle for lower back pain. 

QL

It’s important to say that not all the trigger points may be present at one time, but this shows where each individual one will likely be producing pain. It’s really interesting to see where the tension is actually held compared to where you might be feeling pain.  

Treatment of Trigger Points

Having manual work done on the muscle to reduce active trigger points feels so good, it reduces pain and increases range of motion. When working on trigger points, it’s not about how painful it is and the old saying ‘no pain, no gain’ just isn’t the case with trigger points. If it feels too painful then the brain will automatically think there is a danger and will tense the muscle further.  This is an involuntary reaction within the body. Therefore when working on trigger points, you do not want to feel any pain over a 6 or 7 out of 10 (where 1 is no pain at all, and 10 is excruciating pain). Therefore if the pain felt is about a 3 or 4 the trigger point is more likely to release. 

Releasing trigger points yourself

If you would like to help release trigger points on yourself, self-massage over the tender area with a tennis ball/spiky ball or your hands and really focus on any tender spots is a great way to help them release. Don’t overwork the area and only hold direct pressure on a trigger point for 8 to 12 seconds, otherwise it can become more irritable. Carrying out some simple stretching to the affected area is another great way to help tight muscles to release and holding a stretch for between 30 – 60 seconds gives your body and mind time to relax. 

If you have any questions or want to know more information, please don’t hesitate to contact me, to discuss your requirements.  Also, I want to acknowledge and say thanks for Jing Massage School for teaching me and passing on all these important lessons about the body and it's functions.