The dreaded trigger point… also known as a knot in the muscle. These buggers often elicit some degree of pain upon compression or stretching the affected muscle. Trigger points can develop anywhere in the body, however there are more common areas than others. These common trigger points have pain referral patterns that can be local or may travel to a completely different area of the body. While the mechanism of trigger points is not completely understood, here is one accurate definition: “A trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle or its fascia. It is point tender on site, often exhibits a predictable pain referral patter and causes a shortening of the affected muscle.” – Fiona Rattray, RMT.
So what exactly is a taut band? It is believed that it may be a contracture of muscle fibres that have been damaged by some form of trauma, and have not fully recovered, leaving the muscle in a sustained contraction, or contracture. An active trigger point will be painful during movement of the muscle containing the taut band as well as at rest. The trigger point will usually prevent the muscle from being fully stretched, and if that muscle is stretched to the point of pain, protective muscle spasm will occur, preventing any further stretch. Trigger points are seen less in healthy muscles that are exercised daily, because these muscles are being stretched on a regular basis. They usually crop up in muscles that are more sedentary, specifically muscles that are suddenly overworked, and not stretched properly before overloading them.
How do we treat them? Trigger points can be treated with massage therapy and they can be integrated into any massage treatment easily. The muscles must be in a relaxed state before using direct compression on the trigger point. There may be some discomfort in treating a trigger point with ischemic compression, and it is important that the pressure does not exceed the client’s pain tolerance. Working within a pain threshold is done in order to keep the muscle as relaxed as possible, otherwise the muscle could tense up or develop a protective spasm, which will only worsen the pain. If the trigger point is too painful to use ischemic compression, there are other methods to treat it, that are more indirect, such as gentle slow stretching of the muscle, gentle petrissage over affected area, or applying heat over the muscle to relax it.
The best thing you can do at home is avoid any overuse of the affected muscle, have regular warm baths, or heat applied to the affected area, gentle stretching of the affected muscle, and adjust any postural imbalances that may be contributing. Massage therapy is a great way to reduce trigger points, and your RMT can provide at home exercises and stretching to help maintain healthy muscles.