Trigger point therapy

Staff spotlight 441x304Tobias is JD’s manager of Bodywork. He has been in HK for 9 years treating sport injuries using trigger point therapy as an important tool to accomplish his result.

 

 

 

His background in trigger point stems back to 2000 when he was fortunate enough to be accepted on an authentic Traditional Chinese Medicine course to Western therapists in Australia, thought by two esteemed Chinese practitioners.

Tobias is now introducing his skills to the other JD therapists as a vital tool in soft tissue therapy.

What is a trigger point?

A trigger point is a sensitive area in the bodies’ soft tissue, feeling like a band or knot, commonly caused by poor posture, excessive use or trauma following an injury. When stimulated, they release referral patterns in neighbouring soft tissues. So when palpated or pressed trigger points are usually very tender.

Healthier muscles usually do not contain such tension, are not tender to pressure and when relaxed, they feel soft and pliable to the touch, not hard and dense, even if you do work out.

When trigger points are looked at on a microscopic level, part of the muscle fibre is contracted into a small thickened area, and the rest of the fibre is stretched thin. Several of these muscle fibre contractures in the same area are probably what we feel as the knot in the muscle. These muscle fibres therefore tend not to be available for use because they are already contracted, which is why it can be challenging when conditioning a muscle that contains trigger points. The contraction mostly leads to the release of sensitising chemicals producing the pain that is felt when the trigger point is pressed. Eventually some of the structural changes may be irreversible if trigger points are left untreated for long enough.

Trigger points can cause pain in the local area as well as in other areas of the body and common patterns have been well documented and diagramed. These are called referral patterns. Approximately 75% of the time trigger points are not located where you feel the symptoms. Referral patterns do not necessarily follow nerve pathways.

Pain levels can vary depending on the stress placed on the muscle and any of other the factors that keep trigger points activated. Tingling, numbness, or burning sensations are more likely due to nerve entrapments, which may be a result of trigger points entrapping a nerve. 

Active versus latent trigger points

If the trigger point is active, it will refer pain or other sensations. If it is latent it may cause a decreased end of range motion and weakness.

Active trigger points often start with some impact to the muscle, such as an injury, poor posture or body mechanics, repetitive use or a nerve root irritation. Active trigger points may at some point cease causing pain and become latent (sleeping). The limbs can feel heavy and poor end of range as mentioned. Latent trigger points can easily return to being active trigger points, often leading the patient to believe they are experiencing a new problem, when in fact it is an old problem being re-aggravated. Latent trigger points can be reactivated by overuse and over-stretching. With pressure on the trigger point, you can often reproduce the symptoms,

– Trigger points can cause symptoms not normally associated with muscular symptoms, such as sweating, ringing in the ears, dizziness, urinary frequency, buckling knees and tearing of the eyes.

– Trigger points limit range-of-motion due to pain. Some muscles are more likely to have a larger degree of restriction than others. Once trigger points are relieved, range-of-motion is usually instantly restored.

– Muscles containing trigger points are fatigued more easily and don’t return to a relaxed state as quickly when use of the muscle ceases. Muscles feel heavy to the person.

– People are often surprised that the same area on the opposite side is also tender, since that side isn’t causing them pain. Unless it is a recent injury, usually both sides eventually get involved (i.e., if the right mid-back is painful, there are also tender points on the left mid-back). For that reason both areas are always examined and treated equally.

– People who exercise regularly and correctly according to their training programme are less likely to develop trigger points than those who exercise occasionally and overdo it, e.g go out all for it once a week!

 

Common mapped out Trapezius TP’s

 

Trigger point

 

To summerise, a trigger point can be located anywhere in the human body, however they do have common areas where they have a habit of returning to, such as areas that have been traumatised through injury or poor posture. An example of a classic region where trigger points are found are within the cervical or neck area and the upper back through the trapezius.General de-hydration can lead to excess trigger points as well, so consuming adequate electrolytes is essential in keeping trigger points at bay.

When asked how do trigger points feel, the most accurate description is: active, dormant, small in size, slightly risen dome, electric, dull, superficial.