What is a Trigger Point (TrP)?

Trigger points are often discrete, hyperirritable spots located in a taut band of skeletal muscle.  These points are often tender to the touch, but also can refer pain to distant locations of the body.

What can cause trigger points to develop in the body?

• Recent or long-term injury

• Decreased range of motion in a joint

• Lack of exercise or loading a joint

• Repetitive stress to a muscle

• Sustained poor posture

There are two types of trigger points that can be described as:

1. Active - Reproduction of a current or past symptoms

2. Latent -  Tender or reproduction of tender points only when being pushed on.

   • Local or referred unrecognized pain

Trigger points have a few different ways they respond when being worked on.

1. Local Twitch Response - A noticeable contraction of the muscle or skin when the muscle fiber has pressure applied to this region.

2. Referred Pain - Pain perceived at a location other than the site of the painful muscle point. Typically these pain patterns can often reproduce a distant site of complaint or recreate the pain you are seeking care for.

 What are the symptoms of a trigger point? What can it lead to?

Trigger points will inhibit overall muscle function, leading to muscle weakness causing a muscle to not function at it's full capacity.

This could lead to an altered movement or motor pattern consciously or unconsciously.

Examples of the effects of a trigger point:

• Improper body mechanics

• Decrease range of motion

• Increased muscle stiffness

• Painful movements or movements that exacerbate symptoms

• Postural abnormalities and compensations

• Tension headaches, migraines, etc

• Chronic persistent pain

Now that we know a little bit more about Trigger Points what are some examples? (limited examples provided, every muscle will have a referral pattern)

(In these examples: X is the trigger point location, Red markings are the referral patterns of the trigger point - locations of the pain)

As you begin to look at the trigger points, you may see locations of pain that can mimic different diagnoses.

Trapezius

Supraspinatus (Rotator Cuff muscle)

Gluteus medius referral patterns

Gastrocnemius  referral patterns

Treatment options for Trigger points:

• Activity of daily living modifications such focusing on ergonomics when sitting at a computer for a long period of time

• Stretching

• Self-Massage in the area

• Ischemic Compression technique: sustained pressure of the trigger point leading to release and relaxation of the trigger point

• Myofascial release

• Foam Rolling

• Movement Pattern Assessment

• Progressive Exercise Loading to return normal range of motion and challenge joint stability

• Dry needling