Often when we’re feeling aches and sore points in our muscles, we claim to have ‘muscle knots’. These are referred to as trigger points… but what is that?
A myofascial trigger point is a hyperirritable spot in skeletal muscle, associated with a hypersensitive, palpable nodule in a taut band. This spot is painful upon compression and may give rise to characteristic referred pain, tenderness, and motor dysfunction.
What Causes These Trigger Points?
Different Types of Trigger Points
There are many different forms of trigger points that can be experienced in different ways, including:
Active: A hyperirritable spot in the muscle that is symptomatic with respect to pain. It is responsible for a referred pattern of pain at rest and/or in motion that is specific to the muscle.
Latent: A hyperirritable spot that is clinically dormant/inactive in the muscle that only becomes painful upon touch.
Key: A trigger point that is responsible for activating one or more satellite trigger points. When this is deactivated, it also deactivates satellite trigger points.
Satellite: A central trigger point that is neurogenically or mechanically induced by the activity of a key trigger point. It is resolved once its key trigger point has been resolved.
Primary: A central trigger point activated directly by acute or chronic overload, or repetitive overuse of the muscle in which it occurs.
Secondary: A trigger point that can be activated by a primary trigger point, but cannot activate a primary trigger point. Unlike satellite trigger points, these aren’t resolved by treatment of primary trigger points.
Treatment of Trigger Points
There are numerous ways that trigger points can be treated through massage. Some methods that might be utilised include:
- Range of motion assessment – looking for changes in ROM, altered motor recruitment, painful movement, weaknesses or imbalance.
- Ischaemic compression – The application of painful pressure on a trigger point, which becomes progressively stronger for the purpose of alleviating tenderness and hyperirritability of the trigger point. The pressure blanches compressed tissues, usually becoming hyperaemic after pressure is released.
- Pincer palpation – the use of the fingers and thumb to hold an area in a pincer-like grasp. Trigger points are located by rolling groups of muscle fibres between the fingertips, eliciting a local twitch response.
- Manual dry needling – This method used thin filament needles for the purpose of deactivating trigger points. In some cases, this will elicit local twitch response, using methods such as fishing or a direct, static technique.
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