Trigger points – what are they, and why do they matter to us at C1?

Luke Norland, one of our excellent sports massage therapists talks about trigger points:

“The dictionary definition of a trigger point is:

A sensitive area of the body, stimulation or irritation of which causes a specific effect in another part, especially a tender area in a muscle which causes generalized musculoskeletal pain when overstimulated.

This is sort of right but lacks some detail, which is important.  What you’ll find when you prod and poke are “muscle knots”.  However, as you know, there are no actual knots involved.  What you are feeling are these tender areas called myofascial trigger points

Myofascial Trigger PointsTrigger point in shoulder

These myofascial trigger points are often just called trigger points (TrP).  They have been know about for years but even still their true nature is uncertain.  The main theory is that a TrP is a small patch of tightly contracted muscle in a larger patch of muscle tissue.  So, this is not a whole-muscle spasm similar to a cramp in your calf.  This hypercontracted muscle compresses the capillaries that run through the muscle and this reduces blood supply.  At the same time, this contraction requires fuel (ATP) to burn. This then releases toxic chemical by-products of metbolism in to the bloodstream for removal.  The compression prevents the blood flowing and leads to a localised area of ischemic poisoning.  This can, in turn, irritate the muscle fibre even more making it contract even more, releasing more by-products — a vicious cycle called a “metabolic crisis.”

Individual TrPs can cause a shocking amount of discomfort.  Far more than most people believe is possible.  They can also have some surprising side effects.  They often produce intense referred pain.  And this is why they are of interest.  This referred pain is often distant from the TrP.  However, TrP’s bark is far louder than their bite and they are not really significant in clinical terms. (This is explained in some detail in this article).

How do they occur?

Travell and Simons, the world gurus on this wrote:

Prolonged immobility is a potent source of aggravation of TrPs.  Since the position of the right foot is fixed on the accelerator when one drives a car, the right hip muscles are effectively immobilized unless a special effort is made to reposition the thigh and hip…..


Gluteus minimus and gluteus medius muscles are relatively immobilizes during prolonged standing, as when waiting in line or when standing at a cocktail party.

So, you sitting at work, only ever getting up to get a coffee, is a great way to aggravate a TrP.  This can cause some spectacular low-back and leg pain.”

We have talked about this a fair bit and if you want to know more have a look here about arm TrPs.  The solution: come and see one of the excellent Sports massage therapists here at C1 and get some deep tissue massage work done and some guided stretches.


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