Understanding Trigger Points and their Role in Myotherapy

The human body is a complex network of muscles, tendons, and nerves, often susceptible to various forms of discomfort and pain. Among the many contributing factors to such discomfort, trigger points play a significant role, often being key focal points in Myotherapy, a form of therapy that aims to alleviate muscular pain and dysfunction.

What are Trigger Points

In the 1940s and 1950s Dr Travell, a Cardiologist and White House Physician worked with Dr Simons, a Research Scientist began researching myofascial pain and found that Trigger points were a key component. Travell and Simons observed that some patients with chronic pain conditions had areas of tenderness and tension in their muscles that seemed to be distinct from other types of pain. They coined the term “myofascial trigger point” to describe these areas of muscle tension and tenderness that could refer pain to other parts of the body.

Trigger points are hyper-irritable spots located in taut bands of skeletal muscles. Thought to arise from an excess release of acetyl choline and calcium produced during a muscle contraction, a metabolic storm gives rise to these spots characterised by the presence of palpable nodules or knots within the muscle fibres. The elevated levels of many of the substances present such as IL-6 and IL-8 near active trigger points are consistent with biochemical pathways involved in tissue injury and inflammation (1992, p. 19).

Trigger points can be localised, causing tenderness in one specific spot and can also display a pain referral pattern where pain can radiate toward another part of the body. For eg. Triggers points in the Infraspinatus muscle in the rotator can be felt both in the direct site of the shoulder blade and potentially radiate down the back of the arm into the hand down into the fingers (pictured below).

Role in Myotherapy

In Myotherapy, understanding and addressing trigger points is crucial. Myotherapy focuses on the assessment, treatment, and rehabilitation of musculoskeletal pain and associated conditions. Trigger points are commonly identified during a Myotherapy session through careful palpation and observation of the patient’s symptoms.

Myotherapist’s employ various techniques to address trigger points and their associated pain. These may include:

• Trigger Point Therapy: Applying sustained pressure to the trigger point to release tension and encourage muscle relaxation. The sense of relief is often immediate and can be quite powerful when a trigger point is released.
• Dry Needling: Inserting thin needles into the trigger point to stimulate the muscle, improve blood flow, and release tension.
• Stretching and Exercise: Prescribing specific stretches and exercises to alleviate trigger point-related discomfort and prevent recurrence.

Managing Trigger Points

Managing trigger points involves a comprehensive approach that goes beyond merely treating the symptoms. Lifestyle modifications, corrective exercises, stress management, ergonomic improvements, and regular physical activity are essential aspects of managing trigger points effectively.

Moreover, identifying and addressing the underlying causes contributing to the development of trigger points is relevant. Factors such as poor posture, overuse of muscles, stress, and inadequate rest can contribute to the formation and persistence of trigger points.

Conclusion