Trigger Point Clues – how they form and what to do about them.

A trigger point is a tight area found in certain muscles that cause pain when pressure is applied directly on it. Some trigger points are small, and feel like a pea, some are larger and feel like a section of a marble. Understanding them is absolutely crucial for anyone who is committed to helping people recover from muscle injury.

Finding a trigger point is one thing; however there are two levels that one needs to get to after that.  
1) Understanding how to release the point.
2) Working out how it got there in the first place.

How did the trigger point get there?
– Any muscle that works too hard will be prone to trigger points. This is really important for us in that we deal with a number of athletes who over time can place immense strain on their bodies.
– Overexertion.
The most obvious example here, is of someone bending over to pick up something heavy, and suddenly their lower back starts to hurt. What has happened is that the muscle was simply not up to the task at hand. Trigger points will develop  in unconditioned muscles. People involved in physical exercise will often develop trigger points when they take up their new sport. People also at risk are those who have taken a break from exercise due to illness etc. Muscles that used to be strong and conditioned weaken over time and thus injure more easily.
If you are starting an exercise program, don’t give up. Your start might be a bit shaky, but your muscles will adapt. Your patience and consistency will be rewarded.
– Overuse of a muscle.
Any muscular activity repeated day after day can cause muscle overload. This can occur from both work place and sport activity. Again, the muscle’s functional endurance is exceeded by the task at hand. The trigger point will often go together with a tendinitis. However, the tendinitis will often be helped by releasing a trigger point found on its muscle.
– Bio-mechanical imbalance.
The human body is an amazing piece of engineering. Should a robot malfunction it simply becomes useless. However the human body is able to create new patterns of movement to compensate for a specific point of failure.
Each muscle also has an antagonist. Your bicep pulls your hand upward, your triceps, the antagonist, pulls the hand back down.
Injure a primary muscle, and muscles not perfectly suited to the task have to take over. Any muscle not perfectly angled for the task at hand will need to work a lot harder and hence be far more prone to trigger points. Also, any time you have an antagonist muscle tighten, that muscle will put strain on its counterpart and will run the risk of it developing a trigger point. Trigger points thus give out a wealth of information as to what the body is going through.
– Postural Overload.
Sit in front of a computer too long with your shoulders and neck rolled  forward , and muscles around the shoulders will form trigger points. Muscles are designed to work and then rest. When you leave them in a stretched/tense mode they never get a break and tiredness sets in quickly.
Postural overload can also occur when you change the way you move due to a painful muscle. People with painful backs will often lean forward to reduce pain. A catch 22 situation arises, where by protecting one muscle by changing  your posture, you place other muscles under strain. One muscle is kept in an elongated position, while another muscle is kept in a shortened position.
– Muscle trauma.
Physical trauma to a muscle can bring trigger points on.  

Things that will make you more prone to trigger points:
– Muscle tension.
General muscle tension will make you more prone. It is critical to stretch and foam roll from time to time.
– Emotional stress.
Emotional stress can create significant amounts of tension in the neck, shoulder and abdominal muscles.
– Over cooling a muscle.
Sitting or sleeping near a fan can tighten a muscle that will then tense in order to keep warm and so form trigger points.
– Nutritional issues.
Look out for lack in Vitamins B1, B6, B12, folic acid and  Vit C. Also, lack in magnesium, calcium, potassium and iron can cause trigger points.
– Viral and Bacterial infections.
Sinusitis, dental abscesses, urinary tract infections, the flu etc can also cause trigger points.

In summary, the formation of trigger points is a complex issue. Any therapist will have two challenges:
1. Releasing them. Modalities include trigger point release, dry needling, percussion instruments and kinesio tape.
2. Working out what factors cause them and thus helping the person not form more.

Regards,

Mike Roscoe.
Kinesiologist.