Understanding the Terminology…
If you have ever been to a Chiropractor or a Physiotherapist, you have probably heard the term “Trigger Point”. Trigger Points (TP’s) are extremely common, and are likely to affect everyone at some stage in their life. Latent TrP’s cause stiffness and decreased range of motion, while Active TP’s have the added bonus of being pain producing too! These nasty points are described as “local areas of muscle dysfunction” or “hyper-irritable spots in taut bands of muscle fibers”. They can usually be felt easily as knots or ropy bands in the muscles as you move your flat fingers along the area of pain and tension. One of the most common areas for TP’s is along the Upper Trapezius muscles. This muscle forms the border between the bottom of your neck and the tip of your shoulder, if you have ever reached up to feel a nice big knot in this area, chances are you have had your very own hand right on top of one of these horrible fellows!
Features of a Trigger Point
Trigger Points have a few characteristic features that make them easy to find and diagnose:
1. They feel like a knot or a taut band in your muscle.
2. Pressure on the spot reproduces your pain or causes referred pain to another area.
3. Pressure on, or Needling into the TP may cause twitching of the muscle.
4. The TP may cause limited range of motion of the affected muscle along with some mild weakness.
Why do we get them?
There are various direct and indirect factors that can lead to the development of TP’s.
Direct causes include:
1. Overuse-fatigue or repetitive strain from movements repeated hundreds of times on a daily basis. Examples of such repetitive movements include typing, using a mouse, gardening, driving, using handheld electronics and baking.
2. Overloading or sustained loading of muscles. This can occur through lifting heavy objects, carrying a baby or carrying heavy groceries.
3. Holding muscles in a shortened or lengthened position for a prolonged period as occurs with habitually poor posture, or as may occur in sitting for many hours or when sleeping.
4. Direct trauma to the muscles through trips, falls, sports injuries and accidents.
5. Nerve injury or pathology such as a pinched nerve from a disc herniation, or peripheral neuropathy from Diabetes.
6. Prolonged contraction of a muscle from exposure to cold temperatures or a direct draft from an aircon.
A few of the more indirect causes of TP activation include prolonged tensing of muscles due to emotional stress and abnormal use of muscles due to the affects of arthritis and various diseases and illnesses. Furthermore, as muscles work in groups to perform specific actions, an active TP in one muscle may cause a latent TP in one or more of it’s synergistic counterparts, which can then become active over time.
Pulling the Trigger on Trigger Points
There are many different treatment approaches that attempt to eliminate TP’s, however the most important part of treatment is to find and eliminate the cause and perpetuating factors. Often this means that you will need to commit to certain lifestyle changes in order to prevent TP’s re-occuring. These changes may be as small as changing your hand position on the steering wheel when driving, or as big as adapting to a sit-stand work station. Stretching, strengthening, and avoiding overload is the name of the game! If examination shows that certain muscles are shortened and tight, you will likely be sent home with stretches to correct the muscle length. Likewise if examination shows abnormally long or weak muscles, you will probably be sent home with exercises to strengthen and shorten the affected muscles.
Don’t let Trigger Points plague you with pain, stiffness and restriction! Become an active participant in the health of your muscles and learn how to recognise, treat and prevent them so you can enjoy healthy, pain-free movement!