Trigger Point Therapy Explained
Trigger point therapy is a type of therapeutic hands-on treatment that focuses on releasing “trigger points” in the body. A Trigger point or a Myofascial Trigger Point (MTP) is a hyper-irritable spot, usually a palpable nodule in a taut band of the skeletal muscle’s fascia.
Trigger points are behind the most common source of musculoskeletal pain, myofascial pain syndrome (MPS), which occurrence is related to excessive involuntary muscle contraction and is characterised by hardened regions as a result of an accumulation of Myofascial Trigger Points. Considering that this is something that affects a high number of individuals, that can cause functional impairment and compromise the quality of life it is important to have an accessible system in place to address it.
Trigger points commonly called knots can be active or latent. Active Trigger points cause pain and other symptoms, either locally around the area where they’re located or referred pain over a larger area or somewhere else in the body far from their location area. Latent Trigger points are not actively causing pain or other symptoms but can become active at any time so they are equally treated and released by the skilful therapist.
Trigger Point therapy is commonly used for the treatment of chronic pain conditions as well as other more acute clinical conditions. It’s also used by athletes and those who engage in regular physical activity to alleviate muscle tension and promote recovery.
Very often unfortunately misdiagnosed with more severe conditions with a prognosis involving surgical intervention, the role of the hands-on therapist in identifying and releasing MTP presentations can be life changing for people experiencing these conditions. Unfortunately the lack of knowledge within qualified health professionals about Trigger Points presentations and about local hands-on therapists specialised in releasing them usually results in patients being left at the mercy when presenting with these conditions, sent through a long process of referrals that leads nowhere or that too often results in unnecessary invasive treatment that doesn’t correct the issue or creates complications further down the line.
Some of the most common conditions successfully treated with Trigger Point therapy
- Neck and shoulders pain
- Lower back pain
- Headaches/migraines
- TMJD symptoms (like tinnitus, jaw pain, migraines or clenching…)
- Frozen shoulder and other rotator cuff presentations
- Pain down the arm
- Sciatica
- Pain down the leg
- Carpal tunnel symptoms
- Repetitive strain
- Groin pain
Causes of Myofascial Trigger Points
Trigger points can be caused by different factors. These include:
- Muscle overuse
- Physical trauma
- Poor posture
- Stress
- Emotional trauma
- A sedentary lifestyle
- Lack of exercise
- Poor diet
- Dehydration
Important to note that out of all the possible causes, stress or emotional trauma impact the Myofascial system most drastically.
How do these causes translate into a knot in a muscle
The myofascial tissue, with more nerve endings than the skin itself is an extremely sensitive organ.
The Myofascial tissue responds to both pressure changes and chemical changes within the body incredibly adaptable to both and ready to provide for our demands day to day.
EXAMPLE OF PRESSURE CHANGES IN THE MYOFASCIAL TISSUE
A repeated postural pattern is a great example. Here we’re loading the tissues in a repetitive manner over long periods of time. Imagine an office worker sitting over long periods of time to make it simple. This repeated change in pressure triggers a long term change in the Myofascial tissue that responds and adapts to these demands. In case of an office worker these usually mean shortening of the front and lateral myofascial lines, which results in the so common kyphotic (hunched over) and forward head posture. Trigger Points develop directly as a result of this pattern.
EXAMPLE OF CHEMICAL CHANGES IN THE MYOFASCIAL TISSIE
We’ve mentioned that the Myofascial tissue responds to chemical changes as well. These being changes in the composition of the extracellular matrix as a result of different causes, one of the most important ones being Stress.
Stress causes an enzymatic reaction in our brain, that releases fight or flight hormones. Stress hormones are useful in situations of emergency but become toxic for our body when sustained over a long period of time, which is what happens in the case of stress.
The Myofascial tissue becomes irritated and Myofascial trigger points develop as a result.
What happens during a Trigger point therapy session with us
During a trigger point therapy session, your therapist will ask you simple questions about your lifestyle and previous medical history and proceed with quick postural assessment and orthopaedic assessment when needed before getting you in the massage couch.
During the hands-on treatment the therapist uses a variety of techniques to locate and release Myofascial trigger points and the Myofascial tissue. These vary depending on condition, age, history, desired outcome, etc.
In our clinic our therapist is trained in clinical massage to the highest qualification available in Europe, simultaneously we believe the best outcome is obtained with a combination of the best techniques from different disciplines of hands-on treatment, therefore our therapist uses a mixture of advanced techniques.
These include Myofascial release techniques, Trigger Point work and sports massage combined with Eastern techniques like Acupressure or Amma fusion between others as well as STR, or AIS stretching techniques.
Our treatments are slow flow with little ointment (usually massage wax rather than massage oil) the therapists will gently apply pressure and tune into the Myofascial tissue and slowly work their way through the restrictions and Trigger points, giving enough time for the Myofascial tissue to release. The therapist might also use their fingers, knuckles, or special tools to apply and hold pressure to the trigger points.
Benefits of Trigger point therapy
The treatment feels relaxing yet effective and deeply healing. This is because the Myofascial tissue is deeply connected with our nervous system and releasing one usually calms the other. under the hands of a skilful therapist. Trigger Point therapy especially when used in combination with the previously mentioned techniques can therefore have mental health benefits if done correctly. It can result in improved sleep, of course reduced stress levels, and an overall improvement in general well-being and mood.
Pain relief, once the Trigger points responsible for the pain are released the pain subsides as well.
Increased flexibility and increased muscle functionality.
Improved blood flow, which can aid and speed up recovery and healing processes.
Reduce muscle stiffness and increased range of motion, allowing for better movement and coordination or improved biomechanics.
Regular sessions can prevent musculoskeletal chronic pain from reoccurring.
What happens after the session
After the session, clients typically experience immediate pain relief, increased range of motion and flexibility. Some people mentions that they feel taller.
The Myofascial tissue usually takes between 2-3 days to settle down after the treatment session and it can occasionally feel irritated with symptoms worsening the day after the treatment (especially after the first treatment), although this is not always the case. After these adaptation phase the Myofascial tissue settles down and the symptoms tend to improve in relation to prior to treatment.
You might feel thirsty and will be encouraged to drink plenty of water and avoid alcohol or sugary drinks. We also recommend that you avoid going back to work on the same day when possible although this is not a requisite and not always possible.
To finish, I want to mention that even though really effective, this treatment method is by no means magic, when dealing with Myofascial presentations that have taken years to develop it is normal that they take a little bit of time to release as well. Trusting the process and the professional therapist is essential to get the most out of the treatment as well as committing to a block of sessions before giving up on it.
I hope you found this article helpful and if you are experiencing Myofascial pain or any of the above conditions we’ll be happy to help.
References:
Pathophysiology of myofascial trigger points: a review of literature L. J. Holanda 1*; A. H. S. Fernandes 1, A. C. A. Cabral 1, F. F. U. Santos-Júnior 2, International Journal of Basic and Applied Sciences, 4 (1) (2015) 73-77
Massage Fusion: The Jing Method for the Treatment of Chronic Pain, Meghan Mari and Rachel Fairweather, 2015
About the author
Rocio Santiago
MA in Nursing, Dip. Soft Tissue Therapy
Ro initially began her career as a nurse. Following this and after a difficult time in her life that resulted in a career change, Ro went on to train at one of the leading soft tissue therapy schools in Europe, completing a 3 year degree level course and specialising in effective soft tissue manipulation for the treatment of musculoskeletal pain.
The treatment method Ro uses consists of a combined approach using different specialised techniques, myofascial release and trigger point work among others, with the intention and focus on providing effective results in the least possible amount of time.
Combining her training, science background and life experience, her treatment method is based in science and built using a whole body approach, where mind and body are addressed as one.
Ro has been seeing clients as a soft tissue therapist for 8 years, successfully treating a wide range of conditions.