Trigger Points are what many of us think of as “knots” the swollen achy cables of muscle that produce pain.
Trigger Points are what many of us think of as “knots” the swollen achy cables of muscle that produce pain. Healthy muscle tissue is pliable and soft and underlying bony structures can be easily felt. A dysfunctional muscle by contrast has remained shortened and with time becomes ropy and tough to palpate, underlying bones may be difficult to distinguish. Within the hardest nodules of muscle may be found hypersensitive points that, when pressure is applied, may produce a “jump response” and referred pain.
In the 1980’s doctor Janet Travell began identifying common myofscial pain phenomena and discovered that across numerous individuals shared patterns could be distinguished. Trigger Points as she coined the term, were found to develop in common places within the musculature and furthermore produced shared pain referral patterns. Her work led to the development of two extensive volumes documenting symptomology not just of pain but also phenomenon due to the interruption of related visceral function causing such problems as indigestion, heart palpitations, shortness of breath, abdominal cramping, and nausea. This was revolutionary work at that time and has led to the widespread acceptance of the notion that pain syndromes result from muscular dysfunction.
Of great value to the massage practitioner familiar with Travell’s work is the diagrams depicting the locations of common trigger points and their referral pattern. Many trigger points are latent, existing in the tissue but below our awareness on a conscious level. A trigger point is said to have become “active” when it produces phenomenon that we are consciously aware of. Where we experience pain is a clue by which the practitioner familiar with trigger point referral patterns can guess the source. Usually where we experience the pain is not exactly where the dysfunction is, which is why rubbing at sore achy muscles often seems to not relieve the pain.
Headaches are a classic example of trigger point referral. You want to rub your head but the source of the pain is a trigger point in the neck or shoulder. Where you experience the headache, behind the eyes or in the temple or across the forehead, suggest at the likely location of the trigger point. With some careful palpation we may be able to discover and exquisitely painful band of tissue that momentarily intensifies the complaint before it releases.
We are all familiar with the ache in the back of the shoulders after long hours on the computer. The pain may seem to encompass the entirely of the upper back. However, generally it’s just a few hyperirritable points that cause all of the discomfort.
Lower back pain is often not treated effectively by massage practitioners because they only work on the back. Some of the most common trigger points that produce lower or mid-back pain in those whose occupations require them to sit for long periods of time are located in abdominal musculature. Trigger Points here have been demonstrated to provoke or aggravate indigestion. They may play a large role in irritable bowel syndrome, heartburn, and produce lower back pain when standing from a seated position. Our approach to Seattle Trigger Point Therapy is holistic. Contact us today to experience the care and mindfulness we instill in with every treatment.
Having knowledge about Trigger Points is handy in taking a patient out of pain. Mostly we use the client’s complaint as a clue about where to work and then use slow careful palpation to locate the source. This isn’t so much the long stroke of more commonly familiar massage techniques, but much more specific and “to the point”. The common technique is to find the point, apply gradual pressure so that it produces referral pain within the tolerance of the client and wait for the twitch response or melting sensation that tells you the point has released. In practice we all work intuitively.
Trigger Points can be painful, sometimes the aforementioned technique seems appropriate but often gentle slackening of the affected nerves will provoke the positive feedback we are looking for without a lot of discomfort. "No pain No gain" does not apply to massage.
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