Trigger points

What are they?

Trigger Points (TP’s) also called Myofascial Trigger Points are small areas of contracted muscle involving a group of myofibrils. This group forms a taut palpable band within the muscle which is characteristically only a few millimeters wide. They vary in depth from the very surface to the innermost depth of the muscle belly. There are two types of Trigger points LATENT and ACTIVE. Latent TP’s can be viewed as potential troublemakers and exist in almost every individual. Active TP’s are a nastier form altogether and are the cause of radiating pain, even the cause of headaches. NMT techniques manually deactivate TP’s. Dry Needling is another form of treatment which is extremely efficient. Dry Needling is the use of acupuncture needles to eliminate local and referred pain.

Characteristics of Trigger points

  • 1. PAIN ON COMPRESSION OF THE TP
  • 2. PAIN UPON CONTRACTION
  • 3. PAINFUL LIMIT TO FULL LENGTHENING DURING RANGE OF MOVEMENT
  • 4. PRODUCE SHORTENING OF THE HOST MUSCLE
  • 5. MUSCULAR WEAKNESS
  • 6. CAN REFER PAIN AND AUTONOMIC PHENOMENA

Travell & Simons (1983) have described the trigger point as follows:

In the core of the trigger lies a muscle spindle that is in trouble for some reason. Visualise a spindle like a strand of yarn in a knitted sweater ... a metabolic crisis takes place which increases the temperature locally in the trigger point, shortens a minute part of the muscle (sarcomere) - like a snag in a sweater, and reduces the supply of oxygen and nutrients into the trigger point. During this disturbed episode an influx of calcium occurs and the muscle spindle does not have enough energy to pump the calcium outside the cell where it belongs. Thus a vicious cycle is maintained and the muscle spindle can't seem to loosen up and the affected muscle can't relax.

Causes of Trigger points

  • Injury, sustained from accident/ or fall
  • Poor posture
  • Over-exertion
  • Inactivity
  • Poor respiration
  • Physical stress/tension
  • Nutritional imbalances

Dry needling

Needling of TP’s is a modern technique using acupuncture needles. If manual therapy is not releasing the taut bands the use of an acupuncture needle directly on to the trigger point can have instant results. Inactivation of a TP can rapidly eliminate pain and relax the taut band. The muscle will then improve and respond well to stretching and other therapeutic approaches, such as physical therapy. I also use dry needling for the treatment of joints, ligaments and tendons. For example tennis elbow, frozen shoulder and sprained ankles.