One of the many factors that may contribute to the pain and dysfunction of a muscle is the development of trigger points within it.?A trigger point is a hyperirritable nodule within a taut band of skeletal muscle or its associated fascia.?A trigger point is painful on compression and can produce referred pain, tenderness, a local twitch response and autonomic phenomena, such as visual disturbances, redness and tearing of the eyes
Trigger points can be active or latent. An active trigger point causes pain at rest and refers pain away from the affected muscle to another area of the body in a distinct and predictable pain pattern. For example, a trigger point in the neck can manifest as a headache, a trigger point in the back may refer pain in the neck, or a trigger point in the gluteal muscles can refer pain down the leg or low back pain. This referred pain is an important characteristic of an active trigger point. A latent trigger point does not cause pain at rest.
Trigger point pain is generally poorly localised, and characterised as persistent, deep, dull, and aching. On rare occasions it may be burning, tingly, or numb. Pain varies in intensity from a mild ache to excruciating pain resulting in decreased range of motion in the affected muscles.
Trigger points can develop within any muscle of the body but muscles with greater postural demand tend to harbor trigger points more frequently.
Causes of trigger points are many and varied. The formation of trigger points can be in response to:
- acute trauma or repetitive microtrauma
- prolonged poor posture
- poor work ergonomic leading to muscle overuse
- poor biomechanics
- muscle fatigue from repetitive movement
- muscle weakness
- muscle imbalance
- physical training errors/ inadequate preparation
- inappropriate shoes/equipment
- nutritional insufficiencies
- impaired sleep
- Inactivating the trigger point: Once the trigger point is located ischemic compression is applied and then released, which stimulates the nervous system and encourages blood flow to the area, removing toxins and supplying necessary nutrients. Direct and sustained pressure is applied for a period of time lasting up to 30 seconds.
- Ischemic compression is followed by manipulation of the surrounding muscles to reduce local tensions and taut muscular bands. Both ischemic compression and manipulation encourages releasing of energising endorphins.
- Lengthening the taut band: Passively stretching the affected muscle once the trigger points are inactivated facilitates its return to a normal resting length and improve its range of motion.
- Keeping the muscle warm: Heat pack is often used to relax the surrounding muscles and help reduce tension in a trigger point.
- Eliminating perpetuating factors: Trigger point massage is a mean of pain management. Predisposing and perpetuating factors should be identified and eliminated where possible to prevent redevelopment of trigger point.
