What are Trigger Points?
Have a tight knot in your shoulder? It’s likely a trigger point!
Myofascial trigger points are defined as hyperirritable areas in a skeletal muscle and the surrounding fascia, characterized by a tender nodule (knot) or taut band of tissue that can produce referred pain.
Trigger points can develop due to overuse of a muscle, chronic over-lengthening of a muscle, chronic over-shortening of a muscle, or stagnation of a muscle/area of the body. Trigger points can develop in almost every skeletal muscle of the body, and typically produce a pain referral pattern when active* or when palpated. These pain referral patterns are typically predictable, and also idiopathic. This means that we don’t yet have a concrete explanation as to why these pain referral patterns occur (especially in the predictable way the pain presents) even though we can track very similar referral patterns amongst different people. Some trigger point pain patterns are only experienced within the boundary of the muscle in question, however some muscles have a trigger point pain pattern that refers outside of the boundary of the muscle and to a different area of the body altogether.
*Trigger points can be classified as Active (ATrP) or Latent (LTrP).
Active vs Latent Trigger Points
Active Trigger Points (ATrPs): Active trigger points elicit referred pain and tenderness constantly, even when resting (i.e. in the case of a tension headache, this is typically the result of an active trigger point).
Latent Trigger Points (LTrPs): Latent trigger points elicit referred pain only upon manual palpation, contraction of the muscle, or applied pressure via a therapy ball.
Pictured to the left is the trigger point referral pattern of the upper trapezius (muscle). The X marks the typical location of a trigger point that can be found in this muscle. The upper trapezius commonly develops trigger points due to poor postural habits and chronic over-shortening of this muscle. The upper trapezius is also a muscle that is commonly associated with stress and the stress response, hence why it presents as short and tight in many people.
Trigger Point Referral Explained
Trigger point pain referral typically presents as a painful dull ache sensation. Active trigger points can also produce symptoms other than pain — for example, an active trigger point in the the sternocleidomastoid muscle in the neck (clavicular head pictured to the right) can present as ringing/pressure in the ears, or even difficulties with swallowing. Every skeletal muscle of the body has a unique trigger point referral and associated symptoms.
Upon applying pressure to an active OR latent trigger point, the local area may produce a muscle twitch response (fasciculation). The local area will also be tender to the touch, and the pain referral pattern will be experienced (or heightened) under palpation
How to address trigger points in your body
Trigger points can be addressed using self massage techniques, via your own hands or using self-myofascial release balls (link at end of post). A great technique to release a trigger point is an ischemic compression. This involves locating a trigger point, knowing that the pain referral pattern may be experienced once located, and applying sustained pressure to the area (via your hands or a massage ball) to 30 seconds up to 2 minutes, or until you feel the tissues soften and the referred pain dissipate. Another option is to seek out the help of a healthcare professional that offers hands-on manual treatment, such as a Physiotherapist, RMT, or Chiropractor. *Please note that the advice is this blog is not a substitute for medical advice or treatment, and it is always recommended that you seek out professional care if you are experiencing pain or discomfort in your body.
Suboccipital (Neck) Self Release
Below is a 7min video guiding you through a self-massage release for the neck using massage balls! This practice will help to reduce headaches, neck pain, and eye fatigue, as the technique used in the video addresses the suboccipital muscles which have a trigger point referral pattern to the area of the forehead, temples, and behind the eyes. Try it out!
What type of balls should be used for self myofascial release?
A rubber ball should be used for self myofascial release practices. The two types of rubber balls that are recommended are either the High-Bounce Pinky Ball that can be found on Amazon HERE, or Tune Up Fitness Balls which are available for purchase from the HealthyHips Prop Shop — see Add To Cart link below.
