What is a Trigger Point?

The definitive text on the subject of trigger points is, Myofascial Pain and Dysfunction; The Trigger Point Manual, by Janet Travell and David Simons. Clair Davies, in his book The Trigger Point Therapy Workbook, simplifies the language of Travell and Simons work. He writes:

“Travell and Simons describe a trigger point as simply a small contraction knot in muscle tissue. It often feels like a partly cooked piece of macaroni, or like a pea buried deep in the muscle. A trigger point affects a muscle by keeping it tight and weak. At the same turn, these taut bands of muscle fiber keep constant tension on the muscle’s attachments, often producing symptoms in adjacent joints. The contant tension in the fibers of the trigger point itself restricts circulation in its immediate area. The resulting accumulation of the by-products of metabolism, as well as deprivation of the oxygen and nutrients needed, can perpetuate trigger points for months or even years unless some intervention occurs.” (pg 3)

So are trigger points the knots we all feel in our muscles from time to time? The answer can be yes and no. (Nothing in life is simple is it?) The other key factor in defining trigger points is referred pain.This is the single factor that makes trigger points hard to treat. A trigger point in one muscle refers pain to another part of the body.

A common trigger point is in the anterior scalene muscles. These muscles are located in the front on the neck and go under your collar bone and attach to your upper ribs. The pain shows up just below the scapula (shoulder blade) on your back. The pain is hard to pinpoint and many therapists are asked to work the client’s back around the mid back. (For most women this is the area that is covered by the back of the bra.) No amount of working this area will fix the problem because the culprit is in the front of the neck. The client goes away unsatisfied because the back is still sore. The key is to work the scalene muscles and relieve the offending trigger point.

The other complicating factor in treating trigger points is they rarely occur alone. Over time the muscle tightness ends up causing other trigger points in supporting muscles. This gives a confusing and often complicated pain map. Often a general massage will release enough tension to give a better indication of what trigger points still need to be treated.

I will add more information about trigger points in the near future.

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