First of all a disclaimer:
A Trigger Point, sometimes also called a myofascial trigger point, is a made up concept that as of yet does NOT have consistent, and unanimous support as being an actual “thing” across the medical and fitness fields. Way back in 1942, Dr. Janet Travell came up with the term “trigger point” to describe some of her clinical findings, but even to this day, health, wellness and medical practitioners do NOT agree on the specifics of what constitutes a trigger point.
Wait a second.
Why am I writing an article about something that even the scientists who do research on this kind of stuff can’t agree is what it is claimed to be? Well, as much as I live and die by the sword of the scientific method, just because there isn’t a consensus about these things that we so fondly call knots or trigger points, doesn’t mean they don’t exist. As someone who has in the past experienced and will probably continue to experience the effects of trigger points both personally as well as with my clients, I would be remiss if I didn’t take some time to speak to the questions I have been asked over and over about this concept. So, what the heck are these painful knots that you sometimes feel in various muscles on your body?
Funny you should ask.
A trigger point is a tender, sometimes swollen or “lumpy” section of a muscle that is involuntarily contracted more than the surrounding tissue. Think of it like a little tiny Charlie Horse that affects just a small localized part of a muscle. They can occur in pretty much any skeletal muscle and when that small patch of muscle is in a spasm, or knotted up, it just plain sucks! One of these trigger points can be painful to the touch right where the muscle spasm is located or it can even affect the nerves around it in such a way as to refer pain to another seemingly unrelated part of the body. This means that sometimes you can have pain in the front of your shoulder, but the actual issue (trigger point) could be located on your back somewhere. Weird, right?
Trigger points are pretty nasty little suckers, as they are responsible for:
- Causing pain – At some point or another in your life, you too will experience one of these little muscle spasms and they do NOT feel good.
- Complicating pain problems – A trigger point can make an already uncomfortable situation (ie: A strained muscle from a fall) even worse by referring pain elsewhere.
- Mimicking other pain problems – Sometimes repetitive stress injuries like shin splints, can be misdiagnosed when the cause of the pain in the lower leg is in fact due to an aggravated trigger point issue.
What a pain! (See what I did there?)
So, these stupid trigger points are basically “angry” little bits of muscle that are causing you to be in pain and/or not be able to move around in the world the way you would like to, so what do we do about them? Well, this is a great question, so let me first tell you why you won’t get a straight answer from the “usual suspects”; doctors, physical therapists and chiropractors.
David Simons, in the forward of The Trigger Point Therapy Workbook said,
“Muscle is an orphan organ. No medical speciality claims it.”
While there are doctors who specialize in bones, joints, bursae and nerves, you won’t find many (if any at all) that have in depth knowledge about the largest organ in the body: muscle. Doctors in pain clinics tend to be a little more informed about trigger points, but they also tend to treat the symptom (pain) and not directly address the trigger points themselves. Physical therapists and chiropractors typically address joint function, biomechanics and the alignment of your parts in space. While improvements in movement and posture are all fine and dandy, maybe we should look to the commonplace massage therapist for a clue on how to fix what ails us.
Massage therapists, whether due to incredible anatomical knowledge, and/or through extensive hands on training (see what I did there too?), have managed to squeeze, compress, pinch, elbow, poke and prod their ways into our hearts by decreasing and/or eliminating those terrible muscle knots and putting us at ease. If you have experienced what I am talking about, you know that the hands (and elbows) of a good massage therapist can bring immense pain relief as well as improved mobility, both of which are well worth the money spent. How does all of this manual manipulation help to reduce the effects of trigger points? Another great question!
Myotherapy is the term used to describe the manual manipulation of the soft tissues (skin, fascia and muscle) in order to release the small patches of muscle that are spasming and causing the trigger points you are experiencing. Gently applying direct pressure to the trigger point with the hands, a fist or an elbow, decreases the neural load on that portion of the muscle and relaxes it so that it is less tender and more pliable. The exact mechanics of what occurs inside the body are highly debated and as of yet, unknown, but the results are undeniable. Applying pressure, gently moving the skin and/or fascia as well as manipulating the underlying muscle tissue in a controlled, methodical manner has shown time and time again to decrease pain, increase mobility and help improve quality of life. Exactly what you are looking for!
This sure does sound like a great advertisement for massage therapy, but the reality is most of us cannot afford to get a massage every time we have a crick in our neck, so if you would like to be able to take care of these irritating pains in the neck by yourself, you are going to want to pick up a myotherapy tool like a foam roller to help you get the job done. I have written about using foam rollers before, so make sure to check out my article on how best to use these great tools.
I personally use the Grid X Foam Roller because I like the extra firm surface it has (I am a big tough guy, or at least I think I am), as well as it fits right into my luggage when I am traveling. A foam roller is a great tool that can be used to apply pressure on varying parts of the body where you have an overactive muscle (trigger point) to help eliminate that pain and immobility that comes with these issues.
If you have small muscles that need a little extra attention, you might want to consider using a lacrosse ball (I play lacrosse, so I have some extra balls laying around the house) or a specialized tool like the TP Massage Ball. I like using these on my forearms and even my rhomboids on my middle back near my shoulder blades, as the smaller surface of the ball allows for a more focused pressure point where I can target a specific area and “attack” a stubborn trigger point.
At some point in your life, no matter if you are young, old or somewhere in between, you are going to experience some pain and discomfort that is due to an angry, knotted up piece of muscle. None of us can escape the wrath of a trigger point sneaking up on us here and there. The best we can do, is learn a little more about what these things are and find ways to heal our bodies as quickly as possible so what starts as a small issue, doesn’t turn into a giant, lifelong disability.
I know it sounds dramatic, but by pretending that pain isn’t there, a lot of people find that they lose quality of life because they tend to want to move a lot less. Trigger points may currently be a hot topic of discussion in the scientific circles, but you don’t need to have your doctorate degree in order to get some relief from that pain in your neck.