I often find myself providing trigger point therapy for clients, and whilst I explain what I’m going to do before carrying it out, given the often amazing results it can have at alleviating pain I thought it worthy of more explanation. It’s at the same time completely complex and totally simple.
In very simple terms, tightness in a muscle can cause chronic pain in other parts of the body and masquerade as more serious conditions. Alleviating the tightness can help relieve chronic pain and allow the muscle to return to normal and ta-dah! you feel wonderful again.
I make no apologies for super simplifying it, as the client on the lovely, snuggly massage table, I just want you to know that this technique exists and with good conversation about what replicates your pain there may way to alleviate it. Here’s some more detailed information…
What is a ‘Trigger Point’?
A trigger point is a painful lump or nodule felt within a tight band of muscle, you might also know these as ‘knots’. When pressure is applied it causes symptoms of pain which radiate out and are felt somewhere else in the body. Usually the pain felt is chronic and can’t be explained by routine medical examinations. It’s estimated that in 75 – 95% cases of muscular pain, trigger points are a primary cause.
Trigger points make the muscle they are in shorter and fatter, reducing the efficiency of the muscle which then creates imbalances, compensations and adaptations in other muscles. The points can be active and painful, or may be inactive, not causing you any pain at all.
These points arise in muscles for many reasons such as accidents, chronic stress, sports injury, bad postural habits or disease. Some things you might not think would cause trigger points: chewing gum, emotional tension, playing musical instruments, cold drafts, poor glasses, computer mouse and keyboard use, dog walking, long periods of driving, sitting on your wallet or phone, sitting cross legged.
It’s useful for me if before you come for a massage you have a think about lifestyle factors, such as anything repetitive that your do which might be creating your trigger points. I’ll try and get to the bottom of it during your initial consultation and provide you with aftercare exercises or tips for you to practice between massages.
How Does Trigger Point Therapy Work?
Trigger point therapy is a range of techniques which aims to deactivate the painful area of the muscle so that the pain is not felt elsewhere in the body, thus creating balance. First of all it’s essential to identify the correct trigger point, then identify how or why it’s there, use massage techniques to deactivate it, then use aftercare strategies to prevent it returning.
More specifically, as a massage therapist, when I press on a trigger point it has several effects:
- Numbs and reduces pain in the treated area
- Interrupts pain pathways in the body
- Breaks the pattern of spasm and pain in the muscle
- Stimulates blood supply to the area which clears away debris and toxins
- Releases endorphins (pain killing happy hormones)
- Allows the body to relax
What I’m looking for when I treat a trigger point is for it to replicate the symptoms of pain that you feel e.g. when I press around your shoulder blade, you feel pain up into the base of your skull which might be why you’ve come to see me in the first place. Another example is lower back pain which can be alleviated by addressing trigger points in the gluteus muscles in the buttocks.
My approach is to take a detailed history of your pain, find out lifestyle factors that may be affecting it then get you on the table. Initially I massage to explore the area and see what’s going on, then in conversation with you (and sometimes consulting the book!) will find areas of tension and use a combination of techniques to see if it will release.
What Do Trigger Points Feel Like?
Trigger points can feel any number of ways under my hands and the way I describe them is not very technical! A ‘block’ in the muscle, a little lumpy bit, thick banding where it should be smooth, extra bulk on one side compared to the other, rice krispies, thick gristle, slight warmth, the muscle and fascia ‘not letting me in’. You’ve probably had a massage and felt the crunchy, grindy feelings around your neck and shoulders and felt the sensation radiate out, these are trigger points.
When a trigger point releases you might feel a ‘clunk’ as the tight muscle releases, this usually happens in the long muscles of the quadriceps and hamstrings. In the back and shoulders it might be more subtle for you, but what I see is a ripple of movement or pulsation across the skin.
Hopefully I’ve made trigger point therapy a bit clearer for you. In my next blog I will cover aftercare and self help for dealing with trigger points, both of which can have great effect in reducing chronic pain.
It’s important to note that massage therapy works in conjunction with conventional medicine and if you are experiencing acute symptoms of pain it’s essential that you consult with your GP prior to coming for a massage.
Reference: The Concise Book of Trigger Points: A Professional and Self Help Manual by Simeon Niel-Asher