What are the Trigger Points
Also known as myofascial trigger points (MTrPs), people describe them as hyperirritable spots in the skeletal muscle (Wikipedia). Translated in human language they are knots in the muscle fibers that can cause pain, both on the spot and in nearby locations.
They can involve several common conditions such as: chronic pain, sciatica, low back pain, frozen shoulder, plantar fasciitis and even headaches.
Massaging the trigger points can be very beneficial to reduce the painful symptoms of the above conditions.
How they come to be
Without going too much into the the physiological details (excessive release of acetylcholine affecting the muscle’s fibers), muscle overload is the most common cause. They form only on muscles and they usually tend to appear only in a small number of fibers. These points show a reduced blood circulation, hence restricting the energy needs of the region.
Pain patterns and diagnosis
The lack of blood flow and energy usually increases the sensitivity of the area, which can lead to localized pain and weakness in the muscle.
The pain patterns often follow the nerves pathways, and that can help healthcare professionals diagnose the condition. An effective diagnosis typically considers the symptoms, the pain patterns and the manual palpation of the points where the famous “knots” can be found.
If the muscle is large enough (i.e. Gluteus), it is not uncommon to find clusters of active trigger points.
How massage can help
Massage Therapy effectively treats the trigger points because it is not invasive, can treat both the specific point and the bigger region, and can be even pleasant.
By listening to the client and following the pain pattern, the massage therapist can identify all the active trigger points and release them one by one. Digital pressure (30 to 90 seconds) is probably the most effective way to reduce the spasm and return the fibers to their original length.
This pressure can be quite painful and the massage therapist will always need to listen to the client and adapt, as pain thresholds are very subjective.
During my career I noticed that ischemic compression is one of the most effective methods to treat trigger points. Or at least is the one that gave me the best results.
Choosing the right therapist
The job market is getting more and more competitive by the day, and the number of people faking certain skills is increasing on a daily basis. While faking Project Management skills is not such a big issue (worse case scenario the person will get fired because unable to manage a project), faking knowledge in health-related topic can lead to problems.
If you have reasons to doubt the skills or knowledge of the therapist, just ask a simple question: “hey, can you explain me what are the trigger points? I saw on your website that you treat them”.
Last time I did this, the answer started like this: “Of course, trigger points are small wounds in the muscles…” I didn’t hear the rest.
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Pubmed link to an interesting article on this topic: Trigger Points