Trigger Point Therapy (TPT)

If you have ever received massage you may have heard of the term ‘Trigger Point’;

but what exactly is a Trigger Point and why is it important to remediate?

What is a Trigger Point (TP)? A small lump, bump, knot, nodule varying from the size of a pin head to the size of a grape. They occur in muscle tissue and connective tissue i.e. ligaments, tendons and the fascial web.

The initial causes of a TP; include posture (i.e. desk work, when we do not get up and move around for hours), over use, under use (if we have a sedentary lifestyle), mental stress, repetitive movement, gait (the way we walk, run), injury/trauma (i.e. broken bones, soft tissue damage). Anytime a skeletal muscle is held repeatedly in a state of contraction or for a prolonged period of time there is a risk a TP will develop.

Why does a TP form? When a muscle engages, the fibres slide over each other shortening and contracting, when the muscle relaxes the fibres release. Trigger points form when the fibres fail to release, causing them to remain in a state of shortened contraction. The whole muscle or connective tissue does not remain contracted only a small area. This small contracture causes the fibres around it to lengthen, becoming taught and weak, this is the reason TP’s are found in tense or tight muscles. 

Why TPT is needed? when a TP has formed, it causes a cycle to begin whereby the taught fibres press on and stimulate the motor nerve causing the area to remain contracted. If this cycle is sustained and not broken, the by-products of cell respiration build up in the area causing the area to become painful. Through the continued nerve stimulation, the brain learns to accept the new lengthened and tight state of the muscle as normal.

Cell respiration; is the metabolic process of every cell to produce energy. Through this process the cell produces by-products, waste material, that is removed from the area with blood flow. When a TP forms, the blood supply is hindered hence the build-up of the cells’ by-products and the discomfort to the area.

Muscle inefficiency and nerve impingement; when a TP has formed; the muscle becomes inefficient and can become atrophied, resulting in surrounding muscles being called in to use, these muscles are then put at risk of a TP forming. The contracted muscle can also impinge on nerves that pass close to it, resulting in referred symptoms i.e. pins and needles, headaches, painful joint movement, sciatica.

What the treatment involves; trigger point therapy is a gentle applied pressure directly over the TP site, both therapist and client need to communicate during this technique to achieve the best results. The treatment also includes massage techniques to improve blood flow to the area. The aim is to interrupt and break the TP cycle, facilitating change that will support restoring the muscle to its original resting length, relieving pain, dysfunction and stress on the surrounding muscles and connective tissues.