What are trigger points and why do I use them so much in my sports massage/ deep tissue work?

Here's the easy answer as to why: – because I find they really work! Working on trigger points can provide fast, often instant relief.

Here's the nerdy answer as to what they are: Myofascial trigger points (MTrPs), also known as trigger points (TP's), are described as hyperirritable spots in the skeletal muscle. They are associated with palpable nodules in taut bands of muscle fibres.[1]

You probably know them more simply as knots – as in "I've got a knot in my shoulder that's killing me!"

These "knots" are localized areas of muscle tightness and tenderness that can cause pain and discomfort. These knots in the muscle fibres can result from overuse, injury, poor posture, or stress. Understanding trigger points and their impact on the body is crucial for managing and preventing pain associated with them.

They can cause a variety of symptoms, including localized pain, referred pain (pain that is felt in another part of the body), chronic pain, reduced range of motion, and muscle stiffness.

Often you will have many, many trigger points you are completely unaware of. However, there are commonly documented and mapped points within nearly every muscle that can be identified and targeted for treatment once located.

In practice, although the official definition is a tight nodule, I sometimes feel the TPs as nodules, lumps or knots, but also sometimes as a small indentation or even just a change in texture.

Here are a couple of common examples:

1. Trapezius Muscle:

- Trigger Points: Located at the top of the shoulder.

- Referred Pain: Can cause pain that radiates to the neck, temple area, and down the arm.

x = Trigger point

Red: Possible areas of referred pain

2. Gluteus Medius Muscle:

- Trigger Points: Located in the buttocks.

- Referred Pain: Can cause pain that radiates to the hip, lower back, and down the leg.

And a lesser-known but still very common example:

x = Trigger point

Red: Possible areas of referred pain

3. Scalene muscles:

- Trigger Points: Located in the front of the neck.

- Referred Pain: Can cause pain that radiates to the central collar bone, back or crown of the head, temple, around the eye socket, and more!

Performing a postural assessment and conducting a comprehensive consultation enables one to pinpoint areas for investigation. Then careful and thorough palpation of the muscle tissue allows identification of trigger points and we can begin to address them.

All of this is occurring as part of a wider process of course – it's really important to warm and relax the general area and specific muscles before approaching the TP's as it can be uncomfortable. Time is taken to ensure the client is also in a relaxed and calm state of mind. More general fascial release is often carried out before as that can help to release TP's without the need for more direct work and is often more comfortable for the client.

SELF CARE:

One of the other reasons I really like working with TP's so much is, that they can often be taught easily to the client – who can then work on them themselves either with self-massage, massage gun, massage ball or foam roller.     

It fits well into my model of how I like to work – I don't want you to keep coming back to me over and over for the same problem- the idea is to not only work directly on the body but give you skills to help you help yourself. I'd rather you tell your friends than I see you every week!

By understanding how trigger points develop and implementing appropriate management techniques, you can take control of your muscle health and live a more comfortable, pain-free life.

Travell, Janet; Simons David; Simons Lois (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual (2 vol. set, 2nd Ed.). US: Lippincott Williams & Williams. ISBN 9780683083637.