What is a Trigger Point?


The most frequent question I get asked is, “What *is* a trigger point?” thanks to my heavy application of techniques to reduce trigger points (or what you think of as muscle knots). This term is a big massage buzz word that many know about but have no idea what a trigger point actually is. Much of the medical community disputes the existence of trigger points because they do not appear in cadaver dissections but, to anyone who has had trigger point massage therapy will tell you they are absolutely real.

The best way to put it is that a trigger point is a super irritable sore spot in muscle tissue that is painful upon being compressed. These hyper irritable spots appear in muscle tissue after either trauma or repetitive use. Basically, what leads to trigger points is that your brain sends overly hyper-active signals via chains of nerve cells called neurons to the muscle. These neurons over fire and cause basic units of muscle (called sarcomeres) to constrict. This constriction causes decreased vascular flow to the area and less metabolic nutrition to the muscle fibers. Over time these trigger points cause pain locally or a referred dull, achy pain to other areas of the body.

Example: Think you have a temporal headache? Think again. That headache just might be caused by a trigger point in a neck muscle. Or do you use your hands for your work a lot? That pain you feel in your hands could be coming from a muscle on your shoulder.

Overtime, these trigger points can cause reduced range of motion and weakness due to the sustained muscle contraction and dysfunctional biomechanical use. There are many ways to approach trigger points. Thru cortisol injections or an acupuncture method called dry needling. JFK’s doctor Janet Travell (who pioneered trigger point therapy) liked to inject them with a solution or use a method called “spray and stretch” using a cold spray but, the easiest and least complicated way is through massage! To a well-trained massage therapist, they feel like round little hard nodules(or knots) that you “slip” into (kind of like a center of a knot). the bands of the muscle in the direction around the trigger point are taut (not unlike a guitar string). When they are pressed into, they often cause a pain that is felt in another area and often illicit a twitching response in the muscle and surrounding structures.

Although, there are many ways a massage therapist can address trigger points, one of the most common ways to get taut, trigger point filled muscles to release is through heat therapy, and using sustained compression on a trigger point work within the pain tolerance of the patient and then stretching the muscle. Clients can do after care as well including warm baths to the area or through exercises shown to them by a Licensed Massage Therapist.