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Trigger Point Therapy

Trigger point therapy is basically getting rid of the active trigger points (knots), that develop in muscles. It forms part of any of the other massages that I do. Trigger point therapy is not a massage in itself, but an added technique in my fight against pain, and incorporated into a sports or deep tissue massage.

Studies show that trigger points are involved in 95% of pain, and the main cause of 85% of all pain, including headaches, and even toothache, and period pain. So, it stands to reason that treating trigger points can do away with almost all pain, and it turns out that that is in fact true.

What are trigger points?

A big part of sports massage therapy is dealing with trigger points. A good sports massage therapist should be familiar with trigger points, where they are found, what their pain referral patterns are, and how to treat them. But what are trigger points? And what do they do? If we look at the text books, well get a very confusing definition, and most of us will be none the wiser.

Definition: Basically, trigger points are knots. We all know what knots in the muscles feel like. They are nodules that form in tight muscles. Trigger points usually occur in very predictable places that have been mapped out in text books, and they are either latent, or active. Latent trigger points might hurt when you press on them, other than that, they don't do anything. However, if left untreated, a latent trigger point can develop into an active trigger point. These active trigger point do lots of very strange things, including refer pain, cause goose flesh in strange places, cause muscle tremors, sweating etc. These pain referral patterns are also well known, and predictable. Dr. Janice Travell , an army medic, did a lot of research poking at soldiers' trigger points, and documented the pain referral patters. For example, there are 7 trigger points that can develop in the traps, and trigger point 1 at the top of the trap, usually refers pain to just behind the eye.

What causes trigger points?

The simple answer is stress, i.e. physical stress on the muscle, either from overuse, a lack of nutrients (electrolytes, vitamins), bad posture, or poor circulation. Hard training is almost certainly going to result in some trigger points forming in the muscles. For instance with running, you can expect to develop trigger points in the quads and calves, with cycling trigger points in the quads and traps are common. With swimming it may be the traps, hamstrings and calves.

How can trigger point therapy help you?

What benefit does all this have for the triathlete. Well, remember that trigger points refer pain. So that pain you feel in your shoulder might not actually be coming from your shoulder, but rather from trigger points somewhere in the back. That knee pain you've had for a while and the doctor can't figure out, might not be coming from your knee, but trigger points in the quads, and the plantar fascia pain that you struggle with may just be pain referred by trigger points in the calves. So, you may not actually need that arthroscope in the knee, to find what's wrong with the knee, and then you sit with scar tissue, and unable to train for months as you recover from the procedure where they found no problem. Why? Because a few trigger points treatments for trigger points in the quads may be able to get rid of that knee pain.


Remember though, that the knee pain, may very well be a cruciate ligament, or torn cartilage. So, a proper examination might be required. But start conservatively, with some trigger point treatments. You can always have the arthroscope later. It's better than starting with the arthroscope and then afterwards finding out that the problem was a trigger point in the quads.

How are trigger points treated?

Massage therapists and physios may use finger pressure A technique call ischaemic (lack of blood) pressure is used. Basically press all the blood out of the trigger point, and when you let go, new blood rushes in with nutrients such as oxygen, and the trigger point starts to resolves. Or a massage therapist can use deep tissue strip massage (the muscle is stripped of it's blood, allowing new blood to come in and feed the muscle). Physios also like to use the same needles that are used in acupuncture. This is called dry needling: the needles are inserted into the trigger point, you may have some tingling and redness around the needle. This treatment has both a neurological affect as well as encouraging blood flow in the area, both of which help resolve the trigger point. Some sports doctors like to do what is call infiltration; basically inject fluid into the trigger point. This helps flush out toxins and resolve the trigger point. The fluid injected into the trigger point can vary from saline solution to cortisone (not great), to special preparations. It is important to note that if you have had a trigger point infiltrated, you can't have finger pressure treatment done to that trigger point for a few days. So, before you go under the knife to have the shoulder, knee, or hip scoped, pay a visit to a properly qualified massage therapist, sports doctor, physiotherapist or similar, just to make sure that it isn't simply a knot in your muscle causing you all that grief. In the diagram, the dots represent the trigger points, and the shaded areas represent the corresponding pain referral pater. Every muscle in the body has these potential trigger point spots.

Some of the benefits of massage may include:
Stress reduction
Improved immune function
Relief of muscle tension
Detoxification the body
Reduced cellulite (deep connective tissue massage)
Improved circulation
Reduced risk of stress related diseases
Speedy recovery from hard training or sports events.

Anybody can have a massage at any time, for any reason.

A regular massage is one of the most basic health needs for everybody, for both physical and psychological health. Treat yourself to the healing qualities of a soothing massage, while at the same time de-stressing the mind and easing all those tight muscles, boosting your immune system and improving your health. Leave your treatment feeling on top of the world.

As an endurance sports man, I have come to value the benefits of regular massage. Although a one-off massage is
always good, the true benefit of massage is only realised with regular massage sessions of between once a week to
once every 4 weeks.