06 Nov Trigger Point Release Techniques
Trigger points or muscle “knots” are sensitive spots in soft tissue that are implicated in the Myofascial pain syndrome. They are painful when pressed on, as they cause referred pain. When our muscles have trigger points, there is pain, stiffness and tension and limited motion.
Factors that predispose to trigger point formation include de-conditioning, poor posture, repetitive stress, postural imbalance, joint disorders, non-restorative sleep and vitamin deficiencies. Trigger points may be present secondary to other sources of pain or may be causing the painful symptoms.
Conditions associated with trigger points include back pain, headaches, neck pain, rotator cuff pain, jaw pain, tennis elbow, carpal tunnel syndrome, pelvic pain, hip pain, sciatic pain, knee pain, plantar fasciitis pain, tendonitis, bursitis, arthritis, radiculopathy, frozen shoulder, fibromyalgia, etc.
The majority of patients seeking relief from pain are still treated with anti-inflammatory medications, muscle relaxants and/or strengthening programs. These are largely ineffective as trigger points do not respond to them and may be aggravated by further straining. There are no drugs that eliminate myofascial trigger points. But myofascial trigger points are being acknowledged by physicians while managing their patients. Some primary care physicians, regularly administer trigger point injections.
Trigger points have two phases, active and latent. The active phase is painful – it hurts when pressed with a finger and localized and referred pain. Trigger points can also be latent they elicit tenderness only when pressed, otherwise, there is no pain. Many things can cause a latent trigger point to become active, such as muscle overload, fatigue, infection, illness, or stress.
Treating each trigger point is quite simple, but treating myofascial pain syndrome completely can be difficult. First of all, you should not strengthen a muscle that has a trigger point, because it is already contracted and the muscle is locked into a shortened position. The technique involves unlocking that contraction mechanism. This can be achieved by applying pressure with a finger or other instrument to the trigger point and increasing the pressure as the trigger point “releases” and softens. There are a number of variations on this technique based on the individual and the nature of his complaints.
There is another technique, called Spray-and-Stretch method that involves using a vapocoolant spray and stretching the muscle to help release the trigger point. Once trigger points are released, the muscle is moved throughout its full range.
Overall, these are effective, non-invasive techniques that are easy to perform and often produce quick pain relief. They should be fully embraced by clinicians who would need to acknowledge the role of trigger points in musculoskeletal pain in order to take these trigger point release approaches seriously. More research would also help establish myofascial pain syndrome as a proper diagnosis and validate these techniques as its viable therapy.