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Trigger points are described as hyperirritable spots in skeletal muscle that often refer pain to other areas in the body. Later in this blog I will discuss other symptoms associated with them. As a Neuromuscular Therapist, I believe that they are a common cause of pain and something I see regularly with my clients.

Research by Drs. Janet Travell and David Simons, authors of “The Trigger Point Manual,” has shown that trigger points are the primary cause of pain at least 75 percent of the time and are a factor in nearly every painful condition.

Many health care professionals wrongly assume that the problem is located where the pain is. Improper assessment methods therefore fail to assess the body correctly to find the root cause of injury and dysfunction.

I have always been taught that if you are not assessing, you are guessing!

Trigger points can occur from being in a car accident, a trip or fall, sports and work-related injuries from postural stress by sitting at the computer all day.

Your body’s instinctive reaction to a stressful event is to protect itself. It does this by altering the way you move, sit, or stand, which puts abnormal stress on your body. This produces muscle imbalances and as a result can create poor posture and increase the likelihood of an injury.

An Example of Trigger Point Referral

A common place for trigger points is in the sternocleidomastoid muscle of the neck which commonly get mistaken for migraines, headaches and jaw pain etc. Trigger points can also mimic back pain and sciatica too. Muscles of the lower back called the quadratus lumborum (QL) are located just above your hips. There are plenty of reasons why the Quadratus Lumborum can become a problem and harbour Trigger points however when the QL becomes dysfunctional, it will alter the position of the pelvis. As the pelvis becomes dysfunctional, it will force the spine into an abnormal curvature that will put abnormal pressure on the discs. Over time, the discs will begin to herniate.

Trigger point referrals of the QL can spread into the buttocks, in the back and down the legs.

Trigger Point Symptoms

If you have lingering pain, muscle tightness, or restriction in certain movements, it’s a good chance you may well have trigger point development in the body. These points may produce symptoms as diverse as:

• migraines
• headaches
• neck and jaw pain
• low back pain
• sciatica
• dizziness
• earaches

The Fibromyalgia Connection

There is a strong connection between Fibromyalgia and myofascial trigger point development with many research studies suggesting the connection. Leon Chatiow who referrenced Travell & Simmons (1992) (Neuromuscular Techniques Volume 1 manual) stated ”Most of these (fibromyalgia) patients would be likely to have specific myofasical pain syndromes that would respond to myafascial therapy”. Also, Granges & Littlejohn (1993) in Austrialia have researched the overlap and came to serval conculsions including; “Of those Fibromyalgia patients with active trigger points, around 60% reported that pressure on the trigger ‘reported a localised and familar Fibromyalgia syndrome pain”

What is Fibromyalgia?

Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue, and sleep disturbances.

The pain can be spread over any part of your body, but the most common sites tend to be your neck, back, shoulders, pelvic girdle, and hands.

How does Trigger Point Massage work?

As a trained Neuromuscular Therapist and Sports Massage Therapist I focus heavily on trigger points and offer deep and focused pressure to areas of restriction that may harbour them. Simply rubbing the surface of the skin with massage oil, hot stones and or with a massage device will not release the muscle and or TrPs.

What is needed is sufficient deep sustained pressure to the restore blood flow, improve flexibility and health of the tissue. As you release the Trigger Point, your body will undergo soft tissue release, allowing for increased blood flow, a reduction in muscle spasm, and the break-up of scar tissue. It will also help remove any build-up of toxic metabolic waste.

How Long Does it Take to Get Relief?

The length of time it takes to release trigger points depend on several factors, one of which is how long you have had them and to how severe they are. Other factors include the number of trigger points you have and to how healthy the body is to recover. Myofascial Points can present themselves by having poor digestive health also so unless diet and lifestyle factors have been addressed and improved it may take longer to heal.

What is Neuromuscular Therapy?

Neuromuscular Therapy is a structurally integrative approach to pain relief for conditions such as back pain, neck pain and sports injury using massage, muscle energy and trigger point release techniques.  The method is based on finding improper structural (posture) and biomechanical patterns (movement) in the patient’s body. 

Neuromuscular massage techniques will attempt to address (or at least take account of) a number of features that are commonly involved in soft tissue pain and dysfunction. These include, among others, the following factors that affect the whole body:

• Breathing Patterns (hyperventilation tendencies)
• Posture (including patterns of use)
• Stress (physical, chemical or psychological)
• Endocrine and hormonal Imbalances
• Digestive health
• Nutritional imbalance and or deficiencies
• Food/environmental and chemical allergy or intolerance
• Faulty Movement patterns (habits , lack of flexibility etc)

Once these factors are analyzed and considered, a comprehensive Neuromuscular Therapy program is designed to guide the client through the five stages of rehabilitation:

1. Eliminate muscle spasm and Trigger Points
2. Restore flexibility
3. Restore proper biomechanics
4. Increase muscle strength
5. Increase muscular endurance

At Tom Smith Health and Performance the purpose is to not only to eliminate myofascial points, muscle spasm and dysfunction that lead to pain, but also to educate you, on ways to prevent a recurrence of the injury.

Neuromuscular Therapy fills a void left by traditional health care by analyzing soft tissue causes of pain.  According to recent research approximately 90% of pain symptoms are considered idiopathic, which means there is no known cause.  I believe the reason there is no known cause is that a proper investigation into the patient’s physical, chemical and mental emotional state has not been fully investigated. The body is a system of systems, with all bodily functions working together to create body balance or homeostasis.

Trigger Points Neuromuscular Therapy also addresses the following:

Ischemia is a lack of blood supply to the soft tissues, which causes them to be very sensitive touch.

Trigger Points occur when nerves fire impulses at a rapid speed into an area of the body other than that which has been traumatized. Because of trigger points, the cause of serious pain may often be far from the actual site of the pain. This, in turn, inhibits proper blood flow, which causes ischemia an often leads to more pain and discomfort.

Nerve Compression and Entrapment is pressure on a nerve by bone, cartilage or soft tissue. The role of the soft tissues in nerve compression is vital. Failure to treat the associated soft tissue often treats the symptom without eliminating the cause of the pain. Nerve entrapment is the most common type of pain and always causes ischemia. Ignored, it can produce associated trigger points.

Postural Distortion or muscular contraction occurs when there is an imbalance of the musculoskeletal system resulting from movement of the body off the coronal, midsagital or horizontal planes. When the body tries to compensate in an effort maintain structural balance, muscle contraction, body distortion, and pain result. For example, lower limb-length inequality can cause a tilted pelvis, which usually results in a compensatory scoliosis that is maintained by sustained muscular effort.

Biomechanical Dysfunction is an imbalance of the musculoskeletal system resulting in faulty movement patterns. Repetitive strain of certain soft tissue result in adapted movement patterns that become muscular “habits” and must be reeducated.

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