What is a Trigger Point
Focus of hyperirritability in a tissue that, when compressed, is locally tender and, if sufficiently hypersensitive, gives rise to referred pain and tenderness, and sometimes to referred autonomic phenomena and distortion or proprioception.
Tender area in muscle and its fascia
Can cause referred pain
Upon Palpation, feels like a taut band with a nodule
Techniques to treat : ice, Massage, Digital or Ischemic Compression, PNF, TPPR
Large, Rounded, Darkly stained muscle fibers,
Statistically significant increase in diameter of muscle fibers.
coined "contraction knots"
Characteristics of Trigger points
Consistant referred pain pattern upon compression of TrP
Local Twitch response elicited by palpation.
Possible restricted ROM
Muscle weakness with no appreciable Atrophy
Possible autonimic phenomena including vasomotor and pilomotor responses.
Two Types of Trigger Points
Active - always tender, produce referred pain. associated muscle may be weak and present with decreased motion/flexibility. when palpated, present with a localized twitch response.
Latent - Painful only when palpated.
Potential TrP Causes
Acute Conditions - Fractures, Sprains, Dislocations, Muscle impact injuries
Stress from excessive or unusual exercise
Overload on the muscle from prolonged stationary posture or prolonged muscle immobilization in a shortened position
Muscle contraction ----> local blood vessels to be compressed which decreases oxygen supply
Decreased Oxygen + Metabolic demands = depletion on ATP
Depletion of ATP = increase in ACh and a decrease in Ca+ reuptake
= Continued muscle contraction.
Trigger Point Pressure Release
gentle digital pressure; aim to reduce ischemic effect to the injures tissue.
One finger palpating the TrP whilel the muscle is passively lengthened to the point of tissue resistance.
At tissue resistance, pressure on the TrP is slowly increased.
should be applied to one point for a prolonged period (10-45 secs) and pressure released with the resolution of pain,
effleruge/petrissage top warm tissues
Effleurage / petrissage