Trigger points/referral patterns

Question 1

Wkhat are trigger points?

Answer 1

Highly irritable/sensitive local area lying within a taut band of muscle fibre. Often found within muscle belly or near MTJ

Question 2

Why are they formed?

Answer 2

• Microscopic contraction ‘knots’ within muscle fibres
• Action and myosin do not release their contraction and cause sarcomeres to bunch up and become taut

Question 3

Types of loading

Answer 3

Repetition/Exertional/Biomechanical/Postural

Question 4

Active trigger points

Answer 4

• Spontaneously painful
• Area of soft tissue is hypoxic and ischemic
• Referred pain and tenderness on palpation
• Can deactivate to latent form by use of dry needling
• Can take time to relieve pain and initial treatment can make pain worse

Question 5

Latent trigger points

Answer 5

• Painful only when stimulated with manual stimulation
• Area of soft tissue is hypoxic and ischemic with lower PH
• Associated with local twitch response
• Found in many pain free skeletal muscles and may be ‘activated’ and converted into active trigger points
• Cause weakness and reduced range of motion

Question 6

2 treatment methods

Answer 6

Ischemic pressure: Specific pressure either sustained or repeated
- Sustained - 20 seconds or on and off for 2 minutes for repeated. VAS 7/10 to 3/10
Deep stroking: Sustained pressure working along the line of muscle fibre
- milking effect