What Are Those Knots?
Well, it’s about time I focused the next few articles on trigger points and treating with Trigger Point Therapy.. The following articles will be specific to areas like the shoulder, low back, neck, etc, so stay tuned!
Before I dive straight into specific areas of pain that we can address (and you can address at home), I thought it important to talk about trigger points in general- what exactly are they anyway? how do I (and you) relieve them? and how can you prevent them from causing pain?
What Are Trigger Points?
Trigger points are found in soft tissues, primarily muscles and fascia (the connective that acts like a web throughout your body to hold everything together). They are primarily caused by muscle overload (whether it be from postural overload, repetitive stress overload, exertion overload, etc). And trigger points cause localized pain or referred pain to another area, which is how some trigger points are left untreated- we assume the area of pain is the place to treat.
A trigger point is a small area of muscle that has stayed contracted without a nerve impulse, forming a little knot. This usually causes a muscle to feel tight, and it will contribute to weakening the rest of the muscle. A trigger point, if left untreated, causes a chain reaction of other trigger point areas emerging, as other muscle groups have to compensate for this weakened, inefficient muscle. Many times a diagnosed “tendonitis” is actually trigger points causing pain, and can be treated with Trigger Point Therapy.
According to Dr. Janet Travell, who pioneered myofascial pain research and treatment, trigger points are the sole cause of pain seen in clinics 85% of the time. That’s a huge percentage!
Treatment
Trigger points are best treated by massage – self massage can do the trick too!- but more specifically, Trigger Point Therapy, where the massage therapist places pressure on the trigger point, usually causing some tenderness and referral sensations. This pressure helps release the held muscle tissue, and causes more blood flow (and thus oxygen for healing) to the area. Creating some minor, bearable pain while pressing on a trigger point will send your brain a signal- there is pain! Then, a slight neurological happening occurs- when the massage therapist (or you) releases pressure on the point, the pain goes away and your brain forgets about the previous, chronic pain that was there to begin with. This is similar to the Gate Control Theory of Pain.
After you’ve released the nagging trigger point and relieved your pain, it’s important to find out how the trigger points developed, so you can prevent them from returning. Did they develop because of bad postural patterns? An old injury that your body has compensated for for years? Or maybe a minor acute injury, that within a week or two, could heal on its own. You might need some guidance to get to the root of the problem (I know I have a hard time figuring out what’s actually going on with me without an outside eye), so seek help. We at Free Bodied are always here to answer any questions you might have to help lead you towards pain relief.
Prevention
Move yourself! That’s right, get into some sort of exercise regimen. Building up strength with prevent muscle overload (remember, that’s the primary cause of trigger points). I highly recommend crossfit because of it’s varied exercises and importance in taking the joints to their full range of motion (just make sure you go at your own pace). If you are just running or just biking or just getting on the eliptical, you are not moving your body at full capacity. We all start somewhere, so if it’s starting with a 10 min walk 4 times a week, start there! And then do some stretches post walk.
If you are afraid of starting to exercise (or getting back into exercise) because of pain, start by talking to some specialists and ask their opinion- maybe a physical therapist, a crossfit trainer, an acupuncturist, or a massage therapist (not a surgeon!). They will give you a good idea as to what you might be able to do and whether or not you might need to see a surgeon or might not.
Develop good postural habits. Like your mum (or dad) always told you, sit up straight! This should be done by stacking your spine, not by forcing your shoulders back and your chest forward. Here’s a great video by Ruthie Streiter (a dear friend of mine in NY) that I recommend many of my clients to watch so they can sit well. If this is hard for you, you can also try sitting at the back of your seat, using the seat’s back to prop your butt so it has that slight curve. Just make sure your feet are planted on the ground.
I hope this information sparks some interest in the journey of your healthy body. Remember, we are all working on something at any given moment. It is not just the resolution of pain or disease that is important, but also the knowledge and understanding we receive along the way.
Do you have a specific area of pain you’d like me to talk about in my next article on trigger points? Please let me know in the comment box below. For knee pain trigger points, check out this article.
Here’s to your health!
My pain is in the muscles at the base of my neck on the right side. If I had to pin point the location I would say right where the trapezius starts to curve up from my shoulder to my neck. It happens if I bow my head forward and then pick it up, or if I rock my head from side to side.
Craig- Thanks for the detailed response! The pain you’re likely experiencing is from trigger points in your levator scapula- a muscle that runs from the top of you scapula to your cervical spine. I’ll definitely focus on that trigger point in my next article. It’s actually extremely common because people tend to carry their heads too far forward, causing the levator scapula to work hard, kind of like how a bridle pulls a horses head back.
Yes! Finally someone writes about structural integration.