Do you ever have that chronic pain that will dissipate for a few days after a treatment, whether it be chiropractic, physio, acupuncture etc, just to have that same pain return a few days later? You could be suffering with Trigger Points! Which doesn't sound awesome but really, it is, because it is something that we can target and treat. Yay!
You have probably heard me say it before, "it is most likely a trigger point" and had no idea what I was talking about. I will often give a brief explanation on what a Trigger Point is and what I do to treat it but who wants to have a massage and listen to me rant about how amazing tigger point work is? So here is an overview of trigger points, how they affect us and what we do to treat them. I hope you are as excited as I am!
A Trigger Point is a small contraction or knot within the belly of a muscle that, according to pain clinic doctors, is the primary cause of 75% of pain. Thats a huge number! They can cause a multitude of problems such as headaches, neck and jaw pain, low back pain, symptoms of carpal tunnel and shin splints, joint pain, tendinitis, earaches, dizziness, sinus pain, congestion, and chronic fatigue just to name a few.
Dealing with these problems over a prolonged period of time can lead to depression. This is no joke people. These are some serious chronic pain issues. Issues that you have gone to see your doctor about and most likely masked with pain killers. You have seen numerous specialists and no one seems to be able to pinpoint what the issue is. You sound crazy. You are going crazy! But don't worry! There is a solution. Unfortunately, even though there has been Western medical research done on trigger points and the evidence has been around for many years, the knowledge of trigger points is still very limited. It is not something that doctors spend a lot, if any time on in med school. So let me shed some light.
A trigger point is a hyper-irratable contraction in your muscle tissue that can often feel like a piece of partially cooked pasta or a marble buried deep within the muscle. They emit distinct electrical signals and have been photographed in muscle tissue. They can also cause radiating pain in predictable patterns. Trigger points keep muscles both short and weak. Think about combing your hair, everything is good until you hit a knot. The knot causes this strand of hair to be shorter than the rest, attached at one end to your scalp and at the other end to the comb. You can keep pulling and pulling on the knot (ie. stretching it), but unless you deal with the knot itself you are only going to cause more damage. This pull on the attachments can produce symptoms in adjacent joints, leading to a confusing diagnosis. You are feeling pain in your wrist which is coming from trigger points in your forearm. The knot also restricts localized circulation which perpetuates the trigger point, causing more pain and tightening. It is this pain cycle which needs to be broken.
How do you know if you have a Trigger Point? The biggest sign is referral pain with applied pressure. The theory behind referral pain is an evolutionary one. The pain often occurs in or close to a joint which will encourage you to modify the activities that have created the problem in the first place. Other symptoms that you may notice are muscle weakness and stiffness, swelling, nausea, dizziness and postural distortions. There can be a decrease in your range of motion in corresponding joints. Your muscle may fatigue quickly and recover slowly. For example, you aren't able to type at your computer for 10 hours a day anymore or you can't turn that wrench just one more time without dropping it. There could also be popping or catching in your joints due to your muscles being short and out of balance.
The one thing that you are going to want to do is stretch out that muscle. As tempting as this sounds, don't do it! It will only aggravate your trigger points. Because they are in a shortened state in comparison with the rest of the muscle fibres, they are already being pulled, stretched and stressed constantly. If you are not able to book an appointment for a massage, an alternative is to use a rubber ball and massage your trigger point on your own. I will be posting more on specific trigger points in future blog posts but a great resource is "The Trigger Point Therapy Workbook" by Clair Davies.
Now you are wondering what causes Trigger Points? There are some unavoidable causes such as a direct impact or injury, immobilization of a joint, surgery, injections or certain medications. Other causes are more within your control. Overuse and repetitive motion are often guilty and they are common in the world we live in today. Dietary deficiencies can wreak havoc on your muscle tissue. Ladies, a heavy purse can create new trigger points, especially if carried on the same shoulder. Men, a thick wallet in your back pocket can truly create a pain in the ass. And parents, a heavy backpack worn incorrectly can do just as much damage to your children. Nicotine, caffeine and alcohol can perpetuate trigger points making them more difficult to treat. For those of you who hold on to your stress you really need to let it go! Choose your battles wisely because chronic tension and anxiety can lead to trigger points throughout your muscles. Luckily, with some lifestyle changes and learning to listen to our bodies we can create significant positive change in our quality of life.
So how do we treat it? Well, we need to break into the chemical and neurological loop that is maintaining the locked up muscle tissue. We need to increase circulation by bringing in some fresh blood flow and flush out any metabolites that are trapped within the muscle. Then we need to directly stretch the muscle to reeducate the fibres to align in the proper direction. This can all be done with direct manipulation of the muscles using deep massage techniques and in depth knowledge of the anatomy.
Trigger point work can be uncomfortable and sometimes painful, generating a deep aching sensation and it is immensely important that a clear line of communication is open between the therapist and the client. Pressure above your pain tolerance will do more damage than good and leave you feeling sore much longer than normal. Being able to communicate when the pressure is too deep or not quite on point will help to create an ideal treatment. Together we will reeducate your body through breathing and teamwork to bring you closer to a state of balance and pain-free living!