What are they?
Trigger points are taut bands of skeletal muscle that develop following either acute trauma or repetitive micro trauma. Following an injury, the muscles near the injured tissue, joint, or bone have to work over time to compensate for the injury itself. Due to the muscles working harder than normal, the stress on the muscle fibers increases, causing the muscle fiber to become taut and therefore, it becomes a trigger point. People most likely feel pain directly on the trigger point and sometimes feel pain radiating to a specific region associated with specific muscle trigger points. Over time this pain may result in a loss in joint range of motion involving the muscle that is involved. Research shows a body map of common areas that trigger points occur as well as the pain referral pattern associated with each trigger point.
Why they form?
According to one research article, there may be many mechanisms on how trigger points are formed. Unfortunately there is not enough research and evidence to suggest one main cause of trigger points. Research suggests that possible causes of trigger points may include lack of exercise, prolonged poor posture, vitamin deficiencies, sleep disturbances, and joint problems. These may individually predispose the development of micro trauma and therefore cause trigger points. Again, these are all possible contributors to the development of trigger points and each individual’s case may vary. In addition, if someone participates in work related or recreational activities that require repetitive stress on muscles, that may also predispose them to trigger point development. Lastly, acute sports injuries that cause sprain or repetitive stress on tissues such as baseball pitching may cause trigger points.
Physical Therapy to treat Trigger Points-
Physical therapists are trained in manual techniques to help reduce and rid muscles of trigger points. During an examination by a physical therapist, they will apply pressure on the muscles involved and feel for evident tissue changes, such as trigger points. When a therapist comes across taut band or a firmer area in the muscle, they may apply deeper pressure to see if it reproduces your pain at that site and determine if it radiates to another area. Some examples of muscles involved and pain referral areas include shoulder pain when trigger points are present in upper extremity muscles, back pain when muscles involving the lower extremity muscles such as the gluteals, and lastly, if trigger points are present in the upper back and neck region, neck pain is often present and one may experience tension headaches. Again, every person does vary and may not follow these exact patterns.
Once the interview and examination is completed, the physical therapist will have a better idea of the possible cause of trigger point development. You may be asked to stop any specific activities that apply repetitive stress to your muscles to allow those muscles to normalize and heal. Physical therapists will also apply soft or deep tissue massage to the areas with trigger points to release those trigger points completely or partially relax the trigger point and muscle to allow for proper muscle action and recruitment. Once the trigger points are released or reduced, the muscle can now properly fire, allowing for a reduction in pain you may have been feeling. It is important to note that it may take multiple visits to your physical therapist to fully release all trigger points due to the demands of your muscles in your work, recreational, or daily activities. Along with manual therapy to release the trigger points, your therapist will also give you exercises to address any underlying strength or balance deficits. Lastly, there is equipment you can purchase such as a foam roll to use at home to help reduce trigger points throughout your muscles. By using the foam roller, the pressure from your body weight and the firmness of the foam roller can help to apply pressure to the trigger point areas and help the progress of releasing those trigger points. For more information on physical therapy services go to www.totalperformancept.com.
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