Most of us have felt the “knots” or tight spots; or asked a friend or loved one to get stuck into that muscle in the hope that it will release some tension or pain.
But what are these “knots” and why does a deep massage or lots of pressing help alleviate the tension or discomfort associated with them?
Trigger point formation and release is not an exact science; with many hypotheses out there as to their precise pathophysiology.
In short: muscle is made up of a series of protein filaments that when stimulated (by nerve conduction from the brain via the spinal cord) slide on top of one another causing the muscle to contract and relax.
The “knot” or myofascial trigger point (slightly more scientific name for them) forms when the protein filaments are no longer able to slide alongside each other causing a small patch of tightly contracted muscle; usually found in the centre of the muscle belly. These hardened bands can compress the underlying tissues, blood vessels and nerves resulting in pain (local or referred to other areas of the body), weakness or stiffness.
Unfortunately this compression can further exacerbate the trigger point by limiting the influx of vital nutrients that are required for the protein filaments to “unlock” and thus return to their natural resting state. This can explain why a knot or pain associated with a trigger point often does not go away until an intervention is applied (often by a third party).
Trigger point release can involve a number of techniques (including deep pressure, massage, ischaemic compression, dry needling, muscle energy techniques and stretching) and may involve the use of special tools, elbows or thumbs to elicit said pressure. There is no clear explanation as to how these methods alleviate trigger points, however it is thought that releasing the tension caused by the taut bands will help to reverse the compression on the underlying structures and thus allow blood flow and nutrient influx once again so the filaments can “unlock”. Releasing the trigger point alone will not fully resolve your symptoms however, and identifying the cause is vital in the long term resolution of your symptoms.
Common causes of trigger points are:
A thorough physical and subjective assessment will be conducted by our Physiotherapists to correctly identify the location and cause of these trigger points and thus select an appropriate treatment strategy in order to best benefit you and your ailment.