Understanding Myofascial trigger points

First, what are trigger points?

A trigger point (TrP) can be defined as a focus of hyperirritability in a tissue, palpable as a nodule or a cord that, when compressed, is locally tender and can give rise to referred pain. Types of TrPs include myofascial, cutaneous, fascial, ligamentous and periosteal. This book focuses on myofascial TrPs.

Understanding myofascial trigger points

Myofascial TrPs were brought to medical attention by the late Dr Janet Travell, the personal physician to the late US President John F Kennedy. Dr Travell had a diverse background; she worked as a cardiologist and a pharmacology professor. Dr Travell co-authored a two-volume book with Dr David Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual. Dr Travell observed that palpable tender muscular knots/cords/nodules or TrPs can cause pain at the site and refer to adjacent regions, often mimicking other conditions. For example, TrPs in the left latissimus dorsi can mimic angina, or TrPs in the piriformis and gluteus minimus can mimic lumbar radiculopathy. Travell and Simons painstakingly listed, studied and mapped the pain distribution of every trigger point for all the muscles in the body.

I believe that TrPs can result from:

1. Traumatic injury to a muscle, e.g. a fall or misstep straining some thigh muscles.

2. Constant contraction of a muscle due to repetitive strain, e.g., an antalgic gait of a patient walking with a severe knee OA or heel pain, thereby straining the lumbosacral muscles.

3. Constant activation of a muscle to protect a nearby painful joint or structure, e.g. constant activation of the gracilis and quadriceps to protect the pain of an osteoarthritic knee joint, or constant activation of multiple shoulder muscles to protect the pain of a supraspinatus tear.

The above is a short excerpt from my book, which you can purchase here.

Watch the short tutorial video’s that accompany the book here.