What are Myofascial Trigger points?
Myofascial Trigger Points Explained
Many times, when people complain about muscular pain, myofascial trigger points are actually the root cause of that pain. In fact, Myofascial Trigger points are so common, that mostly everybody will experience pain due to trigger points in their lifetime. The pain often gets misdiagnosed or undiagnosed by the medical community.
If doctors do not know what is causing the issue, they will usually prescribe pain medications to give relief. The problem is, this is just a bandaid treatment, as it does not get rid of the root cause. Since pain is the bodies way of telling you something is wrong, it is not the best decision to just take medications to mute the pain.
The reason why doctors are not typically aware of myofascial trigger points, is that medical schools do not typically include the study of these trigger points in their curriculum. They also don’t lear about the referred pain patterns that trigger points often exhibit, confusing the diagnosis even further. As a result, medical doctors are not usually aware of what trigger points are, how common they are, and how they can be a major factor in their patients pain.
The doctors that do know about trigger point therapy usually embark on a self-study to learn about myofascial trigger points later on in their career. They usually start seeking for answers after attempting to diagnose and treat a patient without any success.
There are countless people who suffer from muscular pain. Many of these people learn to live with the pain because they don’t get any answers or results from their doctors. If your pain is in fact from myofascial trigger points, you may be able reduce or completely eliminate the pain by releasing the myofascial trigger points through various methods.
What is a Myofascial Trigger Point?
A myofascial trigger point is essentially an area of the muscle that is stuck in a contraction. Usually it will be very tender or painful, and it can also feel like a little nodule. Myofascial Trigger points can develop in any muscle in the body. Since there are over 650 muscles in the body, there is potential to have many trigger points throughout the body.
When people have trigger points, it is common to have several of them throughout the body or certain areas of the body. It is also common to have trigger points on corresponding muscles. For example if you have a trigger point on your left trapezius muscle, you will likely have one on your right trapezius muscle. However, if you use one side of the body more often (such as using a mouse all day long), you can have a bigger myofascial trigger point on that side.
Types of Myofascial Trigger Points
There are two types of myofascial trigger points. There are ones that are active and ones that are latent. The active trigger points are called active because they are actively causing you pain / referred pain throughout the day. The latent trigger points are not causing you any noticeable pain, unless pressure is put on the latent trigger point.
Active Myofascial Trigger Points
Myofascial trigger points can reduce the range of motion you have in your body because the muscles are tight. Trigger points can also cause pain, usually to a separate area of the body. For example, a myofascial trigger point in your back can cause pain in your neck. This is called referred pain and is the reason why muscular pain is so hard to diagnose and treat. Many times when people have neck pain, they will massage their neck, without resulting in any major improvement. This is because trigger points elsewhere in the body are actually causing the neck pain.
Latent Myofascial Trigger Points
There are also myofascial trigger points that don’t actively produce any pain, unless touched. The latent trigger points can be very tender to massage, and should be addressed because there is potential for latent myofascial trigger points to turn into active trigger points which can cause pain later down the road if they become active.
Since latent trigger points do not cause any noticeable pain unless touched, and since active trigger points cause pain to a separate area the body, trigger points are difficult to diagnose, especially by somebody who is not trained or aware of myofascial trigger point therapy. However, there are common referred pain patterns and common myofascial trigger points that you can familiarize yourself with, in order to troubleshoot your own pain.
Myofascial Trigger points are found in a Taut Band
A myofascial trigger point is found in a Taut band, which is a tight band of tense muscle fibers. The Taut band feels like a small cord or rope, almost like a tendon. It is also sometimes described as feeling almost like a guitar string. The muscles natural state is that of relaxed muscle fibers. The Taut band is essentially a thin band of tight muscle fibers amidst the naturally relaxed muscle fibers. The myofascial trigger point is found in this Taut band, and the contraction knots within the trigger point cause this tight band of muscle fiber.
As defined by Travell and Simons (the forefathers of myofascial trigger point therapy), a myofascial trigger point is “a hyper irritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a Taut band”
The size of a myofascial trigger point varies in size. It can be as small as a pinhead or it can be the size of the Pea, and can almost feel like a half cooked macaroni. It can also get bigger. It just depends on how bad the trigger points get.
How Myofascial Trigger Points are Formed
Muscles contract so that we can move our body. The way they contract is through hundreds of thousands to millions of sarcomeres. Sarcomeres allow the muscle to contract, and are like a telescoping pole. Since muscle fibers are a cylinder tube, the sarcomeres will shorten or lengthen to allow the muscle to contract or relax.
What happens is overstimulation of the muscle causes the sarcomeres to contract and get stuck in that contracted state. So you have one muscle fiber that has a small area of sarcomeres that are contracted through the shortening of the muscle fiber. Then the remaining two ends of the muscle fiber are stretched or lengthened because of the contracted middle. When you have several of these muscle fibers that are stuck in a contracted state, all those small muscle fibers there are overstimulated and stuck in that contracted state combine to make up the trigger point.
So all the areas where it is shortened is where the trigger point lies, and all the surrounding lengthen parts of the muscle fiber are what makes up the Taut band, which causes the tightness in that band.
Video showing how muscles contract:
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Why Myofascial Trigger Points are Painful
Where the sarcomeres are shorten and create the trigger point, it prevents blood flow to that area. This further results in a build up of toxins and waste which can irritate the area of the myofascial trigger point. At the same time, it is thought that there is a compression of the surrounding nerves. The effect that the lack of blood supply and also the compression of nearby nerves causes referred pain to other areas of the body.
The muscles that have the myofascial trigger point also become weak, which can further facilitate tight and shortened muscles. Also, trigger points seem to be connected in that myofascial trigger points can cause trigger points in other areas. For example, trigger points in your back muscles can cause myofascial trigger points in your jaw or neck muscles.
How to treat Myofascial Trigger Points
There are several different methods to treat the myofascial trigger points, but some of the most effective treatments are ones that you can actually do at home by yourself without any need of assistance. You can directly press on the trigger points or massage them with a muscle roller, such as a foam roller, muscle roller stick or a massage ball. You can also seek out a trained massage or physical therapist if you need help finding which trigger points to target, and how to effectively massage them.
If you are doing self myofascial release with a foam roller or massage ball, there are several techniques to accomplish this. With the massage ball, you could place the ball between your back and a wall. Then to massage the myofascial trigger point, you would move either side to side or up and down.
It’s best to massage the myofascial trigger points slowly and in only one direction with a massage ball. Depending on how your body reacts to massaging the trigger points, you can massage a particular trigger point up to one minute (possibly two minutes). You can do this anywhere between 5 to 12 times per day. It’s important not to over do it, and to let your body do the healing. The massaging is just allowing your body to heal the area.
Why Foam Rolling helps Myofascial Trigger Points
When you use a foam roller to massage the myofascial trigger point, it helps push out the toxins created by the contracted muscles, and allow new blood flow to come in. The new blood that comes in allows oxygen and nutrients to heal the area and allow the muscle fibers to be freed from their contracted state.
While you massage the trigger points, you will probably feel the pain in and around the trigger points itself, along with the referred pain that you may have been expecting. This is key to deciphering whether it is a trigger point or not. Does it trigger that referred pain, or is it very tender and painful? Chances are it might be a myofascial trigger point that needs attention.
Foam Rollers vs Massage Balls for Trigger Points
Foam rollers are great to target all of you body. They are a good way to keep all of your myofascial trigger points at bay and to maintain your muscles and fascia on the macro level. We recommend foam rolling every day (or every other day) if you can. Sometimes you may find new myofascial trigger points due to the large surface area that the foam rollers covers.
Massage balls are good for specific trigger points that you might need to target. Massage balls allow you to really target that specific myofascial trigger point and it allows you to spend a little more time on the most troublesome trigger points. Massage balls are also nice in that you can reach myofascial trigger points that are much more difficult to reach with just a foam roller.
How Long Will it Take to See Results?
Depending on how bad your myofascial trigger points are, it may take several weeks or even longer to reduce or eliminate the pain associated with trigger points. Sometimes you’ll feel relief from pain right away, or after a few days. Everybody is different, and everyone’s bodies reacts differently and heal the different rates. As a general rule of thumb, the longer that you’ve had the myofascial trigger points, the longer it will take to get rid of the pain that they are causing.
Is important to address the trigger points so that they do not turn into chronic pain which can be much more difficult to resolve, if not impossible. Once something gets into the chronic pain round, it’s effect is not on the trigger points self but there is a dysfunction of the cortex in the brain that causes you to continually feel the pain, through pathways that are so reinforced it can become permanent.