Trigger points are hypersensitive areas in muscles, fascia, tendons and ligaments that refer pain to other areas of the body. They can be the result of repetitive or stressful motion, trauma, or poor posture. Dietary, environmental, and emotional stress can also create these localized areas. Many physiologists dispute exactly what trigger points are and what causes them, so there is no single universal explanation. If an area is locally sensitive but stimulation of the site causes no referred sensations, it is considered a tender point. The referred pain may be experienced as pain, tingling, numbness, itching, aching, heat or cold. The area of referred pain is usually massaged, too. There can also be satellite trigger points around the primary trigger point.
The tissue is warmed up before trigger point work is applied. Trigger point work is sustained digital pressure applied to trigger points to relieve pain and discomfort. The therapist may use a thumb, finger, knuckle or elbow to apply pressure to the site. Palpation is used to locate trigger points and sometimes a twitch response helps the therapist locate them. They may present as taut bands or firm nodules. The tissue surrounding them might feel ropy, stringy or knotted. There is often a palpable crunch in the soft tissues.
Trigger point work may be used between other strokes during the massage session. Other deep tissue techniques, such as myofascial release, may be indicated for chronic pain from fascial adhesions, lesions and general ischemia.
The benefits of trigger point work are: stimulating local blood flow and the release of vasodilators, broadening muscle tissue and interrupting the pain cycle. It may be contraindicated for clients who are on large doses of blood thinners because it may cause bruising.
Clients may be sore for up to 48 hours after trigger point work Applying ice, increasing water intake and stretching and stretching may be recommended to decrease recovery time.
References:
Myofascial Pain and Dysfunction, the Trigger Point Manual.Travell and Simons.
1983
Massage Therapy Principles and Practice. Susan G. Salvo. 1999