Trigger points are an often referred to and discussed concept in the world of soft tissue therapies and

training. Over the next few posts I will review symptoms, assessment procedures and relevant clinical
information with regards to trigger points.
A trigger point is typically defined a hyperirritable spot within a taut band of skeletal muscle or fascia.
This may be associated with localized ischemia, changes in physiology andor shortening of local
sarcomeres.
There are many different types of adhesions in the body. The body can bind fascia, restrict !oints
capsules, lay down excess bone or produce collagen during the inflammatory response. All of these can
be palpable adhesions in the body. In saying that not every palpable adhesion contains a trigger point.
In the Trigger Point Manual-Myofascial Pain and Dysfunction Travell and Simmons explain in detail
characteristics of myofascial trigger points"
#. Myofascial trigger points refer pain along specific patterns. $ain is typically dull and achy, and is
generally increased or produced by applied pressure to the trigger point once found. This does not
mean that because pain is present in the posterior aspect of the shoulder a trigger point will always be
present. Trigger points do not always follow a dermatological pathway, and therefore are not directly
related to neurological compromise.
%. Trigger points are activated by acute load, overwork fatigue, direct trauma or chilling. The
most important thing to recognize out of this statement is overwork fatigue. &hen a trigger point is
present, a muscle is tired and frustrated. Overworked muscles carry the load for typically weaker, lazier
synergistic muscles. 'or example it is not uncommon to get a rectus femoris trigger point from an
under worked psoas ma!or. In these instances treating the trigger point solely, will not resolve the
condition.
(. Trigger points can be activated by other trigger points, disease, stress or other dysfunctional
physiology. This means symptoms are held in the soft tissue, but this may not be the direct cause.
Always )uestion hydration, medication, diet, stress levels and sleep wake cycles with your athletes.
*. Trigger points vary in intensity and frequency from person to person. +on,t treat every athlete
the same, the more athlete centered your programs and treatments the more effective you will be at
elminating trigger points.
-. Trigger points can exist in a latent fashion. The threshold of circumstance by which trigger points
become active varies from person to person but is largely related to tissue )uality .related strongly to
point /(0.
1. Symptoms of a trigger point long outlast the mechanism of injury. The body is very intelligent,
post trauma trigger points can develop in healing tissue to help 2guard3 or spasm against re
in!ury. 4ontrol and removal of perpetuating factors .posture, work modification0 can )uickly result in
their latency or resolution. Always analyze movements mechanics, posture, duties at work and
activities of daily living5
6. Trigger points may cause autonomic phenomenon. This may include sweating, vasoconstriction,
pilomotor activity or trouble swallowing. If present treatment of trigger points and appropriate
structures may reduce or eliminate symptoms.
7. Trigger points cause pain and weakness in the involved muscle. Again this means that the trigger
point causes a muscle to become weak, this does not mean the muscle was weak to begin with.
8uscular weakness can also be caused by neurological comprise, under conditioning, or lack of !oint
mobility. Take these into account when examining your athletes.
In the next blog we will discuss common ways to determine whether or not your athletes are suffereing
from trigger points and what to do about it.