Health & Fitness The Newsletter About Achieving and Maintaining Optimal Well-Being
August 2020
DO YOU HAVE PAIN FROM TRIGGER POINTS? HOW PHYSICAL THERAPY CAN HELP YOU
WHAT ARE TRIGGER POINTS? As pain can be a frequent part of someone’s vocabulary with the daily experience of its intrusion into their world, one can wonder, “When will this pain go away?” Why we hurt could easily be a book in itself, but let us explore a small but really important reason for pain that is not playing fair and not going away predictably. Pain that originates from trigger points is one such source that does not play fair, and is a master of disguise in how it camouflages its origins. It does not play fair because it is not the type of pain that heals in a defined period of time like an ankle sprain or when you bite your tongue. Trigger points do not heal and do not follow some time table for improving. They are local nodules or tight knots in muscle, which when active can cause pain not only in that area, but at times even in areas remote from itself. This is where it can disguise and hide itself adding more confusion to a situation that is frustrating enough. Trigger points are created by a variety of inputs that can relate to muscle overload like in a rotator cuff muscle after working a long day in the yard, or from a trauma like a car accident where there is muscle overstretching and a strain such as in the neck. They are a very common source of chronic or ongoing pain, or pain that reemerges after heavy use and they like to nag you while you try to sleep or rest, or they interfere with motion and strength. TRIGGER POINT EXAMPLE Since trigger points primarily occur in muscle and are a large source of ongoing pain, it is sometimes surprising to learn the body hasmore than 600 muscles. So, it is not a huge leap in logic to see how trigger
points can be a significant problem to someone’s ongoing pain pattern. As an example, the rotator cuff is a vulnerablemuscle group for trigger points because these muscles are prone to being overwhelmed by heavy armuse in conjunctionwith poor postural control of the shoulder complex. Here is a picture of a common trigger point that refers deeply into the front of the shoulder; the irony is the muscle is located in the back of the shoulder (see picture). It does not hurt in the back, but refers to the front and even down the armmimicking nerve symptoms.
Here is a good example of how trigger points can mislead by treating only the pain site or assuming it is only tendon irritation since the pain is in the same location for a tendonitis; this would not treat the source of the problem. A thorough shoulder, muscle, rib and neck examwould be needed to really understand all the variables that could be causing pain in the shoulder. There are numerous examples of trigger
Rotator Cuff Trigger Points Trigger point denoted by X.
point pain which relate to all of our common orthopedic pain areas, and it is rare that trigger points have not developed if pain has been more chronic. What makes trigger points self-sustaining is when the muscle tissue forms a knot (which are actually just over shortened muscle fibers), it then sets up an environment where blood and nutrients are not (Continued inside)
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