Myofascial trigger points and self-treatment
If you’ve ever felt a “knot” in your shoulder and dug in with your fingers to find both tension and relief, then the chances are you’ve found a myofascial trigger point – a knot of connective tissue that is tender to the touch and causes pain or other symptoms. This post today is all about getting to grips with myofascial trigger points.
Where are Myofascial Trigger Points Found
Myofascial trigger points can be found most commonly in the soft tissues of the body – the muscles and fascia – the connective tissue. They can also form in ligaments, tendons and nerves. Some can be as large as a golf ball, while others are as tiny as a grain of sand.
We owe a lot of our understanding of myofascial trigger points to Dr Janet Travell, personal physician to John F Kennedy, whose lifelong study of the phenomenon of myofascial trigger point syndromes started from her desire to understand often unexplainable pain symptoms.
One of her key discoveries is that the effects of a myofascial trigger point may be felt either where the trigger point is located or, more commonly, elsewhere in the body. This is called ‘referred pain’. Although myofascial trigger points are usually associated with pain, they can also produce a wide range of other symptoms including problems with vision, sleep coordination, and balance.
Despite Dr Travell’s work, myofascial trigger points are still not commonly understood from a medical perspective. The referred symptoms that mean trigger points are often overlooked and sometimes misdiagnosed as a better-known medical condition.
Getting To Grips With Myofascial Trigger Points
Nearly everyone experiences symptoms from myofascial trigger points at some time in their lives. The causes of trigger points can be due to trauma, such as an accident or surgery; overworked muscles through work or sport; or the simple wear and tear of daily living.
Many people don’t even know they have problem myofascial trigger points until they visit a massage therapist or other hands-on bodyworker. However, once you know about the typical patterns of pain and other symptoms caused by specific trigger points, it is easy to start to treat yourself. Regular self-care can address existing myofascial trigger points, it is easy to start to treat yourself. Regular self-care can address existing myofascial trigger points and prevent new ones from forming.
Working with your myofascial trigger points is not an exact science, as their location can vary from person to person. However, armed with a good trigger point book that shows ‘body maps’ of common referral patterns and typical trigger point locations, you can identify your most likely problem areas.
Start by getting the feel of myofascial trigger points. They may vary in size but will always feel tender to the touch. Sometimes pressing on a myofascial trigger point will recreate a familiar pain pattern, which means you are in the right place. Often the area you are working on will twitch as the trigger point releases.
Pressure is Key
Myofascial trigger points respond to gentle sustained pressure of up to 90 seconds. Working too hard or too fast can be painful and cause the tissues to tighten instead of releasing the restrictions that have caused the trigger point to form. Maintain the pressure until you feel a softening in the tissues or change in your pain. After 90 seconds release the pressure even if you feel no change in this session. Sometimes myofascial trigger points need to be worked on a few times to help them release.
You can apply pressure with your fingers, thumbs, or a soft fist. Or it’s often easier to use a ball, or a larger inflatable myofascial ball which creates a more gentle pressure.
Little and Often
Little and often is best when working with myofascial trigger points. Regular daily work brings the best results so aim for 20-30 minutes a day in total. Stretching after treatment is beneficial as this helps the muscles return to a relaxed state and prolongs the benefits of your self-care.
Here are some good areas to treat:
Back of Neck
Myofascial trigger point patterns here can cause a stiff painful neck, headaches and burning pain in the scalp. Trigger points under the base of the skull may also cause eye pain and disruption of vision.
Self-treatment: Place 2 inflatable myofascial balls in a bag and lie flat on the floor or your bed with a small pillow under the top of your head. Place the balls just below the base of your skull with one on either side of your spine for comfort. Rest on the balls and the weight of your head should be enough to help release trigger points here.
Top of Shoulder
Myofascial trigger point patterns at the top of the shoulder can cause problems with moving your arm in all directions and can affect movements such as waving, lifting and carrying items like shopping bags. Trigger points here are felt mainly when you use your arm and can also cause a sense of weakness in your arm and pain in your shoulder.
Self-treatment: Position a ball between the top of your shoulder and a wall. Move the ball around slowly until you find a tender area which is a myofascial trigger point. Lean into this with a sustained gentle pressure for at least 90 seconds, or until you feel a sense of eased tension or reduced pain.
Front of Pelvis
Myofascial trigger point patterns at the front of the pelvis can cause pain and tightness in the hips and legs when you walk, run, or go upstairs or up hills. Trigger points here can cause back pain, difficulty getting up from sitting, or standing for long periods, and also can affect your breathing if they restrict the movement of your diaphragm.
Self-treatment: To find the right area, feel on one side of your lower abdomen to locate your pelvic bone, place a ball just inside the bone on the soft tissue, and then lie on your front on the floor or a bed. This may cause an indigestion-like discomfort at first but maintain gentle pressure until the tenderness eases or for 90 seconds. You can then move the ball to work on the other side.
Myofascial trigger point patterns in the calves can give rise to pain in the calf itself, plantar fasciitis or foot pain, and lower back pain.
Self-treatment: sit on the floor with your back to a wall and place a ball under your calf letting your leg rest on it. Allow the weight of your leg to press the ball into your calf for 90 seconds or until you feel the tissue softening. You can move the ball to other tender points on your calf and repeat it.
I hope you find this post of interest. There is a book by Amanda Oswald who is a leading UK myofascial and trigger point specialist entitled “Living Pain-Free: Healing Chronic Pain with Myofascial Release and Trigger Points: Use the Power of Touch to Live Life Pain-Free”.
I’ve got it on my shopping list. As usual please feel free to visit my lifestyle blog which you can find by clicking here.
Love and Light