Friday, December 23, 2011

Trigger Points & Performance

If you have talked therapeutic massage with me, then there’s a pretty good chance you’ve heard me mention trigger points.  Why?  Because I have a love/hate relationship with them.  I HATE the things they can do to me and my muscles, but I LOVE how big of a difference it can make to have just one released.  By definition, a myofascial trigger point is a hyper-sensitive spot in a taut band of tissue.  The tissue in question is either muscles (hence “myo-“) or connective tissue called fascia (hence “fascial”).  The other vitally important attribute of trigger points are their “referral zones.”  A trigger point doesn’t necessarily hurt where it is.  A trigger point in the calf can cause pain further down the leg, in and around the Achilles tendon and the heel.  Usually the referral zones are in some sort of logical line of movement/musculature, but not always.  Referral zones are always consistent.  With little variance, they tend to form in the same places in a given muscles and have the same referral zones, from person to person.  So much so that there are charts, and even smartphone apps to help you locate and cross-reference them with their referral zones.

If the trigger point is “active,” then the pain in the referral zone is present, even when the trigger point isn’t being actively aggravated by touch, contraction or stretch.  A trigger point is known as “latent” if it only causes referral pain upon palpation or other aggravation (such as contracting the muscle it resides in).  If a trigger point is cause referral pain that is bad enough, then it can also wind up causing a satellite trigger point, which lives within the first trigger point’s referral zone.  How “meta.”   I think that pretty well covers trigger points, so how about performance? 

Well…pain can inhibit performance.  But you already knew that, right?  So, the trick is that because trigger points have entire referral zones, the pain they cause can be indistinct in terms of “where” it hurts.  Then you don’t know what to stretch or ice or do self-massage on, and even if you target the whole area, you can miss the trigger point.  Then the pain continues to worsen as the trigger point gets more entrenched and nobody is having a good time except Mr. Grinch Trigger Point.  By extension of this, when you engage the muscle that the trigger point is in, you can aggravate it, and increase the referral pain, even just momentarily.  But even beyond the pain, if the trigger point is holding on, then it means that the taut band of muscle fiber it’s connected to isn’t being allowed to release, either.  Often, the release of a trigger point will ease the release of the rest of the muscles around it.  This is partly because the trigger point is constantly trying to recruit the muscle fibers surrounding it to join in on the excessive contraction it’s engaged in.  Troublemaker. If the trigger point is allowed to continue to do this, then it’s holding the muscle in a state of contraction, and not allowing the muscle its full range of motion or maximum strength through some or any of that range of motion.  This is the most direct impact of the trigger point on performance, and it can happen even with a latent trigger point.

So, trigger points equal a general, and possibly extreme, pain that’s tough to pinpoint and self-treat, plus inhibited muscle fiber performance.  The good news is that we have treatment protocols for them, and this is where my LOVE of trigger points comes in.  By releasing a single trigger point, a coworker of mine dispatched my migraine last week!  A SINGLE trigger point.  Migraine headache (that I’d been fending off for 2 weeks, I might add).  What I love about this is the enormously profound and immediate relief of releasing an active trigger point.  It’s such a powerful thing.  But it’s definitely work – for both the therapist and the client.  When you’re using that foam roller in the gym and you roll over a part of a muscle that’s really painful, there’s a decent chance that’s a trigger point – particularly if it’s always there, every day.  Try to hang out in that spot on the roller for a while and don’t forget to BREATHE through it.  After a few full breaths, it’s likely that it will begin to release and the intensity will subside for you.  Congratulations, you’re self-treating a trigger point, and this is MUCH easier said than done.  I could not have worked through my migraine trigger point on my own.  No way.  Too painful  So I’m really glad I had a massage therapist to help me out.