Myofascial Trigger Points

Massage can help relieve pain

Those annoying knots in muscles and connective tissues are called myofascial trigger points. The 'myo' part of the word means muscle and 'fascial' refers to the elastic, connective tissue that runs throughout the body. Trigger points radiate (or refer) pain from muscle or fascia in a characteristic pattern. For example, trigger points in the shoulders often send pain and tension throughout the shoulders and up into the lower neck. Likewise, trigger points in your buttocks can refer pain down the leg just as in sciatica.

Two doctors, Dr. Janet Travell and Dr. David Simons, revolutionized our understanding of trigger points. They mapped out the entire body and standardized a pain referral pattern for each muscle. Trigger points usually follow these maps. Deep breathing, stretching, applications of heat or cold, and massage can help.

The levator scapula, a problematic muscle

Travell and Simons say that the shoulders are the area most affected by trigger points. The levator scapula muscle connects your shoulder blade to your neck and is responsible for elevating your shoulder blade. It is especially prone to trigger points, and can refer pain to the neck, around the shoulders and down into the mid-back.

Massage techniques to relieve pain

Massage therapists are trained to prevent and reduce these knots and the pain that accompanies them. One of the most effective treatments that therapeutic massage utilizes with trigger points is called 'ischemic compression.' After locating the trigger point, the therapist applies direct pressure, producing some pain, always working within your tolerance level. You may feel discomfort locally or you may feel it radiate and travel away from the area being pressed.

Your therapist may instruct you to breathe deeply, consciously relaxing the area being pressed until the discomfort subsides. Next, the pressure may be slowly increased until the pain returns. This process may be repeated, followed by other massage techniques and hydrotherapy such as moist heat or ice massage. 

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