Knots! aka Trigger points

Okay, we've all heard of a 'knot' in the muscle. To a registered massage therapist we learn that this 'knot' is called a trigger point or also myofascial pain syndrome. Chances are if you take your left hand and squeeze your right trapezius muscle between your neck and your shoulder you will feel your very own trigger point! Easy..it will hurt just a bit.

What is it?
Myofascial pain syndrome (MPS) is a situation that develops when muscles undergo injury or trauma, sometimes on a microscopic level, that never goes through a standard healing process. Instead, the injured area gets locked into a repeating pain-spasm cycle. The trigger point may refer pain into surrounding tissues. The infraspinatus muscle for example is one of the rotator cuff muscles and it can refer pain into the shoulder joint and down the arm, in some clients going as far down the arm into their hand.

Who gets it?
It affects men and women more or less equally; MPS or trigger points, affect people of all ages. Both sedentary people are vulnerable to this condition as well as physically active people.
The incidence of MPS is difficult to estimate. Among one group of patients with chronic pain, 35% of them had active trigger points.5 Even people with no symptoms can show signs of latent trigger points, however, which may develop into active myofascial pain syndrome with little provocation.

Massage?
MPS indicates massage, both for its effectiveness at interrupting the pain-spasm cycle and for its ability to help clean up the debris left behind from chronic muscle tightness. When muscle cells are working and contracting, they cannot exchange nutrients for waste products. Irritating metabolic wastes accumulate in the tissues, perpetuating soreness and fatigue. Massage is an excellent mechanism to help flush the waste away, with the precaution that someone in this condition is easy to over treat. There is a fine line with treating and over treating these trigger points.

Sources:
5 Fomby EW, Mellion MB. Identifying and Treating Myofascial Pain Syndrome. The physician and Sportsmedicine 1997;25(2).
Werner, Ruth. A Massage Therapists Guide to Pathology. Third edition. Lippincott Williams & Wilkins. 2005.