A trigger point is a clinical name given to describe “hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers” (Travell, 1992). So in other words, a focal point within the tissue that is painful, and is most commonly described as a “knot” in the muscle. Now of course the tissue is not “tied in a knot”, but a skilled practioner will be able to feel and isolate this “mini-spasm” within the tissue.

Trigger points are significant because they alter the function of the muscle tissue. The muscle will be tighter, weaker, and create a pattern of pain that often refers to other areas. Have you ever had a headache from working at a computer too long? That could likely be the referred pain of a trigger point you feel, often in the neck or shoulders. Identifying the cause of a trigger point is probably the most significant clinical finding about it – that trigger points are not normal, and they will often point to an underlying cause such as poor posture, repetitive movement or strain, over-exertion, and sometimes the guarding response of a deeper underlying injury. Somatic (muscle) pain can be very debilitating and limiting, and a skilled practitioner will consider and test many factors when making an examination.

A common clinical technique to release a trigger point is through what is called an ischemic compression. An ischemic compression is when the therapist isolates the trigger point, and compresses it with pressure (often using a thumb to be precise). When compressed, the trigger point’s pain referral is often heightened temporarily, but quickly eases as the tissue releases. Ischemia means “a restriction in blood supply”, so by limiting blood supply to the trigger point through this compression technique, the muscle is deprived of essential nutrients (such as O2) needed to continue to contract and the result is that the tissue relaxes somewhat. This is an easy and effective way to help make trigger points smaller, as well as make an active trigger point reduce to a latent trigger point. 

What is the difference between a latent trigger point and active one? Most commonly people refer to ACTIVE trigger points as ones that are ACTIVELY causing pain. I always educate my patients that active trigger points are ANGRY. These are the guys that are giving off constant pain referral and sending messages to the brain and spinal column that we are "hurt" or something is "wrong" within the tissue of the body. These can often mimic other pain referral patterns in the body, such as Sciatica, rotator cuff tears in the soulder and even pinched nerves in our neck. 

Latent trigger points are Trigger points that have not become active yet however will give a pain referral pattern if you press on them. I often teach my patients that latent trigger points are LAZY. They cause dysfunction in the muscle unit because they don't want the muscle they are in to do any work. Essentially they take up space and gripe some if you move a certain way or try to use them in  specific muscle unit. These trigger points need to be released in addition to active trigger points because often times these will develop into active trigger points if allowed to be left alone and contue contrubuting to muscle dynfunction. 

The most common method that the doctors at Bluegrass Doctors of Physcial Therapy use to inactivate trigger points and COMPLETELY release them is through Superficial and/or deep dry needling.