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What are Trigger Points?

And when should I seek treatment for them?


Trigger points are what we commonly refer to as knots in the muscle. They can be associated with extreme tenderness or pain with palpation (touch).  Additionally, they can cause a muscle to twitch—I’ve heard clients describe this twitching as feeling like their heart is beating/fluttering in the muscle.  Trigger points can also limit the range of motion in a joint, and they can refer pain elsewhere in the body.

There are many trigger point pain referral patterns available online; Janet Travell’s are considered the golden standard.  She was JFK’s physician, and he credited her work as the reason he was able to walk.


The Mechanics

 When a muscle contracts, this contraction happens within muscle fibers which are very long and thin.  (Think of one strand of hair as representing a muscle fiber, and a full head of hair being a muscle).  When these fibers contract they can shorten to about half of their initial resting length. Once the muscle fiber stops receiving the signal to contract, it should return to its resting length…but that doesn’t always happen. Enter, trigger points.



There are many trigger point pain referral patterns available online; Janet Travell’s are considered the golden standard.  She was JFK’s physician, and he credited her work as the reason he was able to walk.


Repetitive Use Injuries

While there are a million remedies out there for muscle pain, I would argue that the most significant way to reduce the pain (when it is in its infancy) is to identify the source of it.

Repetitive motions–the way we sit at our desk, drive our car, pull open a door, flop down onto the couch–all carve their impact into our body like water carving a path through a canyon. Recognizing patterns in our movement can aid in identifying the source of muscular pain.

For example, if you’re at your desk when you begin to feel that stubborn pain in your elbow, you may want to consider how frequently throughout the day your elbow is in that same, flexed, position.  Do you find yourself texting or looking at your phone for long periods of time?  Are you lying on the couch reading a book with your elbows flexed? Are you sleeping on your side with your elbows flexed all night long?  


So, when should you consider seeking help from a professional for trigger point relief?
  • The pain is waking you up or making it difficult to fall asleep
  • The pain or weakness is causing you to use your body differently or avoid certain movements.
  • The pain has subsided, but now a different, close-by, area is beginning to hurt.
  • If the pain is in a leg, you now notice the other leg/hip/ankle popping or cracking
  • It is impacting your work, or ability to engage in hobbies/activities
  • It is causing anxiety
  • You have previously injured this area
  • You are experiencing cramping or shaking when trying to use the muscle


This information is meant to be educational, and should not replace any guidelines you’ve been given, in reference to your health, by your primary health care team.