What Are Trigger Points?
Trigger points cause pain more often than any other condition, are drastically under-diagnosed due to lack of information. Trigger points are specific, hyperirritable and hypersensitive areas in muscle that suffer from decreased circulation, increased contraction and spasm. Lack of circulation creates a high anomaly of toxins and increased nerve sensitivity that can range from low ache to sharp pain. Now just because the trigger point causes the pain does not mean that the spot is painful itself. When the pain causing spot is painful it is called a primary trigger point. However, pain can also manifest itself in areas away from the active trigger point - such pain is called referred pain.
A significant trigger point nodule can often be noticed as a small lump in the muscle, usually no larger than a pea. Less substantial trigger points are not so noticable by a lump, but are easy to find anyway - just search your own muscles for the spots that feel most tender; they will transmit pain pain when you press on them. You may not be able to locate a trigger point by feel, but it will always hurt when you press on it.
The supraspinatus is the most commonly injured rotator cuff muscle.
Healthy muscle fiber is neither contracted nor stretched when at rest. When contracted the muscle fiber is closer together and when stretched, it's further apart. In a muscle that is causing trigger point pain, the fiber develops a knot and is in a constant state of contraction. The fiber around these knots is stretched by the excess tension and the muscle fibers become tighter. With the continuous contraction, blood flow is slowed to a stop in the trigger point area and essential oxygen and nutrients are prevented from reaching the muscle tissue. Toxins and waste build up in the muscle and you will experience pain, tension, irritation, and spasm.
It is not uncommon to find a "taut band" of muscle stemming from an advanced trigger point; this taut band will feel much like a small cable. These taut bands extend from the trigger point outward and can be mistaken for a tendon, and it is these taut bands, brought on by trigger points, that keep your muscle in a state of tension. Taut bands that are found in shoulder muscles are directly attributable to lack of shoulder movement. The bad news is that left untreated, the trigger point will worsen and the taut band will become more taut, freezing up your shoulder joint more and more. To free up your shoulder mobility, it is hugely important to:
- Find the location of the trigger points that are the source of your shoulder problem.
- Eliminate these trigger points as soon as possible, to escape the downward spiral toward continually worsening shoulder mobility.
Trigger Points and the Rotator Cuff
Within the physical therapy arena, one of the classic resources for Kinesiology (the study of movement and the way muscles cause movement to occur) reference is Brunnstrom's Clinical Kinesiology (Smith, Weiss, and Lehmkuhl 1996); much of the following information on this page will stem from this book. Though much of Kinesiology is focused on movement, it is also concerned with the myriad of factors that limit the function of muscles.
As you may or may not know, many shoulder problems will occur because one or more of the 24 muscles associated with the shoulder are not functioning properly. Trigger points within the muscle tissue affect muscle function negatively, and the most important effects of trigger points are as follows:
- Trigger Points shorten muscles and actively prevent them from lengthening
- Trigger Points often cause muscle weakness.
- Trigger Points often are painful -> This pain makes muscles stay tense -> This constant tension in the muscle will make the trigger point worse, thus completing a continually worsening cycle.
The reality about rotator cuff injuries is that they often start slowly and gradually worsen to the point where the pain from the injury reduces your range of motion, eventually "freezing up" the shoulder joint. Once the shoulder is immobile, adhesions start to develop essentially locking your shoulder into place. In the opinion of some doctors (source) the first step in treatment is to get rid of the trigger points that reside within the muscles associated with the problem shoulder. The sooner the trigger points are treated, the better chance there is to keep adhesions forming in the shoulder joint.
Trigger Point Treament
The good news is that nearly all muscles attributed to shoulder immobility can be treated with the Shoulder Inferno Wrap®. This is exactly what you need to start the process of eliminating your trigger points. I posted a quick summary of Benefits attributed to Electromagnetic Therapy on the front page of this website, but knowing how absolutely important it is when related to trigger point treatments, I'm posting it again below:
Benefits attributed to Electromagnetic Energy (the energy used in Inferno Wraps®:
A Summary from Chapter 9 of "Therapeutic Heat and Cold", 4th edition.
(amazon.com link) Ed. Justus F. Lehmann, M.D., Williams, and Wilkin.
Generally it is accepted that heat on soft tissue (muscles, tendons, ligaments) provides the following desirable therapeutic effects:
- Electromagnetic heat increases the extensibility of collagen tissues
Tissues heated to 45 degrees Celsius and then stretched exhibit a nonelastic residual elongation of about 0.5 to 0.9 percent that persists after the stretch is removed. This does not occur in these same tissues when stretched at normal tissue temperatures. Therefore 20 stretching sessions can produce a 10 to 18 percentage increase in length of tissues heated and stretched.
Stretching of tissue in the presence of heat would be especially valuable in working with ligaments, joint capsules, tendons, fasciae, and synoviurn that have become scarred, thickened, or contracted. Such stretching at 45 degrees Celsius caused much less weakening in stretched tissues for a given elongation than a similar elongation produced at normal tissue temperatures.
Experiments cited clearly showed low-force stretching could produce significant residual elongation when heat is applied together with stretching or range-of-motion exercises. This is safer than stretching tissues at normal tissue temperatures.
- Electromagnetic heat decreases joint stiffness.
There was a 20 percent decrease in rheumatoid finger joint stiffness at 45 degrees Celsius (112 degrees Fahrenheit) as compared with 33 degrees Celsius (92 degrees Fahrenheit), which correlated perfectly to both subjective and objective observation of stiffness. Speculation has it that any stiffened joint and thickened connective tissues may respond in a similar fashion.
- Electromagnetic heat relieves muscle spasms.
Muscle spasms have long been observed to be reduced through the use of heat, be they secondary to underlying skeletal, joint, or neuropathological conditions. This result is possibly produced by the combined effect of heat on both primary and secondary afferent nerves from spindle cells and from its effects on Golgi tendon organs. The results produced demonstrated their peak effect within the therapeutic temperature range obtainable with electromagnetic heat.
- Electromagnetic heat treatment leads to pain relief.
Pain may be relieved via the reduction of attendant or secondary spasms. Pain is also at times related to ischemia (lack of blood supply) due to tension or spasm that can be improved by the hyperemia that heat-induced vasodilatation produces, thus breaking the feedback loop in which the ischemia leads to further spasm and then more pain.
Heat has been shown to reduce pain sensation by direct action on both free-nerve endings in tissues and on peripheral nerves. In one dental study, repeated heat applications led finally to abolishment of the whole nerve response responsible for pain arising from dental pulp.
Localized electromagnetic therapy using lamps tuned to the 2 to 25 micron waveband is used for the treatment and relief of pain by over 40 reputable Chinese medical institutes.
- Electromagnetic heat increases blood flow.
Heating muscles produces an increased blood flow level similar to that seen during exercise. Temperature elevation also produces an increased blood flow and dilation directly in capillaries, arterioles, and venules, probably through direct action on their smooth muscles. The release of bradykinin, released as a consequence of sweat-gland activity, also produces increased blood flow and vasodilatation.
- Electromagnetic heat assists in resolution of inflammatory infiltrates, edema, and exudates.
Increased peripheral circulation provides the transport needed to help evacuate edema, which can help inflammation, decrease pain, and help speed healing.
- Electromagnetic heat affects soft tissue injury.
Electromagnetic healing is now becoming a leading edge care for soft tissue injuries to promote both relief in chronic or intractable "permanent" cases, and accelerated healing in newer injuries.
Your massage therapist can certainly help with trigger point massage, but if you are treating your shoulder at home with the Shoulder Inferno Wrap® multiple times per day, you have a greatly improved chance of getting rid of your trigger points (and subsequently increase the range of motion in your shoulder). In some situations, trigger points in the back could be the cause of shoulder immobility; if you are certain that the underlying problem is in the upper back area, your trigger points are more effectively treated through the use of the Tortoise Shellz® Upper Back Therapy Vest.
A stretching routine can undoubtably lead to a successful outcome for many patients. However, there are time that many people in pain simply cannot tolerate stretching. When pain levels are high and your muscles are too taut, stetching may actually aggravate your injury. In cases such as this, the smart way to go is to first minimize your pain using trigger point massage and BFST® home treatments until you can reach a point where you start some moderate stretching without the pain. If you find the stretching aggravates the problem, stop stretching and just continue with the massage and BFST® treatments.
Combined with a stretching routine, the Shoulder Freezie Wrap® and Shoulder Inferno Wrap® are highly effective treatment products for trigger points. Successful treatment of your trigger points will increase shoulder range of motion and reduce the likelihood of a worsening rotator cuff injury. However, know that no amount of treatment will help with complete detachment cases of rotator cuff tears. If muscles or tendons are severed, the Freezie Wrap® and Inferno Wrap® can help manage your pain and inflammation, but surgery will be required for recovery.
Examples of Possible Causes of Trigger Point Pain
Tender trigger points typically develop from lack of stretching or improper stretching but can also be caused from stress/trauma, repetitive motion or even poor posture. Other common causes are:
- sitting without firm back support (slumped posture)
- prolonged sitting in a chair without armrests, or armrests that are too high, or too low (leaning to one side)
- cradling a phone between ear and shoulder
- large breasts
- one leg shorter than the other
- typing on a keyboard that is too high
- prolonged improper sleeping position
- playing a violin
- overly tight bra straps
- carrying a purse (prolonged hiking up of the shoulder)
- head-forward posture
- walking with a cane that is too long
Reduced circulation in trigger points will eventually lead to muscle shortening and restricted movement which further accentuates the pain, thus completing a cycle of decreased mobility and further pain. This commonly becomes the underlying cause of adhesive capsulitis, chronic shoulder immobility and even chronic headache pain. The patient will typically continue to suffer from these ailments for long periods until the problem trigger points are treated directly.
Mild Trigger Points can be addressed sometimes through massage and some sufferers maintain that acupuncture treats these problems as well, though it is not accepted by many medical institutions. Permanent removal of chronic trigger points and conditions caused by this (headaches, lack of flexibility in shoulders and neck, upper back pain, etc.) typically requires treatment using massage and BFST®.
Treating Trigger Point Pain - What You Can Do!
If you have shoulder and rotator cuff pain caused by tense, constricted muscles BFST® for your trigger points is an effective home treatment. Trigger point pain is caused by constricted muscle fibers, forming knots, and eventually building toxins in the area. The trick to getting rid of this pain is loosening the knots to release the constricted muscle fibers. This will allow blood to flow through the fibers once again, bringing the vital oxygen and nutrients required for healthy tissue. An effective and painfree way to loosen the knots is with Blood Flow Stimulation Therapy™ through use of the Shoulder Inferno Wrap®.
In addition, you want to get your muscle tissue back in the best possible condition you can. To do this, it is important to treat the scar tissue that forms in the muscle when the damaged tissue begins to heal - something our BFST® wraps are great at! Even with optimum healing, there is always less elasticity in previously injured muscles fibers. However, if you heal your trigger point pain properly and treat scar tissue build up, your chance of chronic trigger point pain and shoulder conditions later on is much lower than average.
There are healing tools that can help treat your rotator cuff muscle trigger point pain and speed up the healing process so you can get back to a life without further trigger point pain. Blood Flow Stimulation Therapy (BFST®) will loosen the knots at the trigger points, treat scar tissue, and promote blood flow to loosen your constricted muscles and heal the fibers faster and more completely than other home treatment methods available.
Click here to read more about how the Shoulder Inferno Wrap® helps your body heal.
Click here to read more about how the Shoulder Freezie Wrap® is designed to be the most effective cold compression wrap on the market today.
If you would like to learn more about trigger points and their relation to the rotator cuff and general shoulder joint immobility, then do not hesitate to contact a AidMyRotatorCuff Advisor immediately by phone or email.
Rotator Cuff Injury Facts:
The term "rotator cuff" refers to a group of four tendons that attach four shoulder muscles to the upper arm bone.
About 6 million people in the U.S. seek medical care each year for shoulder problems.
The shoulder joint has the widest range of motion of all joints in the body.
Rotator cuff injuries are typically associated with motions that require repeated overhead motions or forceful pulling motions. This is an injury that is very common in athletes, especially baseball pitchers, football players, weightlifters, rugby players, volleyball players, swimmers, boxers, tennis players, bowlers and cheerleaders.
AidMyRotatorCuff (a division of MendMeShop) is an FDA registered company. This means our products are of very high quality, made from biocompatible materials.
Continual repetitive use of the injured rotator cuff will lead to a worse injury.
Although the rotator cuff can tear suddenly as a result of a serious injury, most rotator cuff problems develop over time.
Remember to include your physician in choosing the best treatment option for you. To discuss your particular situation and how our products can help, call toll-free at 1-866-237-9608.
As soon as I began using the shoulder product much of the swelling and pain went away.
I was impressed because I'm a cynical health practitioner. But it does make total sense to move blood flow to tissue that needs to be repaired. There's really no other way -- except for surgery. And I'm trying to avoid that.
I'd say I have another 30-40% of arm use back.
Thank you MendMeShop for creating such a simple and effective product.
Dr. Judith Valentine