Trigger Point Formation

What is a Microtrauma?
A microtrauma is a tiny, minute tear in the muscle tissue .

Three main causes of Microtrauma are;

1. 2. 3.

Overloading Overshortening repeatedly Overstretching

RE: Lifting an object that is too heavy RE: Manipulating an object RE: Using force past the muscle length

The Mechanisms of Trigger Point Formation

1. Overloading, overshortening, or overstretching occurs 2. This causes a decrease in flexibility 3. Microtrauma occurs( the destruction of muscle tissue and sarcoplasmic reticulum 4. The microtrauma causes calcium ions to be released into the area from the sarcoplasmic reticulum 5. The sarcoplasmic reticulum can not reabsorb or utilize the calcium due to energy depletion 6. The excess calcium in the area causes a sustained muscle contraction 7. The sustained muscle contraction impedes or greatly reduces local circulation

8. This impairment of circulation creates a lack of nutrients and oxygen and an increase of waste products like lactic acid, which then causes muscle tightness and pain. Muscle refers pain, known as: RPP or Referred Pain Pattern

Diagnosis of a Trigger Point A Trigger Point is correctly identified by the manifestation of three criteria.
1. 2. 3.

Palpable Taut Band of Muscle Hypersensitive Nodule or Mass in the Band of Muscle RPP; ( Referred Pain Pattern)

Treatment for Trigger Point/Myofascial Release

The initial therapeutic goal is to increase circulation to the affected area by modalities such as: Hot/Cold pack applications and Massage Locate the point and apply Progressive Ischemic Compression until the nodule dissipates It is recommended to stretch the muscle for a minimum of 30-45 seconds to assure tissue relaxation Muscle strengthening or muscle resistance exercises are recommended, as well as; Proprioceptive Neuromuscular Retraining utilizing Full ROM and Rocking Methods

Trigger Point/Myofascial Release Study Guide

1.

A decrease in flexibility may result in an injury known as: Three causes of this are:
1. 2. 3.

2.

3. 4.

ions are released when muscle tissue Destruction occurs The sarcoplasmic reticulum is unable to reabsorb the excess calcium
due to

5. causes: 6 7. 8.

This excessive localized release of calcium in the area Which causes circulation in the area to become: Impaired circulation will result in a decrease in: An increase in also occurs.

9. As the sustained muscle contraction impedes circulation, thus impairing the flow of nutrients and oxygen and the build up of waste products; the tightened muscle will refer pain. This process will result in ____________________ ______ ______________ ____________________________________________________________ 10. A Trigger Point is correctly identified by the palpation and identification of which three manifestations? A. B. C.

11. Hot/Cold pack application and massage are the first steps in treatment. The goal of these therapies is to:

12.

Apply

13. It is necessary to the muscle for at least how long_____________________________________________________? 14. Additional steps may be used including muscle strengthening exercises, resistance stretching,, and proprioceptive retraining. A massage movement that is effective in proprioceptive retraining is : 15.) A method used to relieve a trigger point by applying compression is known as: