Does this sound like a familiar feeling ... “I can feel knots like little rocks sliding up and down in between my shoulder blades.”? In the land of Physiotherapy we we call there “myofascial trigger point” and they don't just exist in-between our shoulder blades.
These 'knots' are rarely debilitating but they are most certainly annoying and painful and the good news is you don't have to live with them.
To be more specific it is not literally knots in your muscles, researchers have a theory that these points are made of tightly contracted muscle and fascia. This specific point sucks in its own supply of blood which affects your neural structures thus give you symptoms of pain. Trigger points are very common and are described by their tenderness, location in the body or how chronic or acute is it.
Active trigger points, these can be central or satellite and means that it is tender when palpating and brought about referred pain.
Primary or central trigger point, this is always located at the central of the muscle belly. It is the most recognize of all points and referred by all people as their main knot. The secondary or satellite trigger point appears as a feedback from the central trigger point. Also known to be in the referred pain area, which means if the central trigger point will be treated most likely all the satellite points will be gone as well.
There are also studies that say, that there are ligamentous trigger point, which obviously is present in the ligaments. Most common ligaments with trigger points are sacrotuberous ligament which brought about pain on the lower back and ligamentum patellae that refers pain to the knee
Trigger points can also be categorised as diffuse trigger points where there are many satellite secondary to multiple central trigger points. This is often present when a large part of the body is affected like having conditions such as scoliosis.There are trigger points that you physically feel that is present however you don’t feel any pain or tenderness. These points are latent or inactive trigger points. It’s main symptom is muscle stiffness, but these points can still active if the central point is active again as well.
The more interesting question is how do we get these trigger points in the first place?
There are a number of reasons why we get trigger points;
- poor posture
- repetitive mechanical stress
- muscle and joint disease
- lack of enough sleep
- exertion overload
- nutritional deficiencies.
These wide ranging factors can make it seem almost impossible to predict and prevent them. However, with a little investigating it is often fairly easy to put these nasty trigger points to rest. You can do self-release yourself using a spiky, tennis or lacrosse ball to the specific trigger point. Other physiotherapists use modalities such as a metal curved device, dry needling, laser therapy, electrical stimulation and cupping. It is the client’s choice and preferences as too which device they prefer.