Myofascial Trigger Point (TrP)

Authors

Affiliations

Nate Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

• ¹

• ²

• ch14 Myofascial Release in Orthopaedic Manual Physical Therapy³

• Ch16 Myofascial Trigger Point Approach in Orthopaedic Manual Physical Therapy³

Types of trigger points

There are two main types of trigger points:

1. Active: Pain or discomfort during movement²
2. Latent: Pain or discomfort only during direct compression²

Palpation

During palpation, the muscle bundle feels stiff and the trigger point itself feels like a knot².

Histology

A trigger point histologically consists of significantly contracted sarcomeres which compress the Z-lines together and cause an increase in cross-sectional area². This creates the feeling of a “knot.”

Since the fibers of the trigger point are contracted and compressed, the fibers outside of the trigger point must stretch and elongate to compensate². As a result, this causes the rest of the muscle to feel like a taut band².

Treatment

Reading list

• Ch72 Trigger Point Injection and Dry Needling¹
• Ch73 Manual Therapy Considerations¹
• Ch74 Therapeutic Exercise Considerations¹
• Ch75 Therapeutic Modality Considerations¹
• ch76 Postural considerations¹
• Ch77 Footwear considerations¹

trigger point therapy

Jump Sign

A patient can demonstrate a “jump sign” during palpation, where the patient pulls away from palpation that is disproportionate to the pressure provided².

References

1.

Donnelly JM, Simons DG, eds. Travell, Simons & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Third edition. Wolters Kluwer Health; 2019.

2.

Kolar P. Clinical Rehabilitation. 1st ed. Dynamic Neurological Stabilization; 2014.

3.

Wise CH, ed. Orthopaedic Manual Physical Therapy: From Art to Evidence. F.A. Davis Company; 2015.