What are “Knots” or “Trigger Points”

Maria Farrell MISCP discusses Trigger Points or Knots

You’ve probably heard the phrase “you’ve got a knot in your muscle” many times, but do you actually know what has caused it? This article should help explain the processes that lead to this problem.

A “knot” or Trigger Point as they are correctly called, can be an extremely painful problem and can occur within any muscle. Usually they are diagnosed by a therapist feeling the muscle looking for a “knot” or a collection of taught bands of muscle fibres. Trigger points usually are painful to touch and can refer pain to other areas, however sometimes they can be ‘latent’ meaning they are present but not painful.

So how did it get there?

For a trigger point to occur the muscle fibres themselves have been contracted in a sub-standard way. This can occur because of:

• A sudden increase in load (eg lifting something heavier than usual)
• Sustained positions where the muscle is contracted (eg sleeping awkwardly)
• Poor eccentric control (lengthening) of the muscle (i.e. the muscle is weak)
• Repetitive muscle contractions in a deconditioned muscle

This triggers a chemical reaction. Initially the blood vessels narrow which limits blood flow and therefore oxygen to muscle which injuries it. It also causes the pH (or acidity) to increase. As a result chemicals flood into the muscle which sets of ‘nociceptors’ (these are little receptors that send messages to the brain which creates the pain we feel). At the same time our ‘sympathetic nervous system’ is triggered (this controls the amount of adrenaline we release)

These processes combined then lead to different set of chemicals to be released which increases the number of contractions of muscle fibres in the area. Meaning the fibres are constantly contracting and create this area of ‘taught bands’ or ‘knot’ that we feel and cause pain.

If only it were that simple…

It’s not just lifting something too heavy or sleeping awkwardly that contributes to this problem. Vast amounts of research has been carried out that shows when we become stressed our bodies release a very similar cocktail of chemicals to that of a muscle injury. This can have a HUGE impact on the pain we feel, basically because we already have too many of those chemicals from the muscle injury combined with some more from being stressed and before you know it you now have a very painful neck, back, hamstring etc.

Stress doesn’t just come from work or home but it can also be from pre match or race nerves, this too causes a similar response.

So what can be done to help?

Increasing the control of muscles through simple strength training has proved effective to help this problem. Stretching also seems to have positive effects. Relaxation techniques can also help at times of stress and worry.
It seems that the best way to ‘release’ the area is using physiotherapy interventions

At Galway Bay Physio our Physiotherapist have a lot of experience dealing with Trigger Points and use evidence based techniques can help to resolve these problems including:

• Soft tissue manipulation
• Trigger point release
• Dry Needling
• Muscle energy techniques
• Deep tissue massage
• Stretching techniques both static and dynamic
• Advice on injury prevention
• Strengthening affected muscle groups
• Postural adjustments

If you are unsure of whether or not your you are suitable to attend chartered physiotherapist, feel free to contact us for a free telephone consultation, you can be assured that we will inform you if you are not suitable to attend Galway Bay Physio Chartered Physiotherapy and Sports Injury Clinic