What are trigger points?
I’m sure you have all heard me talking about trigger points (TPs) during your animals session and have wondered, well what are these? Let me explain.
A trigger point causes strain and pain in the muscle, TPs are hyper-irritable spots found in myofascia. Direct compression or muscle contraction can cause tenderness, local twitch response and pain. The pain can then travel and become referred pain following a pain pattern from the spot. Often the animal can wince, cry or show pain signs when palpated. Trigger points develop in the myofascial, mainly in the centre of a muscle belly where the motor endplate enters. Small palpable nodules can be felt within the muscle and can cause pain in the skeletal muscle of the body. When trigger points are causing a lot of pain it can be referred to as myofascial pain syndrome.
What is a local twitch response?
A visible contraction of the muscle and skin as the muscle fibres contract when pressure is applied. This is often widely accepted as a diagnostic tool to determine a trigger point.
“A Myofascial trigger point is a point found in a nodule or taut band of skeletal muscular tissue that is extremely tender and refers or radiates pain in a characteristic pattern. Trigger points are produced by muscle stress such as overwork, repetitive motion or sudden excessive stretch.”
What is referred pain?
Reffered pain is pain that is found at a different location to the one that is palpated and is when the pain his located away from the original sources of pain. Often acupressure points can be palpated to find sights of secondary pain.
What causes a trigger point?
Ageing
Injury
Lack of exercise
Postural imbalances
Muscle overuse
Respective micro-trauma
Primary orthopaedic issue
Addicental injury
Persistent banging of the body
Permamant tissue changes
Over use
Chronic stress
Vitamin deficiencies
Joint instability
Post-operative strain
Compensatory patterns
What types of trigger points are there?
Primary tps cause severe local pain on pressure and are based in the centre of a muscle belly
Secondary tps are usually formed around the primary tp and usually are healed when the primary tp is healed.
Active tps cause reffered pain on palpation. The trigger point in the taut band prevents the muscle from fully lengthening and reduces its strength.
Latent tps change the muscle activation or cause muscle weakness without often causing pain unless palpated on a strong pressure
What symptoms do trigger points cause?
Chronic ongoing pain
Nerve irritation
Pain referral
Grumpy behaviour in animal
Premature ageing
Worsening of mobility in active and senior animals
Worsening of orthopaedic conditions eg arthritis
Self mutilation
What might you as the owner see in your animal?
Twitching or flinching of skin
Over sensitive/pain response to handling
Unwilling to be groomed in a certain area
Tickly spot
Coat changes such as change in colour/direction of hair growth in an area
Signs of fatiguing quicker when exercising
Unwilling to exercise
Weight gain
Weakness of limbs
Lack of co-ordination and proprioception
Reduction of performance
Lameness
Increased stiffness
How are these points treated?
Trigger points are treated by veterinary physiotherapists using deep tissue massage including techniques such as ischemic pressure and myofascial release, electrotherapists such as laser therapy, pulsed electromagnetic field therapy (PMFT), Neuromuscular electrostimualtion (NMES) and always followed with stretching.
What happens after the trigger point is treated?
Resolved pain
Muscles able to begin strengthening
Improvement of range of motion
More willing to be handled
Happier to be groomed
Improve sporting performance
Reduced recovery periods
