Are Trigger Points Causing Your Pain?

Are Trigger Points Causing Your Pain?

What Are Trigger Points?

Also known as muscle knots, trigger points are hyperirritable points in taut bands of skeletal muscle. It is thought that a small number of muscle fibers contract abnormally within a larger muscle. This compresses the local blood supply of that area, which then becomes extra sensitive. When pressed, these points are painful and often send pain to the muscles around them; sometimes they even refer pain to a distant location. Trigger points can make everyday activities painful, affecting your workouts, hobbies and even when you rest. When left untreated, trigger points may contribute to pain in many areas, particularly the neck, shoulders, joints, and lower back.

What Causes Trigger Points?

From injuries and trauma to prolonged muscle contractions and excessive loads, there are many factors that may cause trigger points. Inflammation, stress, nutritional deficiencies and prolonged sitting may also contribute to the formation of these painful areas. Muscular overload is generally thought to be the primary cause of trigger points. For this reason, you might notice trigger points after starting a new activity or training program.

Signs and Symptoms

These localized muscle cramps often go undiagnosed as sometimes the pain is felt in a different location to the site of the trigger point. These areas are tender to touch and cause predictable patterns of referred pain. They feel like hard lumps in your muscles, causing stiffness, heavy or dull aching, sharp pain, and general discomfort. They often cause the length of the affected muscles to shorten and for this reason trigger points may worsen the symptoms of arthritis, bursitis, tennis elbow, tendonitis, and ligament injury.

Treatment Options

Specific massage techniques and dry needling may help relieve pain and discomfort. Other common treatment options include trigger point injections, electrostimulation, mechanical vibration, and stretching exercises. These treatments can help to deactivate trigger points, however to prevent trigger points from forming again the causative factors need to be identified.

If you have trigger points, slow your working pace, watch your posture and avoid any exercises that cause pain. Your therapist can help with manual treatments to reduce trigger points and also identify causative factors such as poor training technique, posture and biomechanics. If you have any questions about trigger points and how they might be affecting you, don’t hesitate to ask your practitioner.

Focus on…

Cervicogenic Headache


Headaches are a common condition affecting most people at some stage in their life. There are many different types of headache, which are classified using their cause and symptoms.

A cervicogenic headache is one of the most common types, and is named this way because the underlying cause of the pain actually originates from the structures of the upper neck. Its symptoms and treatments are quite different from other types of headache, such as tension-type headaches and migraines. The latest scientific evidence suggests that cervicogenic headaches respond well to treatment by a Physiotherapist, Chiropractor or Osteopath.


If you experience a cervicogenic headache you are likely to feel a low grade headache; located on one side of the base of your skull, which may refer to the forehead. As these symptoms may be present with many other condtions, your practitioner will assess you and rule out any other potential causes.


A cervicogenic headache usually occurs when there are mechanical changes in the upper neck, such as with wry neck or when there is excessive load placed on the upper neck structures through prolonged activity, for example slouching, poor computing posture, carrying and lifting. It may also occur following a whiplash-associated neck injury. These mechanical changes may cause the joints, muscles, ligaments and nerves to be a source of neck pain and headache. There is no correlation between tissue damage to the neck and the severity of a headache.

A cervicogenic headache is an example ofreferred pain (pain arising from a distant source). It happens because the nerves supplying the upper neck also supply the skin overlying the head, ears, jaw line, back of the eyes and forehead. The muscles of the upper neck may also develop trigger points which refer pain into this area.


A cervicogenic headache is diagnosed by your practitioner from the symptoms described by the patient and a thorough physical examination. Often your therapist will be able to reproduce or aleviate the symptoms of your headache during their assessment, confirming that the structures of the neck are contributing to your pain.


Management of cervicogenic headaches includes treatment to relieve symptoms of headache and exercise to prevent the re-occurance of headache. Your therapist can identify any abnormalities in the joints and muscles which may be contributing to your pain and restore them through manual techniques such as massage, trigger point therapy, joint mobilisations, dry needling and heat therapy as appropriate. Your practitioner will take the time to address both the abnormalities and their causes, which may be as varied as poor posture at work to weakness of the deep neck muscles to thoracic spine stiffness.

Symptoms of a cervicogenic headache usually settle quickly with manual therapy and commencement of home exercises.

Open Faced Prosciutto, Fig and Plum Sandwiches


1/4 cup of fig preserves

1 tbsp fresh lemon juice

1/4 tspn grated, peeled fresh ginger

1/3 cup soft goat cheese

4 Slices whole grain bread, toasted

1 cup of loosely packed rocket

2 ripe plums, cut into thin wedges

100 g very thin slices of prosciutto

1. Combine the fig preserves, lemon juice and ginger in a bowl, stirring with a whisk and set aside.

2. Spread the goat cheese evenly over each bread slice; divide the rocket, plum wedges and prosciutto evenly over the sandwiches. Drizzle each sandwich with roughly one tablespoon of the fig preserves mixture. Serves two.

22,000km Through Africa

Elliot and Kenny are undertaking an incredible motorbike expedition from South Africa to Egypt, visiting some of the least developed countries in the world on the way. Read about their adventures and support their mission to bring fresh water and education to those who need it as they go.

Trace the pattern above with a pencil in one continuous line without taking the pencil point off the paper.

You are not allowed to cross the line, or go over any part of it twice.

Work This Out

1. Which three positive numbers give the same result when multiplied and added together?

2. How can you make “seven” even?

3. What is harder to catch the faster you run?

4. A man pushes his car and stops in front of a hotel and immediately goes bankrupt. What is he doing?

Answers are on the next page…

The 19 Year Old Who Wants To Clean Up Our Oceans

Boyan Slat is a 19 year old who wants to clean up the many tons of waste plastic floating in our oceans. Amazingly, he has created a solution, which he thinks will not only remove most of the plastic waste within three years, but will also be profitable in the process.

To hear him explain how he thinks we can solve this great problem

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