Blog Post

Understanding Trigger Points

January 2, 2025
At Good Health Group Clinic, one of the most common questions I get from clients is, “What is a trigger point, and how is it made?” It’s a great question, as trigger points are a key factor in many musculoskeletal issues that can hinder performance and cause discomfort.

During my own research for this article, I even discovered that what I was taught about trigger points, such as them being caused by crystalised lactic acid, was incorrect.

Let’s break down what trigger points really are, how they develop, and their impact on your sports performance.

What Are Trigger Points?


A trigger point is a
hyperirritable spot within a taut band of skeletal muscle or fascia. It can feel like a small knot under the skin and may cause pain either locally or in referred areas.

Trigger points are classified into:

  • Active Trigger Points: These cause pain at rest or during movement.
  • Latent Trigger Points: These do not cause pain unless pressed but can still restrict movement and weaken muscles.

Trigger points are often located in taut bands, which are tight, rope, like strands of muscle fibers. Understanding the relationship between taut bands and trigger points is important to addressing muscle dysfunction effectively.

What Are Taut Bands, and How Are They Related to Trigger Points?


Taut bands are
tightened segments of muscle fibers that form due to chronic tension or stress in the muscle.

They are often found in areas subjected to repetitive strain or poor posture.

  • Taut Bands: Represent a general state of muscle tension or tightness.
  • Trigger Points: Are specific hypersensitive spots within taut bands that cause pain or dysfunction.

Not all taut bands contain trigger points, but all trigger points are found within taut bands.

Example: Imagine a taut band as the "landscape" of tension in a muscle and a trigger point as the "hot spot" of pain within that landscape.

How Do Trigger Points Form?

Trigger points develop due to a combination of mechanical, biochemical, and neurological factors. Here’s how they’re made:

  • Muscle Overuse or Injury: Repetitive movements or sudden trauma can strain muscle fibers.
  • Prolonged Muscle Contraction: Reduced blood flow leads to oxygen deprivation and an "energy crisis" in the muscle.
  • Stress and Poor Posture: Chronic tension in muscles increases their susceptibility to developing trigger points.

On a microscopic level, trigger points are associated with:

  • Excessive acetylcholine (ACh) release at the neuromuscular junction, leading to sustained contraction.
  • Local ischemia (restricted blood flow) and the accumulation of metabolic waste, creating a cycle of pain and dysfunction.


Dispelling the Myth: Are Trigger Points Caused by Crystalised Lactic Acid?


When I first learned about trigger points, I was taught that they were caused by crystalised lactic acid.
However, research has shown this is incorrect.

  • Lactic Acid Does Not Crystallise: Lactic acid (or lactate) is water-soluble and is rapidly cleared from muscles after exercise.
  • Trigger Points Are Neuromuscular, Not Metabolic: They result from localised energy crises and abnormal muscle contraction, not from lactic acid buildup.

This outdated idea likely originated from early misconceptions about post-exercise soreness (DOMS). Today, we understand that trigger points are more complex and involve a combination of mechanical, biochemical, and neurological factors.

How Do Trigger Points Limit Sports Performance?


Trigger points can significantly impact athletic performance by:

  • Restricting Range of Motion (ROM): Taut bands and trigger points limit muscle flexibility, reducing movement quality.
  • Weakening Muscle Strength: Trigger points interfere with normal muscle activation, leading to weakness.
  • Causing Pain: Active trigger points can cause localized or referred pain, mimicking injuries.
  • Altering Movement Patterns: Pain or tightness from trigger points often leads to compensatory movements, increasing injury risk.

Example: A trigger point in the glutes may restrict hip extension, affecting sprinting or jumping performance.

Managing and Preventing Trigger Points


At
Good Health Group Clinic, we emphasise evidence-based approaches to treat and prevent trigger points. Here are some effective strategies:

  1. Dry Needling: This technique helps deactivate trigger points by improving blood flow, reducing muscle tension, and resetting the neuromuscular junction.
  2. Instrument-Assisted Soft Tissue Mobilisation (IASTM): Using tools to target and release fascial restrictions and tight muscles, IASTM is highly effective in addressing trigger points and restoring normal muscle function.
  3. Deep Tissue Massage (DTM): DTM focuses on releasing tension in deeper muscle layers, helping to alleviate pain, improve circulation, and reduce the tightness associated with trigger points.
  4. Targeted Stretching and Strengthening: Correcting muscle imbalances through personalised stretching and strengthening programs enhances flexibility and reduces the likelihood of developing trigger points.


These evidence-based approaches help alleviate pain, improve muscle function, and prevent the recurrence of trigger points. At
Good Health Group Clinic, we tailor each treatment plan to suit your unique needs, ensuring the best outcomes for your muscle health and performance.


Conclusion


Trigger points are not caused by crystalised lactic acid, as many, including myself, were once taught.
Instead, they result from a combination of mechanical overload, reduced circulation, and neuromuscular dysfunction.
Understanding the difference between taut bands and trigger points can help individuals address these issues effectively, enhancing performance and reducing the risk of injury.

At Good Health Group Clinic, we aim to educate our clients on these topics and provide tailored treatments to restore muscle health and optimise performance.


By understanding and addressing trigger points, you can reduce pain, enhance flexibility, and achieve peak performance in your sport or daily activities.
If you have questions or concerns, feel free to reach out to us at
Good Health Group Clinic, we’re here to help!

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References

  1. Simons, D. G., Travell, J. G., & Simons, L. S. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1. Baltimore: Williams & Wilkins.
  2. Shah, J. P., Phillips, T. M., Danoff, J. V., & Gerber, L. H. (2005). An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. The Journal of Applied Physiology, 99(5), 1977-1984.
  3. Dommerholt, J., Bron, C., & Franssen, J. (2006). Myofascial trigger points: an evidence-informed review. Journal of Manual & Manipulative Therapy, 14(4), 203-221.


Blogs

February 11, 2025
Let me tell you about something weird I saw the other night while scrolling through YouTube. Lately, I’ve been really into watching other therapists work, checking out different approaches on Instagram and YouTube. Last night, I stumbled across a video on a fitness celebrity’s channel in the U.K. He was getting an IASTM (Instrument-Assisted Soft Tissue Mobilisation, also known as Graston technique) treatment from a sports therapist, and everything seemed normal, until the therapist made a pretty bold claim. As soon as redness started appearing on the guy’s skin, the therapist confidently said it was because “toxins were coming out.” No explanation, no scientific backing, just a statement that made it sound like IASTM was some kind of detox miracle. And of course, in the comments section, people ate it up, believing it just because the practitioner is a health expert and the channel owner is a well-known fitness personality.  But let’s set the record straight: IASTM is NOT a detox therapy, and there’s no such thing as a manual “detox” treatment.
February 4, 2025
At Good Health Group Clinic Brighton , we often hear clients say, "I've been stretching my tight muscles, but they just won’t loosen up!" Recently, a viral social media post caught my attention, claiming that stretching makes muscle knots worse and that stretching fascia doesn’t work. The video compared stretching a muscle with trigger points to pulling on a knotted rubber band, it supposedly makes the knot even tighter. The post gained a lot of traction, with many people commenting, "No more stretching for me!" But is this really true? As a clinic that specialises in myotherapy, chiropractic care, and remedial therapy , our practitioners, myotherapist Ian Selvarajoo , chiropractor Dr. Tanja Nishibata , and remedial and dry needling therapist Sam Noh , understand that while stretching alone isn’t always the solution, dismissing it entirely is misleading. So, let’s explore what the science actually says about stretching, trigger points, and flexibility. What Are Trigger Points? Trigger points, commonly known as muscle knots , are hyperirritable spots in the muscle that can cause local and referred pain. They develop due to: Chronic overuse Repetitive strain Poor posture Stress and nervous system tension Inadequate recovery after workouts A muscle with trigger points is often tight but weak , contracted and stiff, yet lacking strength. This explains why simply stretching the muscle may not provide relief. Does Stretching Really Make Trigger Points Worse? The viral video suggested that stretching a tight muscle is counterproductive because it worsens the "knotting" effect. While this analogy may seem logical, the reality is more complex. In some cases, aggressive stretching can aggravate tight muscles, especially when: The muscle is in a highly contracted state (such as after prolonged stress or poor posture). The nervous system is hypersensitive , causing muscles to tighten further in response to a stretch. You hold static stretches for too long without first addressing the root cause of the tension. However, this does not mean stretching is inherently bad, it just needs to be done correctly . What Does the Science Say About Stretching and Trigger Points? Contrary to the claim that stretching is harmful, research shows that when performed properly, stretching can actually help alleviate muscle tightness and improve function . Stretching Increases Blood Flow and Oxygenation Studies have shown that stretching enhances circulation , reducing muscle ischemia (lack of oxygen), which is one of the primary causes of trigger points. Stretching Helps Regulate Muscle Tension When you stretch, you activate the Golgi tendon organs , which help relax overactive muscles and reduce excessive tension. Stretching Restores Functional Muscle Length Chronic muscle tightness can lead to adaptive shortening , making muscles more prone to pain and dysfunction. Stretching helps counteract this. How to Stretch the Right Way Without Making It Worse Instead of avoiding stretching altogether, here’s how to incorporate it safely and effectively : 1. Start With Soft Tissue Work First Before stretching, release the muscle tension using: Self-massage (hands or massage ball) Foam rolling (avoiding excessive pressure on painful spots) Trigger point therapy, dry needling, or myotherapy , which our practitioners at Good Health Group Clinic Brighton offer. 2. Use Active and Dynamic Stretching Instead of prolonged static stretching, opt for controlled, movement-based stretches to encourage blood flow and mobility. Example: Instead of a deep static hamstring stretch, try hamstring swings or single-leg Romanian deadlifts . 3. Avoid Overstretching Painful Muscles Pain is a signal from your body— forcing a stretch won’t fix the issue . If stretching worsens your symptoms, it’s time to adjust your approach. 4. Strengthen Weak Muscles Trigger points often form because a muscle is both tight and weak . That means stretching alone isn’t enough—you also need strength training . Example: Instead of constantly stretching tight hip flexors, incorporate glute and core strengthening exercises . How Good Health Group Clinic Brighton Can Help At Good Health Group Clinic Brighton , we take an evidence-based approach to muscle health and mobility. Our team of skilled practitioners can help with: Myotherapy : Our myotherapist Ian Selvarajoo specialises in releasing muscle knots using advanced soft tissue techniques. Chiropractic S ports and Spinal rehab : Dr. Tanja Nishibata can assess your posture and spinal health, ensuring your nervous system and musculoskeletal system function optimally. Remedial Massage & Dry Needling : Sam Noh provides expert remedial therapy and dry needling to address chronic muscle tension and improve flexibility. Stretching Is Not the Enemy The idea that "stretching makes knots worse" is an oversimplification . While improper stretching can sometimes aggravate muscle tightness, when done correctly , stretching is a powerful tool for reducing discomfort and improving mobility. The key is how you stretch. By combining stretching with soft tissue release, active movement, and strengthening exercises , you can effectively manage muscle tension and enhance performance. If you’re struggling with persistent muscle tightness, book an appointment at Good Health Group Clinic Brighton , where our expert team can help you find the best approach to mobility and recovery.
February 2, 2025
Baseball is not the most popular sport in Australia, but as someone who grew up in South Korea and in a KIA Tigers supporting family, I’ve been watching KBO (Korean Baseball Organization) games since I was born. This year, I noticed an interesting development from one of the team’s top young players, Do-young Kim, who has dramatically improved his hitting performance. In the 2023 season, Kim was already a talented batter, but he only hit 7 home runs with a slugging percentage (SLG) of 0.453. For those unfamiliar with baseball, a home run is when a batter hits the ball over the outfield fence, allowing them to score instantly. Slugging percentage (SLG) measures the total bases a player earns per at-bat, indicating their power-hitting ability. Fast forward to 2024, and Kim’s stats have skyrocketed, he has hit 38 home runs with an SLG of 0.647. That’s an incredible leap! So, what changed? After closely watching his batting stance and swing, I realised he had enhanced his hip internal rotation (HIR) , allowing him to generate more torque and power in his hitting mechanics. This got me thinking, the same principle applies to improving my clients’ daily movements and sports performance.
January 31, 2025
When clients walk into Good Health Group Clinic after a musculoskeletal injury, most have one goal in mind, getting stronger. Strengthening exercises have long been seen as the gold standard for recovery, but in reality, jumping into strength training too soon can often make things worse rather than better . Over the years, I’ve noticed a common pattern, more than half of my clients experience aggravation when they begin strengthening exercises early in rehab . Their pain flares up, movement feels unnatural, and their body starts compensating in ways that lead to more dysfunction. This got me thinking 'Is there a better way?' 
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