MYOFASCIAL TRIGGER POINTS

Iman Rezaei, PhD Student, PT

TRIGGER POINTSTrigger points are localized areas of deep tenderness and increased resistance. Before an active trigger point exists there needs to be a period of evolution towards that unhappy state. many localized muscular areas of sensitivity or pain, which do not refer pain or other symptoms, may be considered to be embryonic or evolutionary trigger points.

STAR OR TART

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T

A

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SENSITIVITY ROM REDUCED TISSUE TEXTURE CHANGE

ASYMMETRY

THE COMMONEST SITES FOR TRIGGER POINTS ARE CLOSE TO:muscular origins and insertions free borders of muscle muscle belly motor end-point body tissues other than muscle, including skin, fascia, ligament, joint capsule and periosteum, and also in scar tissue.

TRIGGER POINTS SYMPTOMSPain Lymphatic stasis Autonomic effects: o

Vasoconstriction Coldness Sweating Pilomotor response Ptosis Hypersecretion

reduced mobility of joints.

CLINICAL SYMPTOMS OTHER THAN PAIN

Diarrhoea,Dysmenorrhoea Diminished gastric motility Vasoconstriction and headache Dermatographia Proprioceptive disturbance, dizziness Excessive maxillary sinus secretion Localized sweating Cardiac arrhythmias Goose flesh Ptosis,Excessive lacrimation Conjunctival reddening Interstitial cystitis

LINKING SYMPTOMS TO SPECIFIC TRIGGERPOINTS Tension-type headache Frozen shoulder Epicondylitis Carpal tunnel syndrome Low back pain Atypical angina pectoris pain

PRODUCTION OF TRIGGER POINTSThe causes of trigger point presence can relate to any combination of physical or psychic stress factors that result in alterations in normal tone in muscles, fascia and other soft tissues which, in turn, can effect changes in joint play, breathing, posture, etc. The feature of ischaemia and prolonged stress seems to be a major predisposing condition in the production of trigger points

IDENTIFYING TRIGGER POINTSAltered cutaneous temperature (increased or decreased) Altered cutaneous humidity (usually increased) Small nodular or spindle-shaped thickening A 'jump' sign A local twitch response Local trophic changes

TRIGGER POINT FEATURESapproximately 80% of major trigger point sites are on established acupuncture points. At the centre of the trigger points there is indeed a lack of oxygen compared with that in the muscles surrounding it

following factors can all help to maintain and enhance trigger point activity:

nutritional deficiency hormonal imbalances infections Allergies low oxygenation of tissues

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