Trigger Point for Massage Therapists: Abs and Chest

Understanding the location and treatment of trigger points in the abs and chest is essential for massage therapists.

These points can lead to pain and discomfort, impacting overall muscle health. However, they need to be treated with caution, particularly when focusing on vulnerable and often reserved areas such as the chest and abdominal regions. 

This article is designed to help therapists identify and address these areas effectively, improve their skills and ability to treat clients safely and effectively. We cover different types of trigger points, methods for identifying and treating them, the benefits they will bring and safety during therapy sessions. Massage therapists can use these to upgrade their treatment and better serve their client’s needs. 

Related: Trigger Point Therapy 

What are trigger points and what causes them? 

Trigger points (TPs) are small, painful (hyperirritable) spots within skeletal muscles that feel extra sensitive and may have knots in them.  

They can develop due to various factors, including: 

• Tension in muscle fibers or surrounding fascia 
• Repetitive movements (persistent muscle shortening) 
• Maintaining positions for extended periods, leading to muscle exhaustion and trigger point formation 
• Direct muscle injuries from collisions, falls, impacts or strains 
• High-impact and intense training sessions 
• Stress-related muscle tension 
• Deficiencies in nutrients affecting muscle and nerve function 
• Systemic conditions like poor blood circulation, resulting in areas of low oxygen levels (hypoxia) and heightened sensitivity 

The symptoms linked to these trigger points can range from dull aches to pain or lingering, throbbing sensations that extend beyond the specific location of the trigger points.  

It can lead to pain in nearby or other parts of the body (referred, distal pain), due to the interconnected nature of muscle tissue and nerves. The pain may persist constantly, fluctuate, or only become noticeable when pressure is applied. 

Understanding the nature of trigger points enables therapists to target treatments effectively, reducing pain and related symptoms while improving muscle function and restoring normal mobility. 

Types of trigger points 

Trigger points come in various types, each affecting the body differently. Active trigger points are particularly sensitive areas within the muscle. They can cause pain directly and in distant areas of the body.  

On the other hand, latent trigger points stay inactive or "asleep" until they're pressed. They might not cause pain right away but can make muscles weaker or less flexible. Central trigger points are intense and can send pain to other body parts. It often results in secondary trigger points in nearby muscles.  

Diffuse trigger points are scattered across larger muscle areas. It typically arises from prolonged bad posture or repetitive strain. It affects the muscle's operation across wider areas. Attachment trigger points, meanwhile, form where muscles connect to bones and may lead to joint issues if untreated. 

Ligamentous trigger points develop within ligaments and can adversely affect the health of adjacent joints, contributing to widespread joint and muscle discomfort.  

How to find and identify trigger points in the abs and chest 

Recognizing trigger points in the abs and chest is crucial for massage therapists. These points are situated in specific areas within the muscles. In females, these muscles are surrounded by a glandular organ, the breast, which can be sensitive to touch and needs consent prior to treatment. 

Moreover, the abdomen contains important organs that may be harmed if not treated with proper care and knowledge. These complexities call for accurate identification of trigger points for safe and effective therapy. 

Trigger points of the chest 

The Pectoralis Major is a large superficial chest muscle that can harbor up to five trigger points. These points often lead to discomfort in the chest, shoulders, and arms. It can worsen with arm movement but typically eases with rest. 

Below the Pectoralis Major lies the Pectoralis Minor, which can also develop trigger points leading to chest and shoulder pain that radiates down the arm. It can also affect scapulohumeral rhythm and lead to conditions like Thoracic Outlet Syndrome. It can compress the median nerve and cause symptoms like Carpal Tunnel Syndrome, leading to wrong treatment or diagnoses. 

While Scalene isn’t in the chest, this muscle found in the neck area may contain trigger points that result in pain in shoulders, numbness in the chest, and arm. These symptoms could be mistaken for nerve impingement (radiculopathy) or other more serious conditions.   

One trigger point can be found in the center of a muscle belly (center of the chest muscle). The others normally lie close by. 

Trigger points of the abdominal muscles 

In the abdomen, the Rectus Abdominis muscle's trigger points can project pain to the back, and misleadingly suggest various internal disorders. This pain can be difficult to pinpoint precisely as it may move from the front to the back of the body. 

To identify this, practitioners should feel tender areas or tight spots in the muscles while considering a patient's medical history and symptoms. However, massage therapy should never be a substitute for medical advice. 

How to treat trigger points in the abs and chest: Effective techniques 

There are several techniques that can be used to treat trigger points in the body, including the chest and abs, including: 

Ischemic pressure 

This technique includes the application of firm but gentle pressure to the trigger point until the pain decreases. This technique reduces blood flow momentarily, then allows a rush of fresh blood to the area when released, helping to heal the muscle.  

Short strokes with release 

This technique includes using short yet firm strokes over a trigger point to release tension and alleviate pain. This technique aims to gradually release the tightness in the muscle fibers and fascia, promoting relaxation and improved muscle function. 

Gentle palpation with range of motion (active or passive movement) 

This method can involve many different techniques. For example, the therapist can gently press and move the affected muscle through its full range of motion (lengthening and shortening of the muscle). This can help to loosen the area and increase flexibility.  

In the case of this technique, the therapist can also add both active and passive movements while gently pressing or palpating the trigger point. 

For example, when targeting trigger points in the quadratus lumborum (QL), the therapist may instruct the client to actively flex the knee or perform hip internal and external rotation, thereby engaging the QL muscle. Alternatively, the therapist can passively move the client's lower limb in and out (passive). This allows the therapist to assess the response of the trigger point to movement and adjust the pressure accordingly for maximum effectiveness and comfort. 

No one size fits all solution 

While we have mentioned some techniques, it's crucial to tailor the treatment to each person's needs and pain tolerance, since everyone reacts differently. No one size fits all! 

Therapists should maintain proper posture and body positioning during treatment sessions. They can utilize their body weight to apply pressure effectively, enhancing the treatment's effectiveness while reducing fatigue, and prevent injuries or strains.