Understanding Trigger Point Release Massage for Pain

During massage sessions, therapists often discover tight, hyperirritable palpable nodules in their client’s muscles.

These are known as trigger points. While identifying these trigger points isn’t always an easy task, it’s important for successful treatment during a trigger point release massage. 

Trigger points can present different symptoms, depending on their location, severity, and the muscles involved. They may cause referred or localized pain, muscle tightness, weakness, and limit their client’s movement. Therefore, understanding trigger point release massage as a pain relief technique is important for massage therapists.  

Related: Trigger Point Therapy 

Causes of trigger points  

Trigger points can develop for many reasons. For instance, muscle weakness and overuse can cause muscles to tighten. Tight muscles can compress the blood vessels and constrict blood flow, or make it irregular. This can contribute to the pain associated with trigger points.  

Poor posture, improper or repetitive lifting, and movement can put mechanical stress on muscles, leading to trigger points. Injuries like falls, strains, sprains, or other tissue damage can also affect muscle function and quality, contributing to trigger points. 

Additionally, nutrient deficiency, like vitamin D can increase the chances of developing them, too. Regular stretching and body maintenance, proper technique, and a healthy balanced diet are all important factors in preventing muscle pains. 

Types of trigger points  

Before we learn how to treat trigger points, therapists should first understand how to recognize them. Knowing the different types of trigger points is essential for effective treatment. 

Active trigger points 

Active trigger points are the most prevalent type, that hurt persistently. They are often tender to touch, but painful even without pressure. The pain they cause often radiates to other areas. Many people describe it as sharp, and throbbing pain, that feels like a deep knot or tightness in a muscle. This type may disrupt daily function in individuals.  

Latent trigger points  

Latent trigger points are not painful unless palpated. They don’t usually cause noticeable pain or discomfort unless therapists put pressure on them. They remain unnoticeable until triggered. 

Primary or central trigger points  

Primary trigger points are the first trigger points to form due to overuse, injury, or stress.  Usually, they provide the main source of pain in the muscle. The pain it causes is often intense and may cause muscle dysfunction. 

The ‘central trigger point’ is a term that describes the focal area of a trigger point where the pain is most noticeable. It may also refer to the central (middle) part of the muscle, where patients feel the most tension. It’s less commonly used than the active or latent ones.   

Pro tip:   

Therapists should always adjust their body mechanics during a massage, including setting the treatment table at the proper height to avoid lower back pain or strain. This can help therapists apply firmer pressure and more controlled movements while offering more stability during massage. 

Related: Saving Your Body, Saving Your Career: 5 Keys to Self-Care for Healthcare Professionals 

 
When massage therapists should avoid treating trigger points  

Trigger point massage is generally safe to perform. However, there are a few occasions when massage therapists must be careful and refrain from working on them.  

For example, therapists should avoid massaging open wounds, skin rashes, or local infections that may present on the skin. Applying pressure on localized infections can push the bacteria into the surrounding tissues or bloodstream, worsening infection. 

They should also refuse treatment while their client is dealing with flu, or viral infections, accompanied by fever. During these infections, the immune system is already altered. Massaging while patients are dealing with fever can worsen inflammation in the body and delay recovery. 

They should keep away from trigger points near an infected joint or bone (arthritis) as it can cause tissue damage. Therapists should avoid deep pressure on pregnant women, especially in the first trimester, due to the risk of blood clotting. 

Similarly, individuals on blood thinners may bruise easily, making deep tissue massage unsuitable. Also, if a client had an injury or accident within the past 72 hours, therapists should refuse treatment until they have fully recovered. 

Therapists should provide a disclaimer to their clients stating massage therapy is not a substitute for medical care and treatment. Clients are advised to consult with their doctor in case of medical conditions and chronic pain.  

Should all trigger points be treated? 

Not all trigger points require treatment. For example, latent trigger points don’t cause any symptoms and may not require any treatment. Trigger points in an area of skin infections should also be avoided! 

Are trigger point knots in muscle tissue? 

Trigger points and knots may seem similar, but they aren’t the same. Trigger points are hyperirritable spots in a muscle that may cause referred pain. In contrast, muscle knots in an area of muscle tension that do not cause referred pain to other areas. They both require different treatment and massage techniques. 

Why do trigger points cause so much pain? 

Trigger points cause pain because the muscles are in a state of constant tightness and contraction. This restricts blood flow and builds up metabolic wastes in the muscles. This causes pain, discomfort, and irritation. 

What are the three types of trigger points?  

Active, latent, and satellite are the most common types of trigger points. Active trigger points are those already painful and also radiate pain and latent ones which are usually painless unless palpated. On the contrary, satellite trigger points develop due to a trigger point in another area, creating a pain network. 

What is the best treatment for trigger points?  

Ischemic pressure, gentle stretching, trigger point massage, acupuncture, and other types of massage therapy are the best ways to treat trigger points. However, it is always best to tailor treatment to the client’s needs and satisfaction.