Walt Morrey, NCBTMTB #331446-00Infants have been observed with point tenderness of the rectus abdominis
When children were examined for them, myofascial trigger points were found to be a common source of musculoskeletal pain in childhood.
In hospitalized and ambulatory patients in England, trigger points were most common in people aged 31 to 50.
With advancing age and reduced activity, the stiffness and restricted range of motion of latent TPs become more prominent than pain.
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What are they?
Small injuries within the body of a muscle that can cause painful sensations far from their location
Who gets them? EVERYONE!!
How can Trigger Points persist for decades?
The most current theory about how TPs can persist for so long is:
Strain or other damage occurs to a muscle, which causes acetylcholine(ACh) to be released at the synapse, often associated with excess calcium.
High calcium levels keeps the calcium-charged gates open and the ACh continues to be released, resulting in ischemia.
The ischemia causes a localized oxygen/nutrient deficiency, which leads to inadequate adenosine tri-phosphate(ATP) production.
Without ATP, the muscle can't remove the calcium ions that are 'keeping the gates open' for ACh release.
Removing the superfluous calcium requires more energy than sustaining a contracture, so the contracture remains.
The contracture is sustained by the local chemistry, not by action potentials from the spinal cord.
As the endplate keeps producing ACh flow, the actin/myosin filaments slide to a fully shortened state around the motor endplate (at the center of the fiber)
As the sarcomeres shorten, they begin to bunch & a contracture knot forms.
The remainder of the sarcomeres are then stretched, creating the taut band common in TPs.
Basic Rules for avoiding Trigger Points:
Never lift or pull with the back bent and twisted
Always lift with the knees, holding the back erect and forward facing.
Never get up from, or sit down in, a chair while leaning forward in the stooped position with the trunk rotated.
Avoid jerky movements -- these cause unnecessary stress.
Observe how you do common tasks and minimize unnecessary movements.
Muscle fibers need to alternately contract and relax to increase blood flow and replenish energy supplies. Avoid keeping muscles in a contracted or fully stretched position - awake OR sleeping.
Avoid using muscles at maximum effort, when they are most likely to be strained. Always leave some reserve. Figure a different way to do the task, if necessary.
Avoid cold drafts -- causes muscular contraction and invites activation of TPs.
Take a hot shower or bath after exercise.
Stretch frequently, but not to pain. Go for full range-of-motion(ROM), but in sloooow steps.
Be more like a cat -- stretch before moving.
Be sure that your TPs have been fully cleared before attempting to build strength in those muscles; otherwise your exercise will be painful and non-productive.
Strengthen support muscles -- hold maximal contraction for 5-10 seconds once a day is enough.
For lower back pain. practice the yoga Boat posture to strengthen your abdominals
Practice the yoga Locust posture to strengthen your lower back - arms forward (shown) is more difficult.
Trigger Point Perpetuating Factors:
Physical imbalances like uneven leg length or short arms
Frequent repetitive movement
Constricting pressure on muscles -- packs, heavy purses, belts, bras, edges of chairs
Nutritional inadequacies, especially vitamins B1, B6, B12, Folic Acid, & C; minerals calcium, iron, potassium, & magnesium
Alcohol use; oral contraceptives; vegan, starchy, or crash diets; & cigarette smoking can all contribute to vitamin deficiencies
According to Travell & Simons, "Nearly half of the patients we see with chronic myofascial pain require resolution of vitamin inadequacies for lasting relief."
RDA for vitamins merely prevents disease, not optimal body function
Tests have shown that many water-soluble vitamins (including B1, B6, B12, Folic Acid, & C) appear to cause no problems at dosages as high as 100xRDA to 10,000xRDA
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