Skip to main content

Trigger Point Therapy (TPT, or TrP): Theory I

This is the second post of my Modality/Theory series explaining the differences in massage modalities and their benefits.  If you have any questions about this post or other modalities you would like to know more about, please do not hesitate to contact me:

We need to start with what a Trigger Point is:

Also referred to as Myofacial Trigger Points, these are localized contractions within muscles that are highly reactive to palpation and typically refer pain or other sensations in known and predictable patterns. 

As an example, I often encounter trigger points in the middle Trapezius.  When I isolate the contraction between fingers and thumb and squeeze, I feel a localized contraction of adjacent muscle fibers and clients indicate pressure at base of the skull or headache like symptoms on the side of the head even toward the temple.     

The way I explain this to clients sounds like this:
"A trigger point is a band of muscle stuck in contraction.  The pain signal it sends is basically a signal to other muscle fibers in that pain path as a deterrent to keep them from contracting fully since the muscles stuck in contraction cannot help to carry the load."  That's an over simplification of the full mechanics of what's happening, but helps to give a frame of reference for the pain they've been feeling.

How do Trigger Points form?

There are several factors that can contribute to trigger point formation:

  • Repetitive stress
    • Not just work tasks, also consider things like the strain on hands and neck from phone use.
  • Sustained loading
    • Lifting and moving of heavy objects, carrying children, or wearing a heavy backpack or bag.
  • Poor postural alignment
    • Muscles having to do extra work due to poor postural alignment are basically having to work in ways they're not designed for.
  • Traumatic injury
  • Inactivity
    • Another way to describe a trigger point is as an ischemic condition caused by a sustained local contraction in a muscle.  If our muscles aren't working, then there is less blood and therefore less nutrients flowing to the muscles. 
  • Nutrition
    • Over abundance of calcium, deficiencies of magnesium or potassium, and even dehydration can contribute to trigger point formation.

What is Trigger Point Therapy (TPT, or TrP), how do we treat them?

There are a few different methods or modalities that can be used to treat trigger points:
  • Active Release Technique (ART)
    • Putting a tissue into a shortened position, gripping or putting tension to hold this tissue, and slowly lengthening the tissue.  To grossly oversimplify: pinning and stretching tissue through active movement.
  • Myofacial Release (MFR)
    • Constant and sustained tension or traction of a tissue to stretch and release contractions.
  • Neuromuscular Therapy (NMT)
    • NMT does a lot of thumb gliding to identify contractions in muscles.  Most NMT practitioners treat trigger points with sustained pressure directly on the trigger point location, just matching its resistance to pressure, mechanically releasing the trigger point.

Just about every client I see is limited by trigger points so I have extensive experience treating them, if you have any questions about Trigger Point Therapy please don't hesitate to contact me:

Follow me on twitter @markcfreeman on Facebook, or Instagram.  Email me at with any questions about bodywork techniques, modalities, or if there are any blog topics you want to know more about!


Popular posts from this blog

Everyday Ergonomics

Have you ever experienced a sudden pain or soreness that you can't explain?  Those deep aches in the neck, shoulder, or lower back that you can't find some accident, slip, fall, or injury to explain the pain? An accident, lift, slip or fall is easy to remember, but those only last a few seconds.  The seemingly mundane everyday moments where nothing seems to happen can actually add up to have lasting effects in our body.  To understand the stress and strain we put on our body, we first need to understand what is called Anatomically Neutral: Generally, good standing posture, or an anatomically neutral position can be summed by a straight line drawn down from the ears, to the shoulders, down through the hips, knees, and through the arch of the foot with all in the same plane of alignment. If only everything we did was possible from this neutral standing position, we would have a better understanding of how to be in proper alignment and avoid injury and fatigue. Dependin

Personal Safety and Massage Therapy

How has the news of sexual assault charges and civil suit against therapists at the massage chain Massage Envy affected your attitude about massage?  Have your feelings of safety with your therapist changed? Have you been victimized during a body work session? In no way is inappropriate touch ever a victim's fault, period.  Your therapist's only intent should be to hold a safe space for you, to meet you where you are at your comfort and safety levels. Anything less than that from your therapist violates your trust.  Because we each have different comfort levels and safety needs, here are some tips to help you feel safe, establish your boundaries, or end and exit a session: Are there areas of your body that you do not want worked, or work that makes you uncomfortable? Most health intake forms provide at least a body diagram to detail areas you want focused work on, these can also be used to detail areas you do not want work as well.   Do not rush to lie down on the

So, you've decided to break up with your client...

Usually this blog is for clients, aficionados, consumers of bodywork, but I had an interesting experience recently that I wanted to share with other therapists.  There can be many reasons to break up with a client: Inappropriate physical or emotional contact. That client that comes to be known as "Mr Gracilis" Chronic tardiness or payment issues. We may enjoy a friendly relationship but this is business. Insensitive or inappropriate comments. Don't confuse your payment for services with permission to get away with being insensitive or offensive. Treatment needs outside your individual scope of practice. Other than for relaxation and maintenance, it may be time to refer out to an other specialist  Now for the story:  Being a mobile massage therapist making house calls can put me in situations that are a little more intimate than other independent contractors.  Of course I am in a business relationship with my clients, but I'm usually being we