Why are my muscles tender to poke?

Do you have that one specific point in your back or shoulders that is tender to press your fingers into? Well, you're not alone when it comes to suffering from these "knots" but what exactly are these "knots" and how do you treat them? Read on to find out.

Medically, these points in muscles are referred to as Myofascial Trigger Points . Myofascial is a fancy way of saying muscle and fascia, fascia being the connective tissue that our muscles are wrapped in, a bit like the skin on a sausage...

So how do they form?

We should first clarify that the muscles are not knotted up like a fishing line and the trigger point cannot be "broken down" with massage, this is a common misconception. Myofascial trigger points are thought to form when a small area of muscle becomes irritated, overworked or becomes hypersensitive. This can happen after a sudden strain, repeated loading, prolonged static postures, stress-related muscle tension, or changes in how the body is moving.

The most widely discussed theory is the integrated trigger point hypothesis. This suggests that repeated or sustained muscle stress may lead to abnormal activity at the motor endplate,

the area where the nerve communicates with the muscle. This can cause a small group of muscle fibres to remain in a shortened, contracted state.

So why do they hurt?

When this contraction of the muscle fibre persists, it may reduce local blood flow and increase the muscle’s demand for energy. This can create a local “energy crisis”, where the tissue becomes more sensitive and releases chemicals that irritate nearby nerve endings. Over time, this may produce a tender, sensitive area within a taut band of muscle, sometimes causing pain locally or referring pain to another area. This referral pain is often a cause of confusion and concern for our patients as the referring pain might mimic other conditions such as sciatica.

Can they be treated?

It is important to note that trigger points are still an area of ongoing research. They are not simply “knots” that need to be broken down, and there is not one single proven cause. Current evidence suggests they are more likely to form through a combination of local muscle overload, altered nerve activity, reduced tissue tolerance, inflammation, pain sensitivity and changes in movement patterns.

Because of this, treatment is usually most effective when it looks beyond the sore spot itself. Manual therapy, soft tissue work, exercise, movement advice, load management, sleep, stress and general health can all play a role in helping symptoms settle and reducing the chance of recurrence. Our chiropractors and sports massage therapists at Cardiff Chiropractic Clinic are highly experienced in helping patients with their trigger points.

What can I do to prevent them from developing?

Due to the complex nature of their formation it is difficult to provide a "cook-book" solution to prevent the formation of trigger points. However, we do know that you can help prevent by doing the following:

1) Avoiding static postures, especially if you work at a desk. Try to change your posture throughout the day to use different muscles, a height-adjustable desk is a great investment.

2)Exercise regularly, particularly strength training, this will strengthen the muscle fibres, increasing their load tolerance and move them through a greater range of motion.

3) Avoid smoking - smoking damages the smallest blood vessels in the body, the capillaries, this will effect the body's ability to send blood and oxygen to those muscle fibres.

4) Try to mitigate stress where possible, Psychological stress is closely linked to pain and sensitivity. We often see patient's whose trigger points are more painful when theyre going through stressful periods.

If you think you're having trouble with trigger points why not book a consultation with one of our therapists? You can book your consultation online here, alternatively, give us a call on 02920488733 where one of our friendly receptionists will find you an appointment.