A Pain in the What?
Have you ever wondered what causes the tight, tender spots in your muscles that we often call knots? In therapy we call them trigger points and they can be a real pain in the neck! Common places to find trigger points are in the forearms, shoulders, and calves, but you can find them anywhere you have a muscle! What is a trigger point, what problems do they cause, and how can we treat them?
Its A Trap!
If you look at your muscle under a microscope, you would see interlaced fibers called actin and myosin. When a muscle contracts normally, myosin fibers pull on actin fibers causing the muscle to shorten and the joint(s) to move. If the muscle contracts more than usual, myosin fibers pull so hard that they get stuck. This happens because the energy needed for a muscle contraction actually comes from resetting those fibers rather than contracting them. That seems backwards, but you can think of it like a mouse trap. If you’ve used an old-fashioned snap trap, you know that it takes a lot of energy to set the trap but little to snap it. Our muscles work the same way, and a powerful contraction can limit the blood supply to that part of the muscle. If there is minimal blood flow to reset the fibers, they just stay contracted. See the problem? Since we can’t get blood to the system it can’t reset, and since it can’t reset we can’t get blood to the system. That means that it stays contracted permanently unless something is done about it.
Under Pressure
The other muscle fibers around that spot get tight and put pressure on the nerves in the area. Prolonged pressure to the nerves sends pain signals to the spinal cord. Constant pain signals “leak” chemicals into the tissues that can be picked up by other nearby nerves. This basically tricks the nervous system into feeling pain in other places. For example, trigger points in your calf muscle can cause pain in the arch of your foot that presents like plantar fasciitis. Other muscles can cause pain that mimics pinched nerves, carpal tunnel syndrome, tennis elbow, and even things like sinus pain or tooth pain!
Trick or Treatment
There are a few different choices for treatment. Traditionally if you have a sore spot your natural reaction is to rub it and current research actually supports that. If you massage a trigger point deeply for at least sixty seconds, it can help dramatically. Sometimes, doctors will directly inject a trigger point with medication to restore blood flow. Personally, my favorite treatment is dry needling. You can read more about dry needling from Hector here (https://advancesheridan.com/dry-needling-101/) if you are curious. Hopefully, you now know enough to recognize the possibility of pain looking like it’s something that it’s “knot!”