I had just finished my third and final leg of a Ragnar Relay race. It was a 9-mile run at 5 o'clock in the morning. I already completed two other legs in the past 24 hours and had little to no sleep. I was completely exhausted. I had been sore prior to this run, but now the soreness really began to settle in. Like most athletes, I previously had experienced this many times after long runs, during training, or after competitions. And once again, the soreness in my lower legs became very evident. As I tried to massage my muscles, I noticed that there were specific spots in the muscle that were quite tender and felt like the muscle was knotted up. This was a familiar "trigger point" that I have not only identified on my own body but hundreds and thousands of times in patients over the years.
Trigger points are commonly referred to as areas where a taut band of muscle can be palpated. These points are often tender to the touch and can refer pain to other parts of the body.1 Trauma to the muscle both by acute injury or chronic microtrauma (overuse), may cause undue stress on the fibers within the muscle belly and lead to the formation of trigger points.2 Athletes participating in activities that are repetitive in nature may develop trigger points during the course of training or competition.
While managing these symptoms on your own can help, specific treatment techniques by a physical therapist have been proven to be effective in treating trigger points. The Journal of Orthopedic and Sport Physical Therapy recently published a study describing the efficacy of one technique. The study demonstrated that individuals with heel pain can decrease their symptoms with home stretching. However, those that performed their stretching program as well as hands-on trigger point release techniques (manual therapy) administered by a physical therapist improved significantly more than those that did only the stretching. This suggested that people who are not getting better on their own may benefit from hands-on treatment techniques.3
Dry needling is another technique used by physical therapists that has been identified as an effective way to treat trigger points.4 Sometimes referred to as trigger point dry needling or intramuscular manual therapy, dry needling is a technique that uses a dry needle (without medication), that is inserted into a trigger point with the goal of releasing/inactivating the trigger points and relieving pain.5 Physical therapists that have been trained and certified in this technique can appropriately evaluate and assess trigger points and administer this treatment technique. Preliminary research supports that dry needling improves pain control, reduces muscle tension, normalizes biochemical and electrical dysfunction of motor endplates, and facilitates an accelerated return to active rehabilitation.6
While these techniques can help you manage your current trigger point issues, a proper physical therapy evaluation may be needed. Not only will a physical therapy assessment and treatment help in the management of your trigger points but also identify complicating factors or faulty movement patterns that may contribute to the development of trigger points. This will allow you to continue to train, compete, and enjoy your active lifestyle.