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Myofascial Pain Trigger points - physiotherapy and deep tissue release
Physiotherapy defines myofascial pain, or trigger points, as very
focused hyperirritability in muscles and fascia (a connective tissue)
that when stimulated, can cause central nervous system modulation. They
are characterized by focal tenderness, that can be widespread when
Qualities of trigger points
There are four (4) sub-types of trigger points we manage in our physiotherapy clinics:
Active Trigger Points – actively referring pain locally or to another location.
Trigger Points – inactive trigger point that doesn’t yet refer pain,
but may be activated when triggered by certain stimuli.
Key Trigger Points – the stimulating trigger point that activates other latent trigger points.
Satellite Trigger Points – the trigger point that is activated by the key trigger point.
Treating the primary or key trigger points do not treat the secondary satellite ones, which must be treated separately.
Potential Causes Of Trigger Points
or activation of trigger points can be caused by several factors, which
includes muscle overloading, activation by other trigger points,
disease, psychological stress, trauma, and imbalance in the human
They form only in the muscles and/or
connective tissues such as fascia. They are a bundle of muscle fibers
which can cause deep pain within muscles and joints when they pull the
associated muscles. When our muscle fibers contract, it creates a
byproduct of lactic acid, which the body will remove via natural
circulation. In a trigger point, the tightened muscle fibres contract
and this constricts localized capillaries, effectively storing the
lactic acid in the bundles itself.
points become active in the muscles, there is very often weakness plus
pain in the affected areas; this pain patterns have a specific neural
pathway, which can be traced easily. However, because there are many
trigger points that have pain patterns that overlap, the treatment of
the trigger points often becomes very extensive to remove them, though
our physiotherapy clients often report a sense of general wellbeing
after each session of trigger point management.
Diagnosing Trigger Points
diagnose them by clinical interviews to identify signs, followed by a
physical examination of the signs, symptoms, pain patterns as well as
using manual clinical palpations. For a trained physiotherapist, we can
detect the taut bands and nodules within muscle fibers that causes a
“all or nothing at all” twitch response – this is a primary sign.
Pressing on the nodule will then cause localized or referred pain.
Some larger muscles such as the back and gluteal muscles have multiple trigger points.
Physiotherapy Treatment Of Myofascial Pain Trigger Points
identifying accurately the trigger points, and the execution and
resolution of all the active and key trigger points. The muscles that
contains inactive, latent ones need to be stretched and mobilized, as
well as to mobilize the fascia of nearby structures.
results of any manual therapy is directly related to the skill and
experience level of the physiotherapist or hand therapist. If trigger
points are pressed for too short time, they main be active still; if
they are pressed too hard or too long, the trigger points becomes
inflamed and bruised, causing longer pain in the area. This bruising may
feel like the soreness related to post-exercise soreness, but it is
Should you do self-treatments for your myofascial pain?
patients wants to administer their own self-treatments in between
physiotherapy sessions, as they want immediate relief. It is possible,
and we can train you in managing the symptomatic relief of pain – you’d
need to have fair working knowledge of the anatomy and physiology of
your affected areas, and understand the risks. We also have trigger balls and foam rollers that can help reach those hard-to-reach knots available in our clinics.
risks includes possible damage of soft tissues and other organs (e.g.
too close to nerve bundles, organs such as kidneys (for the treatment of
trigger point in the quadratus lumborum) or the underlying glands.
Specialist Rehab Group works with specialist physiotherapists and specialist rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
Areas of specialization
physiotherapy: back and neck (spine), sports, shoulder, hip, knee, ankle
Initially, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover. They then provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
To call for inquiries or appointments, please contact us at:
We appreciate you as a patient and want you to know that the #1 way we grow as a clinic is through word of mouth referrals from valued patients like yourself.
We do not rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients.
When you have the opportunity, please take the time to tell your family, friends and physicians about the positive results and experience you have had in our clinic.
Thank you so much, and stay healthy!
SPECIALIST REHAB APPOINTMENTS & ENQUIRIES Please Call/SMS/WhatsApp to xxxxx or xxxx, thanks!
Disclaimer We are a wholly Singapore Private Limited group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations. As listed in our website are the list of services we provide our clients as referred by their medical doctors or by self referrals/word of mouth.
The range of rehabilitation results vary from patients to patients, depending on a variety of factors and reasons such as severity of condition, genetics, gender and age. However, we will still deliver the best evidence-based-practice of physiotherapy, hand therapy, TCM, sports training and deep tissue release therapy that we can deliver.
The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy and occupational therapy, please schedule an appointment with us by contacting our staff by Call/SMS/WhatsApp at 97402164 or 98352929, thanks!