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Trigger Points

Have you been told you have trigger points or pressure points and are not sure what it actually means? Let me explain what trigger points are and how to get rid of them. My explanation comes from my experience of over 35 years of working with muscles.

First, a trigger point by definition is a build-up of lactic acid in or around the muscle tissue. Lacitc acid is a normal waste product excreted from muscle tissue after injury or exercise.

After decades of working on men, women, children, athletes and couch potatoes, I can tell you there is a way to categorize them for better understanding and treatment options.

Traditionally, there are two types: active and latent or those you feel and those you don’t feel. This definition of trigger points is very inadequate. I have separated the trigger point into five different grades of dysfunction.


Grade I: The patient or doctor may feel (palpate) a bump (trigger point), but the patient will feel no pain or discomfort.

Grade II: The patient or doctor will palpate a trigger point and there will be pain or discomfort at the same site as the trigger point.

Grade III: The doctor will palpate the trigger point and the patient will feel pain not only at the site of the trigger point, but also at another place where the pain has radiated. (Touch the shoulders on top and you feel pain up the back of your neck to your head.)

Grade IV: NOBODY touches the trigger point. The patient contracts the muscle and the same radiating pain pattern is felt. (Move your neck and pain goes down to your hand.)

Grade V: I have only witnessed this in four patients over ten years. A trigger point on the SCM muscle of the neck when palpated caused instant loss of vision in the ipsilateral eye. Vision was restored when pressure was removed from the trigger point.

Treatment options

Grades I and II: Ice: 20 minutes on, 40 minutes off. If you are diabetic, 5 minutes on, 30 minutes off. Do this as often as you can. Do NOT sleep with the ice. Massage is also very beneficial when done by a licensed Therapist who truly understands the nuances of trigger points. You do not want to work on one single trigger point for more than 2 minutes in any given session. Inflammation will occur if over stimulated and this will prompt the trigger point to the next level down.

Grade III and IV : Ice massage: Pour water into a paper cup and freeze the cup. Peel the top of the cup down to reveal the ice and have someone rub the ice over the trigger point for no more than two to three minutes with a gentle pressure. Follow this with the same icing procedures for the treatment listed in Grade I and II trigger points. Ice massage should be done two to three times a day. Do NOT massage a Grade III or Grade IV trigger point. This will inflame it further delaying the healing process.

Grade V: I doubt you will experience this. If you do, I always recommend diagnostic tests to rule out any more life threatening illnesses.

Never, ever use heat to treat a trigger point. Though heat ‘feels’ good, it is an inflammatory process and will further complicate your recovery. There is a right time for heat. When in doubt…use ice.


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