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This book is written for you. It’s divided into sections, each covering a different
aspect of trigger points, and what you can do about them.
Introduction
How to Recognise
Triggers
What’s in this Manual?
What’s Coming Next
What trigger points are
They were finally codified by Dr. Janet Travell in the 1970’s. She was a remarkable woman who
was the personal physician to President John F Kennedy and was one of the main people who
A trigger point is defined as a “hyperirritable locus within a tight band of skeletal muscle.”
How to Recognise
Triggers
Let’s look a little closer at how muscles work. In the picture above there is a small knot of muscle
– labeled CTrP- this is the myofascial trigger point. When you have a trigger point, your muscle is
in spasm, it is irritable and tender.
It pulls a thin band of taut muscle which runs the length of the muscle fibre. This feels like a
guitar string within the bulk of your muscle.
How to Recognise
Triggers
The picture above is a photomicrograph of a myofascial trigger point within skeletal muscle. In the
lower half you can see parallel bands of so-called I-bands & A-bands.
They are evenly spread. In the upper half there is a central elliptical area where the bands are
squeezed incredibly tightly together. This is the myofascial trigger point. The band of fibres on
either side of this are stretched further apart than normal.
Why we get Trigger Points Actually a number of these are present in each
myofascial trigger point.
Where you get Triggers
When you run your fingers over a muscle that has
How to Recognise triggers you can feel them as thickened bands,
Triggers ‘knots’ or tight chords like a guitar string
What’s Coming Next At first it may take a bit of practise, but once you
know what to look for, you’ll be able to locate trigger
points reliably.
The Key Point here is that the cause of trigger points is a natural process in our body. It’s
necessary for muscles to be able to contract quickly as a protection that stops damage to the
muscle, and also to your joints and bones. For example if you trip over, your neck muscles will
tighten immediately to prevent yourself from hitting your head on the ground.
This simple reflex arc and the message from the muscle spindle usually does not go higher. This
There are millions of these muscle spindles throughout the body and they are there to allow the
complex movements and postures that your body performs without your conscious thought.
Introduction
Problems (and trigger points) happen when your muscle spindle becomes sensitised - for example
What are trigger points after your have been injured. Then it will not allow the muscle fibre to lengthen at all and will cause
a localised knot of spasm. This localised spasm is the myofascial trigger point.
Why we get Trigger Points
How to Recognise
Triggers
What are trigger points As we have muscles all over our bodies, we
can also get trigger points all over our
Why we get Trigger Points bodies.
Where you get Triggers Trigger point pain can range from a deep,
dull ache to a sharp, stabbing pain.
How to Recognise
Triggers You can get triggers in your head, jaw,
neck, shoulders, legs, stomach, arms,
What’s Coming Next hands, pelvis, back, thigh, calf and foot.
What’s Coming Next This is a special stain showing where the motor
end plates enter the muscle and therefore where
myofascial trigger points are found.
Why we get Trigger Points It’s important to note here that trigger points can
occur in conjunction with other problems. For example,
Where you get Triggers this person may have a prolapsed disc, as well as gluteus
minimus trigger points.
How to Recognise
Triggers To gain proper pain relief, you would need to treat both
problems.
What’s Coming Next
You can also get clusters of triggers. What usually
happens here is that one or two primary triggers set off
pain and tension.
For example, if you find the trapezius trigger from the picture on page 10, if it’s active and you
press on it, you should feel pain up in your neck.
Introduction
It’s always important to conduct a full medical examination for other underlying problems. Chest
pain can be caused by trigger points in the pectoralis major. It can also be caused by heart
What are trigger points
problems, so you need to rule that out first.
Why we get Trigger Points
Once you’ve switched off a trigger point, it can return. Usually switching off a trigger turns it from
an active to a latent trigger point.
Where you get Triggers
If a trigger point is latent, then it is sitting there like an accident waiting to happen. Continuing to
How to Recognise
stretch and treat the site of a latent trigger point will help prevent it coming back.
Triggers
Stiffness can often be a symptom of latent trigger points, so treating them proactively can improve
What’s Coming Next
flexibility. As with most muscle related problems, gentle, regular exercise, stretching and good
nutrition can help prevent triggers coming back.
Introduction
Message 2 - Great free tool to easily Find Triggers anywhere in your body
What are trigger points Message 3 - ‘Getting Rid’ of triggers - why you can’t and why it’s a good thing
Message 4 - 6 Steps to help Stop Triggers Coming Back
Why we get Trigger Points Message 4 - Are You Creating Triggers? (How to make sure you aren’t)
Message 5 - 3 Core Muscle Strengthening Exercises
Where you get Triggers Message 6 - The Really Advanced Stuff
Message 7 - How to Switch Off Triggers - Pain Free Technique
How to Recognise
Triggers If you haven’t signed up for this free email course, here’s where you can go to sign up:
What’s Coming Next The Life After Pain Trigger Point Treatment Email Course
Best Regards,
Dr Jonathan Kuttner.
MBBCh, Dip O&G, FRNZCGP, Dip Sports Med, Dip MSM, FAFMM.
The information contained in this manual is based on sources and information reasonably believed to be accurate as of the
time it was recorded or created. However, this material deals with topics that are constantly changing and are subject to ongo-
ing changes related to technology and the market place as well as legal and related compliance issues. Therefore, the complete-
ness and current accuracy of the materials cannot be guaranteed. These materials do not constitute legal, compliance, medical,
Introduction
or related advice.
What are trigger points
The end user of this information should therefore use the contents of this manual and the materials as a general guideline and
not as the ultimate source of current information and when appropriate the user should consult their own accounting, con-
Why we get Trigger Points
struction or other advisors.
Where you get Triggers
Any case studies, examples, illustrations cannot guarantee that the user will achieve similar results. In fact, your results may
vary significantly and factors such as your health, medical condition and many other circumstances may and will cause results
How to Recognise
to vary.
Triggers
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What’s Coming Next
assure you that your privacy is respected and well protected.