Are Trigger Points Affecting Your Athletic Performance?

Trigger points cause real problems for athletes.

Not only are trigger points exquisitely painful, but they also affect movement. Trigger points inhibit range of motion by keeping muscles short and stiff. They also weaken muscles, causing them to tire quickly and recover slowly. They produce excessive muscle contraction that can partially disarticulate joints or cause nerve entrapment.

That’s the bad news: Trigger points can seriously inhibit athletic performance. The good news? Acupuncture can help. So can self-care (see tips at the end of this article!).

How does a trigger point form?

A trigger point is a hyper-irritable muscle band with a predictable pattern of pain referral. It forms when the process of muscle contraction and release goes awry.

Muscle overload or trauma causes the muscle band to contract too strongly. Such excessive contracture increases metabolic demand and also squeezes shut the network of capillaries supplying the nutrition and oxygen to the region.

This results in a local energy crisis, perpetuating the cycle of contracture. The muscle band cannot release and a trigger point forms.

Can stretching relieve trigger points?

A muscle harboring a trigger point will be too painful to stretch fully. The pain (and subsequent inhibitory reflex) will prevent you from sufficiently lengthening the muscle band.

What’s more, forcing a stretch will often result in injury (muscle strain) and do nothing to resolve the trigger point.

Think of a trigger point like a knot in a rubber band. Stretching the band will cause it to snap, but it will not release the knot. To restore full stretch to that rubber band, you first need to unwind the knot.

Acupuncture is the most effective way to release trigger points

The acupuncture needle provides a mechanical disruption to the trigger point. It halts the vicious cycle of energy crisis in the muscle. Restored to its full length, the muscle recovers its normal blood supply and metabolism, and it can function fully.

You might be wondering, does having acupuncture on trigger points hurt?

Many release techniques require direct pressure to the trigger point, which is by definition painful. Often a trigger point is too irritable to tolerate much additional mechanical stimulation. But a needle can reach the depth of the trigger point without irritating the hyper-sensitive tissues above or around it. There is simply no other technique that can boast such precision.

And acupuncture achieves immediate results. A single well-placed needle into a trigger point will elicit a twitch followed by reduced muscular tension and increased range of motion. Such immediate feedback is immensely satisfying for someone who has been dealing with pain and dysfunction in that muscle for weeks, months, or even years.

3 self-care tips for preventing trigger points

Increase training loads slowly

Trigger points form due to persistent muscular contraction, strain, or overuse. To prevent their formation, don’t do too much too soon—and make sure you have adequate recovery between workouts. Get enough quality sleep to ensure your body can repair itself efficiently.

Maintain range of motion and muscle balance

This requires some work. Regularly take your body through the opposite range of motion you use in your sport. A good rule of thumb is to lengthen the agonist, and strengthen the antagonist.

For cyclists who spend hours in the saddle with forward shoulder posture, this means increasing range of motion in your pectorals, and strengthening the rhomboids and other muscles of the upper back. Runners typically benefit from lengthening the hip flexors (psoas and quadriceps) and strengthening the hip extensors (glutes and hamstrings).

Break up adhesions

You need to be doing something on a regular basis to normalize tight, overworked muscle tissue.

Supple, flexible muscles don’t get injured. Using a lacrosse ball, a foam roller, or even your fingers, apply direct pressure to a tight muscle band for 8-12 seconds. Taking the muscle through its range of motion while compressing it will break up adhesions before a trigger point forms.

This article originally appeared on Acutake and was written by Ginna Ellis.

Piriformis Syndrome

Piriformis syndrome is an uncommon neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk, shift our weight from one foot to another, and maintain balance. It is also used in sports that involve lifting and rotating the thighs -- in short, in almost every motion of the hips and legs.

The sciatic nerve is a thick and long nerve in the body. It passes alongside or goes through the piriformis muscle, goes down the back of the leg, and eventually branches off into smaller nerves that end in the feet. Nerve compression can be caused by spasm of the piriformis muscle.

Piriformis Syndrome Signs and Symptoms

Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time. Most cases of sciatica, however, are not due to piriformis syndrome.

Piriformis Syndrome Diagnosis

There is no definitive test for piriformis syndrome. In many cases, there is a history of trauma to the area, repetitive, vigorous activity such as long-distance running, or prolonged sitting. Diagnosis of piriformis syndrome is made by the patient’s report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle. In some cases, a contracted or tender piriformis muscle can be found on physical exam.

Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc.

Piriformis Syndrome Treatment

If pain is caused by sitting or certain activities, try to avoid positions that trigger pain. Rest, ice, and heat may help relieve symptoms. A doctor or physical therapist can suggest a program of exercises and stretches to help reduce sciatic nerve compression. Osteopathic manipulative treatment has been used to help relieve pain and increase range of motion. Some health care providers may recommend anti-inflammatory medications, muscle relaxants, or injections with a corticosteroid or anesthetic. Other therapies such as iontophoresis, which uses a mild electric current, and injection with botulinum toxin (botox) have been tried by some doctors. Using the paralytic properties of the botulinum toxin, botox injections is thought by some to relieve muscle tightness and sciatic nerve compression to minimize pain.

Surgery may be recommended as a last resort.

Prevention of Piriformis Syndrome

Since piriformis syndrome is usually caused by sports or movement that repeatedly stresses the piriformis muscle, such as running or lunging, prevention is often related to good form. Avoid running or exercising on hills or uneven surfaces. Warm up properly before activity and increase intensity gradually. Use good posture while running, walking, or exercising. If pain occurs, stop the activity and rest until pain subsides. See a health care provider as needed.

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