Why is sore spot not necessarily the problem?
When it comes to muscles, there are two main reasons that pain or tension is caused by another area of the body; feedback issues from nerve compression or satellite referral via active trigger points.
Feedback
If you have tension within your joints (hips, shoulders ect..) or areas with complex small muscle mass (neck), it is likely that you have some form of feedback issue in your extremities. Feedback refers to the nerve signal returning from your extremities to your brain, not the signal from your brain to your extremities. If nerves are compressed along the pathway back to the brain, the brain senses that there is a problem in the extremity due the nerve disruption. In actual fact, the extremity may be fine, however, due to the brain believing that there is damage of some form, the area is ordered to guard itself by tightening the muscles in the area. Short term this is not problematic, however, over a prolonged period of time this excessive tension results in muscular issues in the extremity (pain or weakness).
In treating this condition, it is not uncommon for a therapist to treat the local area of pain or tension, which does provide relief, however, if the compression causing feedback issue is still present the pain or tension will return fairly promptly.
Treatment for issues relating to extremities should always be treated from the point of referral outward, treating the catalyst before the presenting problem area.
Satellite Referral
Satellite referral is an effect caused by active trigger points in a muscle. Every trigger point has a specific referral pattern; however, at times this can change and puzzle therapists and practitioners, often resulting in poor diagnosis.
When a trigger point is active and referring for a long period of time, or the problem is more compound, due to injury etc.. the referred pattern from trigger point A will activate trigger points that fall within the initial referred pattern of point A and add their own referral range to the initial trigger point B referral, thus creating a domino effect.
Treating referral pain requires good knowledge of myofacial referral patterns in the body, muscular groups and connective tissues. Trigger point therapy and sports massage excel in treating this condition, so if this sounds familiar to you, then this is another option which you may not have considered.
Pre and post massage for athletes.
If you’re training for a event coming up and are looking to be in tip-top shape, the needs of those pre sport verses the needs of those post sport are very different. Pre sport massage focuses on relieving muscles via light compression and lymphatic release, where as post sport focuses on repair, via slow deep friction techniques, stretching (passive and active) and mobilisation. Pre sport massage should not be invasive as massage can temporarily weaken muscles in order to aid in successful repair.
Pre sport massage
Pre sport massage is given under the assumption that the athlete is pre conditioned to the activity that they are about to undertake and is therefore a means of enhancing the natural health of muscles by stimulating blood flow to provide nutrients to muscles in a relaxed state, and the lymphatic system, to remove waste from muscles that may be lingering. The massage focus is optimisation, to reduce risk of damage (not to undo damage).
Post sport massage
Post sport massage is focussed on undoing damage caused during activity; with an emphasis on (post sport) it is never advised to get this type of massage before a sport event. The massage focuses on breaking up scar tissue, tight connective tissues, and posture. Generally it is slower than remedial massage to focus on fibre release and increasing range of movement. I like to apply trigger point therapy within my post sport treatments as it allows for a far more successful release and breakdown of scar tissue, therefore, more successful mobilisation post treatment.
Benefits of Trigger Point Therapy
Trigger Point Therapy focuses on relieving referred pain or sensation (pain, tenderness, pins and needles, numbness and burning). A trigger point is a point of bound / taught fibres in a muscle, often referred to as muscle knots, a point of heightened tenderness or sensitivity, which prevents full usage of a particular muscle. Active trigger points have predictable referral patterns, some causing pain locally to the effected trigger point, others referring to other regions of the body. Due to this referral, a domino effect in terms of pain or injury can occur if trigger points are left untreated; this meaning an area previously unaffected by referred sensation may become affected.
From a patients perspective.
Trigger Point Therapy is a compression of the point of tenderness, which temporarily heightens the sensation already experienced due to additional pressure being applied to the area. The pressure must be held and maintained in order to obtain a release; in terms of sensation, it feels as though the practitioner holding the point is slowly releasing pressure, in actual fact the point is releasing / relaxing, which gives a sensation of relief as muscle function is improved and referred sensation is reduced.
Trigger Point Therapy with Massage.
Massaging an area with active trigger points can be painful; however, when massage and trigger point therapy is combined a practitioner can release muscles far more effectively. Remedial massage greatly increases blood flow to muscles, while trigger point therapy releases regions within muscles with restricted blood flow, thus providing nutrients to depleted muscle fibres in a more effective fashion. Active trigger points create a local twitch response (often confused with a muscle spasm); if a trigger point is left active after massage it won’t be long before it becomes tight and sore again due this twitch response, as the muscle is over engaging. Releasing trigger points allows for far greater fibre release with slow / stretching massage, which increases range of movement and encourages capillary growth, resulting in healthier muscle fibres.
In terms of performance: Clients who I have treated with trigger point therapy gain longer periods of relief and suffer less issues with their lymphatic system in terms of acid and other waste build up in their muscles; this meaning greater endurance and performance. If you enjoy sport and like massage, this is definitely something to consider within your fortnightly to monthly massage. Note: Trigger points take time to release, so treatment should be focused on a specific area of the body, not all over, to get the best results.
The Importance of Stretching
Stretching is a very effective and important activity that has a number of known key benefits for all. These benefits include improved flexibility, a decrease in the likelihood of injury and muscle soreness, and an enhancement in physical performance.
Through stretching, the affected muscles will be lengthened, which helps to improve the body’s normal level of flexibility as well as to reduce general muscle tension. This increase in muscle length will also enable the muscles to contract over a greater distance and hence create a greater level of power. The body is then able to move more freely with increased comfort.
After physical exercise, the muscles can often feel tight, sore or stiff. Such soreness occurs due to minute tears that form within the muscle fibres, as well as an accumulation of blood and waste products, such as lactic acid. Stretching after exercise, therefore, helps to diminish any muscle soreness through improved blood circulation and the removal of waste products.
Exercise also creates fatigue, and results in a decrease in both mental and physical performance. Stretching muscles can help to prevent fatigue by reducing the pressure on the working muscles. For every muscle, there is an opposing muscle, and if these are made more flexible through stretching then the working muscles have to exert less force against them. The movements of the working muscles will, therefore, require less effort, which will result in the enhancement of an individual’s physical performance.
Additional benefits of regular stretching include improvements in posture, body awareness, energy levels, coordination, and stress relief.
Stretching should be carried out before and after any physical activity, and as part of an individual’s daily routine. A typical stretching routine should last for around 5-10 minutes, with each muscle group being stretched 2 or 3 times. Each stretch should be performed gently and slowly, and held for around 20 seconds only to the point where tension is felt in the muscle. Only stretch muscles that are 100% healthy and avoid areas that are recovering from injury. Stretches should never be performed when the muscles are cold. Prior to any stretching, light, physical activity that results in a light sweat should be performed for about 10 minutes.
Sports Massage: Pre and Post Event Massage
If you’re training for an upcoming event and are looking to be in tip-top shape, the needs of those pre sport verses the needs of those post sport are very different. Pre sport massage focuses on relieving muscles via light compression and lymphatic release, whereas post sport focuses on repair, via slow deep friction techniques, stretching (passive and active) and mobilisation. Pre sport massage should not be invasive as massage can temporarily weaken muscles in order to aid in successful repair.
Pre sport massage
Pre sport massage is given under the assumption that the athlete is pre conditioned to the activity that they are about to undertake and is therefore a means of enhancing the natural health of muscles by stimulating blood flow to provide nutrients to muscles in a relaxed state, and the lymphatic system, to remove waste from muscles that may be lingering. The massage focus is optimisation, to reduce risk of damage (not to undo damage).
Post sport massage
Post sport massage is focussed on undoing damage caused during activity; with an emphasis on (post sport) it is never advised to get this type of massage before a sport event. The massage focuses on breaking up scar tissue, tight connective tissues, and posture. Generally it is slower than remedial massage to focus on fibre release and increasing range of movement. I like to apply trigger point therapy within my post sport treatments as it allows for a far more successful release and breakdown of scar tissue, therefore, more successful mobilisation post treatment.
Myofascial Trigger Point Therapy
Myofascial Trigger Point Therapy is a technique used by Massage Therapists which was developed over 50 years ago. Direct pressure is applied to a specific muscle that has become contracted or over-lengthened for extended periods of time preventing it from returning to its rest position.
Trigger Points, also commonly referred to as “knots”, are felt as painful areas in the muscles that cause pain to refer into other parts of the body. The individual may also experience symptoms such as tingling, numbness, burning, as well as weakness and restricted range of motion in the affected muscle. These points can occur in any part of the body, but are often most likely to be found in the upper back or neck. Trigger points will usually occur on both sides of the body, with one side being more symptomatic than the other.
Upon compression by the therapist, the trigger point will often reproduce the individual’s pain pattern. As the muscle relaxes, the pain and discomfort should then diminish. Massage therapists will apply pressure to trigger points using their thumbs, knuckles and elbows, as well as with specialised treatment tools. T-bars made of wood, plastic or metal, often rubber capped, may be used.
The most common causes of trigger points are poor posture, structural imbalances, repetitive activity and overuse, emotional factors, and direct trauma or injury.
A Knotty Problem
It is likely that most individuals have at some point in time experienced sensations of pain and discomfort caused by “knots”, also known as Trigger Points. These are painful areas in the muscles that cause pain to refer into other parts of the body, as well as create symptoms of weakness and fatigue.
A Trigger Point is the body’s response to a physical, emotional or chemical disturbance where the muscle becomes contracted or over-lengthened for extended periods of time preventing it from returning to its rest position. This then restricts the movement of the muscle and decreases circulation. The muscle then becomes deprived of nutrients and oxygen, which results in a collection of metabolic waste.
The most common causes of Trigger Points are poor posture, structural imbalances, repetitive activity and overuse, emotional factors, and direct trauma or injury. These points can occur in any muscles of the body, but are most commonly found in the neck and upper back. Trigger points can themselves bring about a variety of issues, such as tension headaches, tinnitus (ringing in the ears), jaw pain, lower back pain and carpal tunnel syndrome.
Trigger Points can be effectively treated with massage therapy where direct pressure is applied to the area in question. Upon compression, the Trigger Point will often reproduce the individual’s pain pattern. As the muscle relaxes, the pain and discomfort should then diminish.
Self care is also important to help prevent the re-occurrence of Trigger Points. This can include using a heat pack when muscles are tense or painful, having hot baths after treatment, keeping well hydrated, and carrying out simple stretch and range of motion exercises. Your massage therapist will be able to assist you with such exercises, and is also there to answer any questions or concerns that you may have.