Professional and Amateur Athletes/Dancers

Muscles that have trigger points should not be exercised.

(until the trigger points are removed and the muscle heals)

Disturbances of motor functions caused by trigger points include spasm of other muscles, weakness of the involved muscle function, loss of coordination by the involved muscle, and decreased work tolerance of the involved muscle. The weakness and loss of work tolerance are often interpreted as the indication for increased exercise, but if this is attempted without inactivating the responsible trigger points, the exercise is likely to encourage and further ingrain substitution by other muscles with further weakening and de-conditioning of the involved muscle.
Travell & Simons

Myofascial Pain and Dysfunction 

The Trigger Point Manual

 

Muscle that has trigger points (TrPs) cannot be strengthened.  

(until the trigger points are removed and the muscle heals)

 

Those of you who are wondering why certain muscles are not developing (even though you are exercising them), should be checking for trigger points in those muscles.
If you have TrPs, you must remove them and allow the muscle to return to normal - otherwise the strengthening programme for the involved muscle(s) is simply non-effective. As well, many athletes and physical therapists don't realize that putting these muscles under load (excess exercise) will actually make matters worse!

 Fact:
Muscle that has myofascial trigger points, will not build mass. So exercising (trying to strengthen) the afflicted muscle(s) will not only be a waste of time, it will cause "similar functioning" muscles  to take on the intended task. This "extra duty" will very likely put these "similar" muscles at risk of also developing trigger points. An example of this would be rectus femoris, trying to compensate for a poorly functioning iliopsoas (primary hip flexor) - they both act as hip flexors. Since the rectus femoris' function is not primarily to flex the hip, it would only a matter of time before both muscles would end-up with trigger points.

 

Strength Training

Muscle that has myofascial trigger points should NOT be considered normal muscle; therefore, strength training (for building muscle mass) and vigorous exercising (includes aerobic) is NOT appropriate for these involved muscles. And yes this includes using stretch bands (for the rotator cuff muscles), running, cycling, and using mechanical equipment.

Once the trigger points are removed and the muscle heals, you may return to a mild exercise routine, and slowly build to a full workout routine. Failing to follow proper trigger point protocol, will very likely lead to recurrence of the TrPs, and of course the related symptoms. This is why so many athletes have recurring problems, such as groin issues (pulled groin), knee problems, shoulder pain, and glute issues.

The athletes I treat, who follow correct TrP protocol almost always have a full recovery from their symptoms.

* * * * * 

The recommended protocol to deal with TrPs and muscle strengthening;

1) History: what are the symptoms... what happened, when and how long, etc.

2) Check: for trigger points in appropriate muscles and if TrPs are found,

3) Stop: the strengthening exercise that involves the problem area.

4) Remove: the trigger points. (Still no strengthening exercise or excessive stretching please!) Do not ice the involved muscles!

NOTE: Trigger points are considered removed when there are no further symptoms AND the trigger point site does not hurt when compressed.

5) Strengthening: may resume when the knots are removed and the problem area is pain-free for two weeks. You may start back with light strengthening, then slowly increase training levels.

* * * * * 

Whether you are a pro hockey player, a swimmer, dancer, golfer, runner, or tennis player, your muscles are very susceptible to these potentially disabling myofascial trigger points. I can think of no athlete that is exempt from the possibility of trigger point related issues.

They may not always cause pain, but you can be sure... they will always affect performance! And of course muscle performance can mean the difference between winning and placing second!

I'm positive that most of you have had some injury related to your sport. Perhaps a pain that has developed over a period of time... and is getting worse.

The usual treatments, (physiotherapy, massage, stretching) for the most part are effective to remedy the problem. But what if you are not getting better or the problem keeps reoccurring?

That’s when Trigger Point Bodywork should be considered. These knots have to be removed if you are going to be rid of the problem. It’s as simple as that.

You can stretch and ice and rub, till the cows come home... but if you still have trigger points (knots) in the muscle(s), you’ll still have pain or performance issues. Many sports therapists are aware of trigger points; however many do not know that trigger point treatments should be a part of all remedial work! Trigger points affect muscles... I can’t stress this enough.

Having said that... knowing how to find the problem knots is the big part of the battle. Trigger points refer pain in predictable patterns.
For example: pain in the front of your shoulder may be coming from trigger points in the infraspinatus (at the scapula). Therefore, massaging the anterior deltoid (sore areas) of the shoulder, will do nothing for the problem. A good Trigger Point bodyworker will know where to work to remove the problem knots.

 

The Dancer/Athlete (return to top)

Trigger points affect Dancers, often!
They can without a doubt, end a career.

Sore back, sore shoulder(s), frozen shoulder, headache, vertigo, lower back pain, piriformis syndrome, hip, and buttock and groin pain...numbness in limbs/hands, knee pain and foot pain. These are only a fraction of the potential problems that may be caused by myofascial trigger points.

The good news... many of these problems can be remedied if the source is trigger points!

Dance is no different than any other athletic activity and practice and passion is everything!

This constant working of muscle will very likely produce trigger points. These trigger points will refer pain, tingling, weakness or numbness, to areas you may not expect. Remember, you may have pain in one area... and the causal trigger points in another.

I’m certain any serious amateur or professional dancer has had many a session with a massage therapist, physiotherapist or other specialists. Most times you will get effective relief and carry on.

But what if you are not getting better? You’ve been poked and prodded... tested and evaluated... iced, heated, bent and twisted. And you are still suffering and your performance is compromised. It's likely that trigger points are causal for the majority of these issues.

I also believe that they can for the most part, be quickly and successfully treated. Whether you are a professional or amateur dancer; if you are losing the joy of dancing due to pain and nothing seems to be helping, please contact me. We can likely find the trigger point source of your problem... and hopefully eliminate it.

Here is the recommended Trigger Point protocol to deal with muscle strengthening and physical rehab;

1) History: what are the symptoms... what happened, when and how long, etc.

2) Check: for trigger points in appropriate muscles and if TrPs are found,

3) Stop: the strengthening exercise that involves the problem area.

4) Remove: the trigger points. (Still no strengthening exercise or excessive stretching please!) Do not ice the involved muscles! Moist heat is best for treating TrPs.

NOTE: Trigger points are considered removed when there are no further symptoms AND the trigger point site does not hurt when compressed.

5) Strengthening: may resume when the knots are removed and the problem area is pain-free for two weeks. You may start back with light strengthening, then slowly increase training levels.

Failure to follow this protocol when trigger points are present, will very likely lead to complete or partial rehab failure. 

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