W2 Trigger points and referral patterns Flashcards
1
Q
What are trigger points?
A
Highly irritable and sensitive local area lying within a taut band of muscle fibre. Often found within muscle belly or near MTJ
2
Q
Why are they formed?
A
- Research is still underway
- Microscopic contraction ‘knots’ within muscle fibres
- Action and myosin do not release their contraction and cause sarcomeres to bunch up and become taut
3
Q
Trigger point formation
A
- Nerve end plate is over-activated
- Increase in acetylcholine
- Stimulates release of too much calcium
- Calcium stimulates sarcomeres to contract
- Contraction causes schema and hypoxia
- Influx of calcium can’t leave into NMJ
- Sarcomeres stay in state of contraction
- Trigger point is formed
4
Q
Other formation
A
Overloading stretch/shortening
5
Q
Types of overload
A
- Repetitive: repetitive action with little rest and poor recovery
- Exertional: sustained loading with heavy lifting
- Biomechanics: dysfunctional movement pattern
- Postural: sedentary lifestyles
6
Q
Types of trauma
A
- Acute: direct injury
- Chronic: dysfunction/weakness
7
Q
Active trigger points
A
- Spontaneously painful
- Area of soft tissue is hypoxic and ischemic
- Referred pain and tenderness on palpation
- Can deactivate to latent form by use of dry needling
- Can take time to relieve pain and initial treatment can make pain worse
8
Q
Latent trigger points
A
- Painful only when stimulated with manual stimulation
- Area of soft tissue is hypoxic and ischemic with. lower PH
- Associated with local twitch response
- Found in many pain free skeletal muscles and may be ‘activated’ and converted into active trigger points
- Cause weakness and reduced range of motion
9
Q
2 treatment methods
A
Ischemic pressure: Specific pressure either sustained or repeated
- Sustained - 20 seconds or on and off for 2 minutes for repeated. VAS 7/10 to 3/10
Deep stroking: Sustained pressure working along the line of muscle fibre
- milking effect
