How To Treat "Latent" Trigger Points
Latent Trigger Points are like land mines - waiting silently under the soil, ready to activate
The article below provides an overview of the different "types" of trigger points. Please see the video above for more information.
Active Trigger Points
Active trigger points can occur directly from an initiating factor (such as repetitive motions) or secondary to another condition, such as arthritis or anything that can induce the energy crisis.
They also result from faulty muscle recruitment patterns.
When a person performs an action—any action—many muscles contract to provide the tension and stiffness required to carry out the task without stressing joints. All the muscles don’t contract at the same time, but in a specific sequence or order.
When “good muscles go wrong,” some muscles contract “too early” and others contract “too late,” with some muscle fibers not contracting at all! This state is called “muscle inhibition.”
Active TrP's tend to generate the well documented referred pain patterns.
If the active TrPs recur in spite of adequate treatment, look for the perpetuating factor(s).
These are mechanical and metabolic factors that keep the TrP(s) active and produce symptoms. The key to controlling TrPs is control of perpetuating factors.
Trigger points are activated by acute or chronic overload. Active TrPs may come from a sports injury, inappropriate physical activity, surgery, a fall, an unexpected movement, an auto accident, or a repetitive trauma.
Note however, that even with acute onset TrPs, there may be delay in TrP formation.
Active TrPs can hurt all the time, even at rest. The tendency is to back away from a roaring lion. You restrict your muscle movement and the pain may go away. The trigger point does not; it has become latent.
During the activation process of a TrP, or while it is in the process of becoming latent, spontaneous pain may be present in the area of a TrP, without the typical referral pattern. These are transitional trigger points.
Latent Trigger Points
Latent TrPs are like land mines waiting silently under the soil, ready to activate at any provocation.
Latent TrPs don’t cause spontaneous pain, but they still cause dysfunction. The muscles are still shortened, tight, weak, and in an energy crisis.
Younger people tend to have more active, painful TrPs; older people have more latent TrPs, with restricted ROM and muscle weakness, because, in general, they move less.
They have decreased their range of motion, because it hurts when they stretch TrP-laden muscles.
Then along comes an infection, a fall, or other stressor. Wham! Those latent TrPs activate, and there is an unexpected pain overload.
This may also occur in sedentary people. Often, one event initiates a TrP and another maintains it. For example, a head cold can cause many symptoms, including headache, stuffy sinuses, and a runny nose.
It may also activate TrPs that cause the same symptoms. The TrPs and their symptoms may remain long after the cold is gone.
The key fact to remember is that latent TrP's do not cause spontaneous pain, but may restrict movement or cause muscle weakness.
The client presenting with muscle restrictions or weakness will typically become aware of pain originating from a latent TrP only when pressure is applied directly over the point.
In many cases, a “local twitch response” will also be elicited when firm pressure is applied.
Transitional Trigger Points
Trigger points are dynamic in nature. During the activation process of a TrP, or while it is in the process of becoming latent, spontaneous pain (occurring without outside pressure) may be present in the area of a TrP, without the typical referral pattern.
Even when pressure is applied to a transitional trigger point, the pain may only be local.
For example, a temporalis trigger point may cause pain that is restricted to the immediate area, without characteristic referral to a tooth, the eyebrow area, or extended areas of the head.
These transitional TrPs may be missed and the pain misdiagnosed, because the characteristic referral pattern is absent.
About NAT Courses
As a manual therapist or exercise professional, there is only one way to expand your business - education!
Learning more skills increases the services that you offer and provides more opportunity for specialization.
Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.
About Niel Asher Education
Niel Asher Education is a leading provider of distance learning and continued education courses.
Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.
Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.
Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).
NAMTPT AWARD 2017
We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.
Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.
Award Winning Instructors
Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.
If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.
In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.
There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.
Most of our courses are accredited for CE/CPD/CPE. A full list of CE accreditations can be found by clicking on the link below.
Niel Asher Technique
Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.
The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.
Most of our courses are available as either "Printed" or 'Download" editions, wherever you live. Internet connection is required to access online and downloadable material.
When you purchase a download edition, you receive immediate lifetime access to all course material. Course texts can be downloaded and printed if required.
When you purchase a "Printed" edition, you will also receive free access to the download edition.
We ship Worldwide from locations in the USA, UK, and Australia. Most items are despatched within 24 hours and shipping is FREE for all orders over US$50.
Where to Start?
We offer a range of over 50 courses, presented by some of the worlds leading manual therapists. All courses are reviewed annually, and new courses are regularly added.
Our courses are modular, and designed to build on what you already know. For more information, please visit our "Where to Start?" page.
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
Share this post