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contractions in small portions of the muscle |
In addition to their immediate detrimental effects on muscle function trigger points often |
cluster together and pull on tendons and ligaments causing joint problems and deep pain |
The tension they cause at joints can result in clicking popping and grating sounds Over time |
they can contribute to bone spurs pinched nerves and arthritis Trigger points can be seen in |
greatly magnified pictures of muscle tissue like the one below They look like bunchedup |
distortions in a weblike matrix |
connective tissue |
Figure Knot of partially contracted sarcomeres in the muscle fiber from the leg of a dog at x magnification |
Compare with the normal sarcomeres above and below it This knot looks like an active contraction but has no |
electrical EMG activity and is thus stuck in partial contraction Reprinted with permission from Simons and |
Stolov |
Dr Janet G Travell MD is generally recognized as the leading pioneer in |
trigger point diagnosis and treatment It has been said that she singlehandedly created this |
branch of medicine Travell who was the White House physician during the Kennedy and |
Johnson administrations emphasized that trigger points are demoralizing and devastating to |
quality of life She called them the scourge of mankind Advancedstage trigger points are the |
worst They usually present in clusters are the most painful and involve highly warped muscle |
fibers with large numbers of molecular aberrations In reality most people are practically |
covered in trigger points from old injuries bad posture poor workout techniques and bracing |
Muscle Tension Develops at the Molecular Level |
To better understand trigger points we need a little more background on muscles themselves |
Muscles are composed of fibers which are themselves made of smaller fibers The thinnest of |
Chapter Recognize Muscular Tension Dormancy |
those hold sarcomeres in which contraction takes place A sarcomere is a microscopic structure |
built from two kinds of filamentlike molecules actin and myosin Actin and myosin form |
interdigitating strands that can be activated When active they move past each other quickly |
creating contractile force |
Fascicle Fiber Myofibril all |
I |
Ui |
ml a a |
illustration A Muscle made of fibers containing sarcomeres B Microscopic view of contracted sarcomeres in |
a muscle myofibril An actual trigger point may contain dozens of these tiny knots |
Millions of sarcomeres must contract to perform even the smallest movement After they |
contract the sarcomeres relax when their actin and myosin strands are uncoupled from each |
other and pull apart In healthy muscle actin and myosin wait patiently in a relaxed decoupled |
state until an impulse from the nervous system tells them to pull past each other again In |
unhealthy muscle they are stuck Many specialists believe that trigger points start to form |
when overuse causes actin and myosin to become fixed in an interlocked position This |
interlocking puts the muscle into a static state of contracture in which the strands no longer |
separate and relax |
Relaxation Actin |
ele ACTIN |
Contraction |
Illustration A Relaxed sarcomere on top and a contracted sarcomere on the bottom with actin and myosin |
visible B Myosin curls like a finger pulling on actin and allowing them to slide past each other to create muscular |
movement C Human neck and shoulders covered with clusters of trigger points |
PROGRAM PEACE Self Care Exercises to Reprogram Your Mind and Body |
Trigger points originate from a few different sources sustained lowlevel contraction |
sudden muscle overload eccentric contraction when a muscle stretches and contracts |
simultaneously and gross trauma or injury to the muscle Regardless of the cause trigger |
points slow blood flow to the muscle and cause oxygen deprivation at the affected site |
The reduced blood flow then causes sarcomeres to contract further constricting the |
surrounding capillaries Capillaries normally supply the muscle with blood so when they |
constrict it leads to reduced circulation or ischemia that impairs many cellular processes |
Without blood flow chemical waste products from muscular activity start to accumulate |
Eventually the waste stimulates pain receptors in nearby nerve endings sending pain signals to |
the brain Active trigger points demonstrate an unusual biochemical mix not seen in healthy |
tissue It is an acidic milieu containing increased levels of proinflammatory contractile and |
paincausing substances And remember we draw our very breaths with muscles that are |
affected by these symptoms |
Muscle Shortening and Scar Tissue |
A muscle can change its resting length to adapt to the length at which it is habitually used or |
positioned Muscles usually become shorter due to prolonged contracture This is known as |
adaptive muscle shortening and places the muscle in a state of partial contraction It is another |
pervasive clinical finding that affects every person who has ever lived |
People confined to long periods of sitting exhibit debilitating shortening of the lower back |
and hip muscles especially the hip flexors Similarly wearing highheeled shoes causes |
prolonged plantar flexion of the foot which results in adaptive shortening of the soleus |
muscles Constant squinting shortens the muscle fibers of the orbicularis oculi narrowing the |
eyes Straining the sneer causes the muscles that lift the top lip to shrink making the face |
appear hideous When the muscles in your knees and ankles shorten they leave you vulnerable |
to sprains and tears Holding a hunched neck posture leads to shortening of the |
sternocleidomastoid and other muscles in the front of the neck making it very difficult to stop |
hunching because the decreased length of these muscles pulls the head down As Chapter |
will explain bracing the muscles surrounding the genitals may play a role in sexual dysfunction |
There are examples of adaptive muscle shortening in muscles all over our bodies |
The pressure from prolonged contracture pulls on tendons straining them and distressing |
the joints when they move Next ligaments and joint capsules retract These changes perturb |
nerve endings within the muscles and joints causing deepseated pain Muscle shortening also |
increases wear and tear contributing to inflammatory and degenerative changes such as |
tendonitis fasciitis bursitis and osteoarthritis Many different tissue types are damaged by |
strain including articular cartilages connective tissues tendons fascia menisci ligaments and |
spinal disks |
Adaptive muscle shortening can be made worse by the accumulation of scar tissue Scar |
tissue is a very tough inflexible fibrous material that binds itself to strained muscle fibers |
attempting to draw the damaged fibers together The result is a bulky mass of stiff tissue |
surrounding the site In some cases it is possible to feel and even see this mass under the skin |
When scar tissue adheres to muscle fibers it prevents them from sliding back and forth |
properly limiting the flexibility of a muscle or joint |
Chapter Recognize Muscular Tension Dormancy |
Scar tissue tends to shrink and deform the surrounding tissues diminishing strength and |
making the body feel heavy It tends to adhere to nerve cells leading to chronic pain Existing |
research has found that scar tissue is weaker less elastic more prone to future reinjury and |
up to times more painsensitive than normal healthy tissue This results in chronic pain |
that under most circumstances lasts a lifetime In people who brace the most these effects |
create visibly apparent postural distortions |
Excessive Tension is Debilitating and Constrains Your Physique |
Muscles encumbered by trigger points and adaptive shortening can be conceptualized as |
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