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Trigger
Point Page
A
self help guide to addressing a common source of muscle pain
I
suggest to all my health and fitness clients and athletes
that they learn how to do trigger point (TP) massage on themselves
and those who do it attest to better recovery, performance,
and fewer repetitive strain injuries. I do trigger point work
on my own muscles a little bit every day and see a therapist
when needed.
This
is me using the Theracane massage tool to work out a trigger
point in my hamstring. There's a little nib about the width
of a thumb (not seen) on the tool that's pressing into a TP.
I'll
leave the explanation of what trigger points are and how to
treat them to the expert, Bryan Cobb ARMT. Bryan
is the massage therapist for the Woodcock
Cycle Works cycling team.
In
my opinion most massage therapy modalities are bunk. Merely
fluff and buff. If someone tells you your "energy fields"
are out of balance and offers to put hot rocks on you to fix
the problem, chances are they have rocks in their head.
Crystals,
meridian energy, essential oils; They fall under the category
of pseudo science with nothing more than anecdotal gibberish
to explain them.
Trigger
point therapy shares no common background with these bogus
massage methods. Trigger point therapy was born out of clinical
observation and scientific research by physicians.
Have
muscle pain? If it's from trigger points, the pain can be
eliminated in most cases.
Cris
LaBossiere
Bryan
Cobb's Articles:
What
the heck is a Trigger Point? A
trigger point is a painful knot in muscle tissue that can
refer pain to other areas of the body. You have probably felt
the characteristic achy pain and stiffness that trigger points
produce, at some time in your life.
Adductors:
The forgotten muscles The
Adductors play a very important role in movement and stabilization
of the leg and pelvis. Problems that arise from injury or
overuse can be severe, even crippling. Care of the Adductors
is as important as care of the Quads and Hamstrings.
Trigger
Points and the Cyclist
What
are the first muscles that you think of when you think about
Cycling? Probably the Quads and Hamstrings (front and back
of the legs respectively). But Cycling uses a wide variety
of muscles to produce force and motion, balance and coordination,
including the gluts, the abs, and the psoas. When any of these
muscles develops Trigger Points, it can decrease performance
and lead to injury.
I
would like to talk about some of the common areas that can
cause problems in Cycling, what the problems are, and how
Trigger Point Therapy can help improve your performance.
Quads
The
most obvious area a Cyclist will develop Trigger Points is
the Quadriceps muscle group. These muscles produce a large
amount of force during peddling. Trigger Points in any of
these muscles will definitely impact on your performance.
Trigger Points can develop anywhere in this group. They can
refer pain either up the leg to the hip or down the leg to
the knee. For example, Trigger Points in the Vastus Lateralis
muscle produce a strong deep pain into the knee. Trigger Points
in the Vastus Medialis can actually cause the knee to give
out randomly when walking. Pain can also be felt in the hip,
as well as deep in the belly of the muscle itself.
Trigger Points in the Quads can cause weakness in that muscle,
as well as a feeling of fatigue and stiffness. This stiffness
can cause your pelvis to tilt anteriorly (forward and down),
which causes your low back to have an excessive arch (Hyper-lordosis).
This, in turn, leads to a tight and painful low back as well
as tight hamstrings.
Hamstrings
Hamstrings
flex the knee and extend the hip. Trigger points in the Hamstrings
will make it difficult to fully extend the knee and flex at
the hip. Trigger Points will cause pain to be felt anywhere
from the back of the knee to the base of the buttock. Trigger
Points in either the Medial or Lateral Hamstrings can cause
the Tibia (big, low leg bone) to rotate either laterally or
medially (inward or outward), respectively. This leads to
poor mechanics and force distribution in the knee joint. It
will also cause the patella (knee cap) to track (move) improperly
in the joint.
Areas
that you might not think of immediately include the Gluts,
Abs, and Psoas.
Gluteus
Minimus
The
Gluteus Minimus is a small muscle in your hip. It helps to
flex the hip and stabilize the pelvis during walking and standing.
Trigger Points develop in this muscle along with the Quads
group, specifically the Vastus Lateralis. Trigger Points in
the Gluts will, of course, cause pain. It will also lead to
the propagation of more Trigger Points in the Vastus Lateralis.
Gluteus
Medeus
The
Gluteus Medeus also stabilizes the pelvis and helps to medially
rotate the Femur (thigh bone). Trigger Points can cause propagation
of Trigger Points down the outside of the leg, due to its
referral pattern down the leg, to the knee. If Trigger Points
develop in this muscle, it could cause other Trigger Points
to develop in the Gluteus Maximus (buttock). It can also maintain
Trigger Points in the Quads or cause them to redevelop after
they have been treated.
Abs
Another overlooked muscle for Cyclists is the Rectus Abdominus
muscle, also known as the "six-pack". This muscle
is constantly contracting to stabilize your core while cycling,
and it is usually forced to do so in a pre-shortened position,
hunched over the handlebars. Trigger Points in the Abs can
cause a wide variety of symptoms, including nausea, indigestion,
difficulty breathing, abdominal pain, back pain, and can even
mimic some forms of visceral disease.
Psoas
Deep
to the Abdominal muscles is another muscle forced to do its
work in a contracted position: the Psoas. The Psoas muscle
group is a major hip flexor (the Up portion of a peddle stroke),
so it is highly active during cycling. But, due to the body
position on a bike (especially a road bike) the Psoas do not
get a chance to lengthen all the way. Trigger Points in this
muscle can cause an anteriorly rotated pelvis, groin pain,
leg pain and low back pain. If this muscle is weakened by
chronic Trigger Points, then reaching full power on a bike
is impossible.
Adductors Group
Another muscle group that is often neglected by the Cyclist
- and that can cause a large amount of dysfunction- is the
Adductor Group. The adductor muscle group consists of the
Adductor Longus, Adductor Brevis, Adductor Magnus, the Gracilis,
and the Pectineus. These muscles are found on the inside of
the thigh and are often referred to as the groin. They have
attachment points from the pubic bone and the inside of the
Femur (large leg bone). Their primary task is to adduct the
femur, that is, they pull the leg in toward the midline of
the body.
This
muscle group works hard in Cyclists to keep the knees from
flaring outward during pedalling. Cyclists often forget to
train this muscle adequately, causing poor mechanics and the
aforementioned knee flare. This biomechanical error in the
peddle stroke will cause chronic shortening of the Gluteus
Minimus and the Lateral Rotators of the hip, as well as the
Vastus Lateralis. All of which will develop Trigger Points.
This problem can propogate all the way down the outside of
the leg, including the calf muscles (Gastronemius and Soleus).
Also, due to the overload of the Adductors, you can develop
Trigger Points in this muscle group, as well, which will cause
pain on the inside of the knee, the groin, and anywhere along
the inside of the thigh.
The Adductor Group is very important to proper cycling mechanics.
Strengthening of this muscles group is essential for Cyclists,
especially if they are experiencing reoccuring Trigger Points
in the Gluteus Minimus, the LateralRotators, or anywhere along
the outside of the leg.
Maximizing Performance
To
maximize your cycling performance, you need to cover all three
bases: stretching, exercise, and Trigger Point Massage Therapy.
A complete stretching program that covers the muscles of the
legs, pelvis, and core is a must. These stretches should be
performed after each training session to encourage the return
of these muscles to their normal physiological length. A balanced
functional resistance training program will help to build
strength and endurance and help prevent Trigger Point development.
However, to address those TP's you already have, and those
that you will inevitably develop, Trigger Point Therapy is
also a must for maximizing your performance.
Remember, Cycling involves more than just the Quads and Hams.
For a Cyclist to achieve his or her full potential, as well
as to manage pain, injury and fatigue, attention should be
paid to all the muscles of the leg and pelvis, with special
attention to the areas outlined in this article.
Bryan Cobb, Advanced Remedial Massage Therapist
Precision Touch Massage Therapy
688-1777
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