Part II: Trigger points - How do We Know if a Trigger Point is Relevant?

 
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Part 1 was a brief description of what trigger points are) 

If we all laid on a foam roller and started foam rolling our quadriceps muscles (front of your thighs), chances are we would all find sensitive spots. But how do we know if these sensitive spots are relevant or not? Does this immediately mean that something is wrong with our quad muscles just because it hurts to roll on it?

Not necessarily.

We cannot judge the function of a muscle just by how it feels when we compress it with our hands or a foam roller. Nor can we judge the function of a muscle just by whether or not it feels tight. 

To address a trigger point thoroughly and figure out if its relevant, first we need to identify a movement pattern that a trigger point is affecting. Then we put the muscle through active and passive range of motion testing.

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If a muscle can’t control a joint through the joint’s available range of motion (via active range of motion or motor control test) &/or a muscle can’t be passively lengthened through a minimum range of motion (via passive range of motion or mobility test), then and only then can we judge the muscle or joint as problematic from either a mobility or motor control perspective. Now trigger point work is functionally relevant because we know the movement that has to be trained after trigger point work is done.

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We should be able to objectively measure improvement in movement control over time if trigger points are being addressed properly & if the manual work is "sticking" from session to session or not. Learn about why manual therapy & corrective exercises don't always work by understanding our Core Principle 3: Protect. correct. Develop

If you pass the active and passive range of motion testing for a particular joint/muscle, then we can confidently say that you have adequate mobility and motor control of that area. We wouldn’t recommend spending that much time foam rolling on the sensitive spots of that muscle. That doesn't mean you cant routinely foam roll it, just don't obsess over it.

Remember the feeling of sensitivity to pressure alone is not enough to call a muscle problematic.

So if your thought process sounds like this:

“Something must be wrong with this muscle because its sensitive every time I roll on it!”. Please keep in mind that we can't look at muscles' sensitivity to compression in a vacuum & make assumptions about function. 

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Objectively testing movement patterns then breaking them down into active & passive range of motion testing is how we determine the relevance of a trigger point. This is our thought process whether we are interested in rehab, injury prevention and/or movement wellness. 

In Part III we further discuss "What we do about Trigger Points?" 

 
Ramez Antoun