Trigger Points and the Athlete: What are They?

September 6, 2009 at 10:43 PM | Posted in Health and Fitness, Psychological Wellness | 3 Comments
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I talk a lot about trigger points in my posts.  They are thus far the center of the Fountain of Youth series (and I apologize for the delay in updating that, it’s coming soon – I promise).  I did give a short introduction to these nasty things and attempt to explain exactly what they are, but I may not have done the greatest job.  At any rate, this article will tell you what they are and how they destroy your performance as an athlete or, on a much greater timescale, your performance in life in general.

This drawing shows what a trigger point looks like schematically, but what do they do?

This drawing shows what a trigger point looks like schematically, but what do they do?

So I mentioned before that trigger points are points in skeletal muscle that can’t stop contracting. Whether it be by nervous system disfunction, soft tissue injuries or some other mechanism, the muscle fibers get stuck in constant contraction. There are a number of reasons for this. The three most common reasons for trigger points to develop are

1. Overuse or repetitive stress injuries: this happens when you use a muscle much more than the other muscles in your body. The obvious example is the typical moronic college freshman intent on building only his pecs and biceps, but there are less obvious, more serious examples too – people who use a keyboard a lot, being on the phone too much, being on your feet all day – all of them can cause trigger points in various muscles.

2. Muscle imbalances: An imbalance between any two antagonistic muscle groups will cause trigger points to develop. For example, consider the pectoralis minor and the rhomboid. The pec minor, if you’ve been reading along with me, is a muscle on the front of your ribcage that attaches to the shoulder blade. The rhomboid goes from the shoulder blade to the spine, right in the middle of your upper back. A LOT of people suffer from rhomboid pain, and it’s because of trigger points. Trigger points develop in the rhomboids because the pec minor becomes short, tight and perhaps even has its own trigger points. With a chronically short pec minor, the rhomboids are forced to stretch out all the time and, because of this, they develop trigger points as a sort of defense mechanism (recall that trigger points shorten a muscle physically).

3. Weak muscles: The rhomboid problem people have is only worsened by the fact that most people have rather weak rhomboids to begin with. If a muscle is excessively weak due to inactivity, underuse or even a muscular wasting disease, weak muscles develop trigger points as a means of preserving their shape. Muscles of the lower back are often found with trigger points, and it’s usually due to either obesity (normally) or weak musculature (sometimes).

At any rate, trigger points do a number of things. First, they shorten the muscle fibers of the muscle they develop in. This is reason number one, biologically and physiologically, that they develop. It’s a means of self-defense for muscles that are put into a lengthened or inhibited state. But they also immobilize (or nearly so) muscles, too. If you have a muscle that has trigger points, it will cease functioning correctly because it is already in a contracted state all of the time. And, of course, trigger points cause pain.

Now that we have a basic understanding of what trigger points do, let’s apply that knowledge. I myself am (and many of my friends are) a bodybuilder. Although we fear plateaus in strength and size, all kinds of performance-oriented athletes fear plateaus in their performance or strength gains. As it turns out, one major cause of plateaus is trigger points. Think about it: you overuse a muscle, it develops trigger points, stops moving and, eventually, atrophies. Sound familiar?

Who doesnt love a pair of chiseled calves?

Who doesn't love a pair of chiseled calves?

Let’s look at some case studies. I’ll start with the classic: calves. Both men AND women value (whether consciously or subconsciously) well-developed calves. Nothing says godly strength quite like a nice set of calves. But it seems to be the case that people are either born with a gift for developing them or doomed to always have a tiny set of legs below the knee. Now, those of you out there who know anything about muscle will claim that this is because genetics play a huge part in calf development and the calves are normally slow-twitch fiber, so they aren’t built to gain size or explosive strength.

I argue that this is not so. It is definitely true that the calves are slow-twitch fiber in most people because they see a lot of use in a person’s lifetime. However, we know that with proper training, slow-twitch muscle can be “converted” to fast-twitch fiber. So what gives? Well, genetics play a role in calf development, but they play a role in ANY muscle’s development, really, and we’ve all seen ectomorphs with some pretty impressive development. It’s the trigger points, people!

Frank Zane is an ectomorph, yet his development still beats the hell out of yours.  Stop using genetics as an excuse and start kicking ass.

Frank Zane is an ectomorph, yet his development still beats the hell out of yours. Stop using genetics as an excuse and start kicking ass.

There are so many muscles in the calf (just like the forearms) and they all see nearly constant use in our lifetimes. Skeletal muscles can only take so much abuse before they adapt. The first level of adaptation in calf muscles is becoming slow-twitch fiber. This makes them less prone to tiring out easily, but the tradeoff is that the fibers are generally smaller and have much less potential to build muscle. They are also relatively weak in power movements.

The second level of adaptation in our calves is trigger points. The calf muscles all have the ability to develop trigger points and they are quite prone to doing so. These muscles will stick together fascially, stop working correctly when they knot up and stop working altogether eventually. This is why many people are frustrated when attempting to build calf muscle in the gym. Of course, there are other reasons, like the person simply isn’t hardcore enough with his or her training (it still takes a helluva beatdown to get calf muscles to respond) or because the trainee isn’t using enough weight, but trigger points will stop development no matter what training approach is used.

Another great example is forearm development. Forearms are built very similar to the way calves are built: the main bone is made up of two smaller bones and most of the muscles are lengthwise down the limb. Once again, forearm muscles are prone to sticking together, developing trigger points and have all the same problems calf muscles do. This is why forearm development is often just as difficult as calf development, if not more frustrating in some cases. It doesn’t help that we use our hands a lot during the day (especially with the onset of the information age).

Moving on from the naturally difficult parts of the body to develop, we move to problem areas like the shoulders and chest. Most guys go to the gym wanting huge shoulders and huge pecs. For the first months or even years these ignorant neophytes pound away at their pecs and delts, seeing acceptable gains in strength and size. Then, somewhere along the way, they hit a plateau: their weight just won’t go up, they begin to fluctuate in strength and their physical development stops. These guys dump obscene amounts of money into supplements, drugs and consultation to keep going. Eventually, most of them either turn to steroids, drop out of the weightlifting game or both.

What they should have done, first off, is realize that they are creating a massive muscular imbalance between muscles in their upper bodies. But, besides that obvious point, we know that muscular imbalance is a leading cause of trigger point development, right? So there’s no doubt that right about the time these guys hit their plateau, they were also developing trigger points in the “show muscles” – anterior deltoids, pec major and minor, and biceps. They are also causing satellite trigger points to develop, too: rhomboids, posterior deltoids, rotator cuff muscles and serratus anterior. All of this can lead up to a really nasty, persistent case of shoulder pain.

On top of all that, you can bet these guys are frustrated to no end with the lack of development in their muscles. They stop functioning correctly, build up metabolic waste and begin to atrophy. If they continue to press forward in lifting and keep trying to make progress, they begin to recruit secondary muscles (those deep muscles used in posture, breathing and other things we don’t really think about. These muscles were never meant to be primary movers and thus are easily and quickly overworked and injured. They too develop trigger points, and people begin to suffer from auxiliary as well as primary pain. Soon, even conventional treatments don’t work because they forget to address the secondary/deep muscles that were abused in the final stages of the lifting. The person receives massage, chiropractic care, physical therapy, MRI’s, and eventually surgery later in life. Once the person has surgery, their internal setup is forever altered and they can never hope to find fully restored function.

So this is the horror story that causes most parents and old people to harp on young people about why they ought not to lift weights and abuse their bodies, lest they end up old and fat and disabled like so many before them have. And perhaps the newbie that attempts only to build his biceps and chest deserves such a fate, but for those of you concerned truly with athletic performance and the complete package of kickass, trigger point therapy is something you should begin to look into.

To finish up, I’ll give some examples of really common trigger points and problems they cause.

  • Calves: Trigger points develop in any and all of these muscles.  The problems they cause are many.  You will notice that you are unable to gain size or strength in your calves, no matter how hard you train them or what approach you take.  Trigger points in the calves may cause knee pain, ankle pain or foot pain, or even pain localized within the calves themselves.  Many people suffer from loss of ankle mobility as a first sign, and ankle mobility is essential in high-performance sports.
  • Hip Flexors: Your hip flexors consist primarily of iliopsoas, rectus femoris and tensor fascia lata (TFL).  These muscles are all extremely prone to trigger points – especially when you consider the squatting/deadlifting involved in an athlete’s regimen.  If one of these muscles develops a trigger point, the other two begin to take up the slack.  It is only a matter of time before all three of the muscles have developed trigger points and cause you immense hip and groin pain.  Massaging the iliopsoas is not an easy task either.  When squatting and deadlifting, activation of the gluteals and abdominals is critical in avoiding an anterior pelvic tilt and shortened, disabled hip flexors.  Sacroiliac joint function and mobility are pivotal (no pun intended).
  • Hamstrings: If you have trigger points in your hamstrings, chances are you know about it.  Since there really aren’t a whole lot of other muscles that can compensate for the function of this group (besides the individuals making the group up), it’s likely that trigger points here will not only disable the athlete, but cause immense pain and prevent any activity until they are cleared up.  In the event that they do remain latent, a hamstring tear is imminent.  Check for postural problems here.
  • Anterior Deltoids: All of the pushing and pressing that recreational gymgoers do puts them at serious risk for these guys.  A lot of young men are far too overzealous in their show muscle training and end up injured for life because of it.  If you have a shoulder strength or size plateau or shoulder pain, this is problem number one to look for.  A great way to tell is to dig in between the anterior muscle fibers and the medial muscle fibers of the delt, all the way down to the bone.  If it’s tender, you f*cked up.  Massage it really well and then get ready to be incredibly sore for the next week.
  • Pectoralis minor/major: If you develop trigger points in the pec major, the good news is you can get rid of them.  If you develop them in the minor, you’re in for a world of pain.  First off, pec minor can’t be effectively self-massaged because of its location – you’ll need the help of a deep-tissue specialist (none of that feel-good, rub-me-down-with-oil happy ending bullshit: a REAL deep tissue massage is going to hurt like hell).  Once you’ve gotten your minors loosened up a bit, you’ll need to work on all the satellite trigger points that develop (rotator cuff, posterior delts, rhomboids, lower traps, serratus anterior).  Settle in: pec minor wreaks havoc.
  • Rotator Cuffs: Whether by sattelite, overuse or what have you, rotator cuff muscles are by nature small and weak.  If you don’t take good care of them, you’ll end up just like your father (Ok, so maybe that’s a little offensive to some people.  Look into my eyes and see if I care.).  I self-massage these muscles weekly, even if I don’t think I need to.  Keeping these muscles loose, pliable and at the correct length reduces your risk of ANY kind of shoulder injury significantly.
  • Biceps and brachialis: With all the hype about huge biceps and all the training of these muscles that happens, it is worth mentioning that you should check these muscles.  Many guys are baffled by their inability to get massive arms.  Secondary to a cure for obesity (You know, that pill you take where you eat cake and cheetos all day, watch the Disney channel and still look like an Olympus god?), this endeavor probably receives the most funding (however indirectly) out of any aesthetic health concern.

I’m not here claiming that simply removing the trigger points from your muscle will get you right back to making newbie gains and huge size/strength increases in ludicrously short periods of time (we only get that once), but I am saying that if you have trigger points and don’t get rid of them, you’ll spend the rest of your life spinning your wheels.

Bottom line: if you have a muscle or muscle group that is no longer growing in strength or size, or if you have reached a plateau on a certain movement, it’s time to begin checking for trigger points. The Fountain of Youth series has much more in-depth information for this part of the process. Those articles may be accessed using the categories on the right-hand side of my website.  You will also find actual treatment of muscles there as well, although the greater internet provides a very complete reference guide as well.

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3 Comments »

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  1. Nice picture of Frank Zane. He was an ectomorph for sure. You know how he stopped being an ectomorph?… he used androgenic anabolic steroids, just like all of those guys did. It was legal at the time, and he did it with a doctor’s supervision.

    They didn’t nickname him “The Chemist” for no reason. I don’t think he’s ever claimed to be natural.

    • You’re correct, Mike. Assuming Frank Zane used steroids is probably valid – and even though they’ve interviewed him a few times, he’s never admitted to it. Now, that’s pretty hard for me to argue with. But, I’m assuming that the reason you brought that up is because you are either

      1. a frustrated ectomorph who is unable to put on size while lifting, or
      2. you are implying that gains like that simply cannot be made without the aid of anabolic steroids.

      If it’s the first case, let me offer a little advice: eat more, lift more and sleep more. You should also stop making excuses or being angry because I called you out on it.

      However, if it’s the second case, I can offer much more. You have the air of a person who knows nothing about anabolic steroids besides what the media has fed you. First, let me just say that there’s almost nothing bad about anabolic steroids – just the user. It’s also worth mentioning that the testicles are not permanently “shrunken” due to steroid use and no correlation between steroid use and atherosclerosis (hardening of arteries) has been found – they’ve tested this time and time again. Many men have been on steroids many times and not committed crimes of rage, rape, or whatever the media told you steroids are responsible for. Secondly, increased testosterone levels in men correlate with increased health, immunity, strength and virility – all good things, no? And, interestingly, research has discovered that extremely high doses of testosterone in men are 90% effective as a male contraceptive, very much like the pill in women (except obviously it’s estrogen). The real problems are when you start getting into things like HGH, growth steroids from animals, IGF-1 (this is still really experimental), etc. This is the kind of shit that has killed people, or disfigured them (see all of the bodybuilders currently in the running for Olympia for disfiguration).

      Now, since you have no idea how anabolic steroids are used by lifters, let me enlighten you. First off, the user gains no muscle mass benefits if he or she does not use them correctly. When you use anabolic steroids, you are supposed to cycle on and off, with the periods depending on which particular type of hormone you are using. Now, let’s say you’re a scrawny gym rat who doesn’t eat enough, gets 5 hours of sleep, slaves away at some corporate job for 8-10 hours a day and leads a highly stressful, hectic life full of children and an unsatisfying marriage. With all of that stress and so little recovery, how could you expect to make any gains at all? You MUST follow the basics of muscle-building: eat, lift, sleep, repeat. That simple. You should be monitoring your calories closely, sleeping more than 8 hours every night and keeping stress in your life to a minimum. If you don’t follow those rules, you won’t get bigger. Period. You can shoot up all the drugs you want – it isn’t going to make you any bigger.

      So anyways, the point of this is that steroids did not MAKE Frank Zane into what you see in that picture. Steroids HELPED Frank Zane get to that point, but he still put in more work and effort than you apparently have (assuming you ARE in fact a frustrated weightlifter who bases his failure on lack of drugs). Steroids help NO one but those who have already put in the hard work and effort to build up. And if you’re pissed off at me now or still not believing me, consider this: steroids speed recovery of muscle tissue. They do NOTHING else within the context of muscle tissue. There you have it – you need more recovery to build muscle. This article, which is about how to relieve yourself from trigger points and speed the recovery of muscle tissue, is meant to help you recover quicker without anabolic steroids (although it will work just fine if you’re using them).

      I apologize if this is unnecessary or lost on you. I took the comment as a somewhat-hostile, skeptic interpretation of my claim. Trigger points are another fundamental method of increasing recovery quality and speed and, in my opinion, should not be overlooked in a complete training program. If you have any further questions or comments, I would be happy to answer them. If you’re wondering why I know so much about steroid use, let me just say that I’ve looked beyond what the media has to say. I’ve never used them, but I know plenty of guys who have.

  2. This design is wicked! You definitely know how
    to keep a reader entertained. Between your wit and your videos, I was
    almost moved to start my own blog (well, almost…HaHa!) Wonderful job.
    I really loved what you had to say, and more than that, how you presented it.
    Too cool!


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