Jan 12, 2024

What Are Trigger Points in the SHOULDER?

The consensus is that trigger points cause pain more often than any other condition and are drastically underdiagnosed due to a lack of information.

Trigger points are specific, hyper-irritable, and hypersensitive areas in muscle that suffer from decreased circulation, increased contraction, and spasms.
Lack of circulation creates a high anomaly of toxins and increased nerve sensitivity, ranging from low aches to sharp pain.

Just because the trigger point causes the pain does not mean the spot is painful. When the pain-causing spot is sore, it is called a primary trigger point. However, pain can also manifest itself in areas away from the active trigger point - such pain is called referred pain.

A significant trigger point nodule can often be noticed as a small lump in the muscle, usually no larger than a pea. Less substantial trigger points are not so noticeable by a lump but are easy to find anyway - search your muscles for the most tender spots; they will transmit pain when you press on them. You may not be able to locate a trigger point by feel, but it will always hurt when you press on it.

TRIGGER POINTS OF SHOULDER PAIN

trigger points of shoulder pain

The Supraspinatus Is The Most Commonly Injured Rotator Cuff Muscle

A healthy muscle fiber is neither contracted nor stretched when at rest. When contracted, the muscle fibers are closer together and when stretched, it's further apart. In a muscle that is causing trigger point pain, the fiber develops a knot and is in a constant state of contraction.

The excess tension stretches the fiber around these knots, and the muscle fibers become tighter.
With continuous contraction, blood flow is slowed to a stop in the trigger point area, and essential oxygen and nutrients are prevented from reaching the muscle tissue.
Toxins and waste build up in the muscle, and you will experience pain, tension, irritation, and spasms.

It is expected to find a "taut band" of muscle stemming from an advanced trigger point, which will feel much like a small cable. These tight bands extend from the trigger point outward and can be mistaken for a tendon, and it is these tight bands, brought on by trigger points, that keep your muscle in a state of tension. Taut bands found in shoulder muscles are directly attributable to a lack of shoulder movement. The bad news is that, left untreated, the trigger point will worsen, and the taut band will become tighter, freezing up your shoulder joint more and more. To free up your shoulder mobility, it is hugely important to:

Find the location of the trigger points that are the source of your shoulder problem.
Eliminate these trigger points immediately to escape the downward spiral toward worsening shoulder mobility.

supraspinatus pain pattern

Trigger Points and the Rotator Cuff

Within the physical therapy arena, one of the classic resources for Kinesiology (the study of movement and the way muscles cause movement to occur) reference is "Brunnstrom's Clinical Kinesiology" (Smith, Weiss, and Lehmkuhl 1996); much of the following information on this page will stem from this book. Though much of Kinesiology is focused on movement, it is also concerned with the myriad of factors that limit the function of muscles.

As you may or may not know, many shoulder problems will occur because one or more of the 24 muscles associated with the shoulder are not functioning correctly. Trigger points within the muscle tissue affect muscle function negatively, and the essential effects of trigger points are as follows:

Trigger Points shorten muscles and actively prevent them from lengthening
Trigger Points often cause muscle weakness.

Trigger Points often are painful -> This pain makes muscles stay tense -> This constant tension in the muscle will worsen the trigger point, thus completing a continually deteriorating cycle.

subscapularis pain pattern shoulder

The reality about rotator cuff injuries is that they often start slowly and gradually worsen to the point where the pain from the injury reduces your range of motion, eventually "freezing up" the shoulder joint. Once the shoulder is immobile, adhesions develop, essentially locking your shoulder into place. In the opinion of some doctors* the first step in treatment is to get rid of the trigger points within the muscles associated with the problem shoulder. The sooner the trigger points are treated, the better chance there is to keep adhesions forming in the shoulder joint.

*Travell, J., and D. Simons. 1983. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1. Baltimore: Williams and Wilkins.

Trigger Point Treatment

The good news is that nearly all muscles attributed to shoulder immobility can be treated with the Shoulder TShellz Wrap. A blood circulation boost device with a warming temperature effect can be a very powerful tool to help eliminate trigger points.

You will find some summarized points from Chapter 9 of "Therapeutic Heat and Cold," 4th edition. Ed. Justus F. Lehmann, M.D., Williams, and Wilkin.
Generally, it is accepted that heat on soft tissue (muscles, tendons, ligaments) provides the following desirable therapeutic effects:

Tissues heated to 45 degrees Celsius and then stretched exhibit a nonelastic residual elongation of about 0.5 to 0.9 percent after removing the stretch. This does not occur in these same tissues when stretched at average tissue temperatures.
Stretching of tissue in the presence of heat would be especially valuable in working with ligaments, joint capsules, tendons, fasciae, and synovium that have become scarred, thickened, or contracted. Such stretching at 45 degrees Celsius caused much less weakening in stretched tissues for a given elongation than a similar elongation produced at average tissue temperatures.
Experiments cited clearly showed that low-force stretching could produce significant residual elongation when heat is applied with stretching or range-of-motion exercises. This is safer than stretching tissues at average tissue temperatures.
Muscle spasms have long been observed to be reduced through the use of heat, be they secondary to underlying skeletal, joint, or neuropathological conditions. This result is likely produced by the combined effect of heat on both primary and secondary afferent nerves from spindle cells and from its effects on Golgi tendon organs.

Heating muscles produce an increased blood flow level similar to that seen during exercise. Temperature elevation also increases blood flow and dilation directly in capillaries, arterioles, and venules, probably through direct action on their smooth muscles. The release of bradykinin, released as a consequence of sweat-gland activity, also produces increased blood flow and vasodilatation.

Increased peripheral circulation provides the transport needed to help evacuate edema, which can help reduce inflammation, decrease pain, and speed healing.

Your massage therapist can undoubtedly help with trigger point massage. Still, if you treat your shoulder at home with the Shoulder TShellz Wrap® multiple times per day, we believe you will have a greatly improved chance of getting rid of your trigger points (and subsequently increase the range of motion in your shoulder). In some situations, trigger points in the back could cause shoulder immobility; if you are confident that the underlying problem is in the upper back area, we recommend using the Back TShellz Wrap®.

man trigger point pain shoulder

The MendMeShop Myofascial Device is a specialized device designed to help relieve muscle soreness, tightness, and trigger points through percussive vibration therapy. Here's how it can be beneficial:

Percussive Vibration Technology: This device uses percussive vibration, a form of massage therapy. The rapid pulsations delivered by the device can penetrate deep into the muscle tissue, helping to increase blood flow and oxygenation. This can lead to faster recovery of muscles, reduction in muscle soreness, and improved range of motion.
Targeting Trigger Points: Trigger points are specific “knots” that form in muscles. They are points of constant strain and often contribute to chronic pain. This device can apply direct pressure to these points, which can help break up the knots, relieve pain, and restore normal muscle function.
Interchangeable Massage Heads: With twelve different massage heads, the device can be customized for various muscle groups and types of massage. This versatility is particularly beneficial in a clinical setting where therapists might need to treat different muscle issues across a diverse client base.

mendmeshop advanced myofascial device 4. Portability and Ease of Use: Being a fully chargeable device, it offers the convenience of portability. This means it can be used at home, in a clinical setting, or on the go. This flexibility can benefit professionals like physical therapists, sports coaches, or massage therapists who might need to use the device in various locations.

5. Risk-Free Trial: The 60-day money-back guarantee allows users to try the device and see if it meets their needs without financial risk. This can be especially appealing for those skeptical about the efficacy of such devices.

6.Cost-Effectiveness: The sale price and the benefit of free shipping make it more accessible for individuals or professionals on a budget seeking quality therapeutic tools.

It's important to note that while devices like this can be highly effective for muscle recovery and pain relief, they should be used as part of a comprehensive approach to muscle health that may include stretching, proper hydration, adequate rest, and, if necessary, consultation with healthcare professionals. Additionally, it's crucial to follow the device's instructions and guidelines to prevent overuse or misuse, which could lead to injury. mendmeshop portable massage gun

Stretching

A stretching routine can undoubtedly lead to a successful outcome for many patients. However, there are times when many people in pain cannot tolerate stretching. When pain levels are high and your muscles are too taut, stretching may aggravate your injury. In such cases, an option would be first to minimize your pain using trigger point massage and TShellz Wrap® home treatments until you can reach a point where you start some moderate stretching without the pain. If stretching aggravates the problem, stop and continue with the massage and TShellz Wrap® treatments.

subacromial pain pattern shoulder

Combined with a stretching routine, the Shoulder TShellz Wrap is an effective treatment product for trigger points. Successful treatment of trigger points will increase the shoulder's range of motion and reduce the likelihood of a worsening rotator cuff injury. However, know that no amount of treatment will help with complete detachment cases of rotator cuff tears. If muscles or tendons are severed, a Cold Compress or Ice Pack and TShellz Wrap can help manage your pain and inflammation, but surgery will be required for recovery.

Symptoms of Trigger Point Pain

The trigger point spot will usually become more tender or sting when you push on the spot, and the referred pain will increase in intensity. Other symptoms include:

you will feel a knot or hard lump on the spot
the muscle may twitch when the spot is pushed
intolerance to weight on the shoulder (purse, backpack, etc.)
a deep ache over the top of the shoulder
pain on the back of the shoulder or the inside of the upper arm

Examples of Possible Causes of Trigger Point Pain

Tender trigger points typically develop from lack of stretching and improper stretching but can also be caused by stress/trauma, repetitive motion, or even poor posture. Other common causes are:

sitting without firm back support (slumped posture)
prolonged sitting in a chair without armrests or armrests that are too high or too low (leaning to one side)
cradling a phone between ear and shoulder
large breasts
one leg shorter than the other
typing on a keyboard that is too high
prolonged improper sleeping position
playing a violin
kayaking
overly tight bra straps
carrying a purse (prolonged hiking up of the shoulder)
head-forward posture
whiplash
walking with a cane that is too long

Reduced circulation in trigger points will eventually lead to muscle shortening and restricted movement, further accentuating the pain, thus completing a cycle of decreased mobility and further pain. This commonly becomes the underlying cause of adhesive capsulitis, chronic shoulder immobility, and even chronic headache pain. The patient will typically continue to suffer from these ailments until the problem trigger points are treated directly.

Mild Trigger Points can be addressed sometimes through massage, and some sufferers maintain that acupuncture treats these problems as well, though many medical institutions do not accept it. Permanent removal of chronic trigger points and conditions caused by this (headaches, lack of flexibility in shoulders and neck, upper back pain, etc.) typically requires treatment using massage and Circulatory Boost.

Treating Trigger Point Pain - What You Can Do!

If you have shoulder and rotator cuff pain caused by tense, constricted muscles - use a TShellz Wrap® for your trigger points. Trigger point pain is caused by constricted muscle fibers that form knots and eventually cause a buildup of toxins in the area. The trick to eliminating this pain is loosening the knots to release the constricted muscle fibers. This will allow blood to flow through the fibers again, bringing the vital oxygen and nutrients required for healthy tissue. A practical and pain-free way to loosen the knots is through a modality such as the TShellz Wrap

lady trigger point pain

In addition, you want to get your muscle tissue back in the best possible condition possible. To do this, treating the scar tissue that forms in the muscle when the damaged tissue begins to heal is essential - something our Circulatory Boost wraps are intended for. Even with optimum healing, there is always less elasticity in previously injured muscle fibers. However, if you heal your trigger point pain properly and treat scar tissue buildup, your chance of chronic trigger point pain and shoulder conditions, later on, is much lower than average.

If you would like to learn more about trigger points and their relation to the rotator cuff and general shoulder joint immobility, then do not hesitate to contact a MendMeShop Advisor immediately by phone or email.

mendmeshop shoulder massage gun trigger point

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During your recovery, you may have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!

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