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You can find your own trigger points!

The diagrams below indicate certain “pain-maps” of the shoulder. Areas of pain are indicated in red - with the solid color representing the strongest area of pain.

The likely location of the corresponding trigger points are indicated with dark blue dots.

If your pain relates to any of the marked areas below, see if you can identify the trigger points - using your fingers to feel for a tender or painful nodule.

When you find the trigger point, gradually press down until pain is felt and hold for at least 5 seconds. You will have now correctly identified the required trigger point.

In order to attempt treatment, press down gradually and firmly on the trigger point and hold this position for approximately 2-4 minutes or until the pain dissipates.

A Simple Exercise to Relieve Pain

Click on left and right arrows to find the
"pain map" that fits your case. Then
follow the instructions above

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Trigger Point therapy is at the heart of many successful “hands-on” techniques

We’ve noticed an increase in interest in trigger points and trigger point therapy. So what’s it all about and how does this all relate to the shoulder?

History of Trigger Points

For centuries or perhaps millennia people have employed therapeutic touch to ease each other’s pain. All cultures and in fact all primates use touch as a powerful language of communication. From groomer apes to blind massage therapist in China, societies value and validate touch as a primary pre-verbal language.

As a body-worker/physical therapist one quickly comes to recognise knots, lumps and bumps inside tight/taught muscles. One intuitively knows to push on these to ease and soothe muscular pain. Those familiar with these tight knots, also quickly came to realise that pushing on some of them sometimes referred pain to other areas. In fact, sometimes they produce intense pain and a jump or twitch when pressed upon. Indeed, Chinese medicine in the form of shiatsu and acupuncture had realized these phenomena since at least 2700 BC.

Dr. Travell’s knowledge of Trigger Points helped keep President Kennedy on his feet

It was not until the pioneering work of Dr Travell (1901-1997) and Dr Simons in the 1950’s that these knots began to yield deeper secrets. The pioneering work of these doctors helped to establish both form and function of them and revealed a beautifully complex set of different points and their corresponding maps for each muscle in the body. They labelled these points “trigger points”. Dr Travell was widely regarded as keeping senator (and later president) JF Kennedy on his feet through his bouts of terrible muscular pain.

What exactly are Trigger Points?

Trigger points are implicated in all types of musculo-skeletal and mechanical muscular pain. The trigger point model is built around the fact that unexplained pain often radiates from these local points of tenderness to broader areas, sometimes distant from the trigger point itself.

Trigger points are hyper-irritable localised spots within muscles. They range in size and are embedded within the muscle fibers. Because there are different type of muscle fibre arrangements,trigger points vary according to the size, shape and type of muscle in which it is generated. They do share some common features, they are tender to pressure; and when pressed hard often cause a wince or ‘jump sign'. The main feature is that once pressed – they cause a specific map of pain – this map often corresponds to the patients symptoms and therefore helps to pin-point the problem muscles.

Anatomically, they tend to develop mainly in the muscle belly or central part of the muscle where the motor end plate enters (these are known as primary or central). Secondary or satellite trigger points can also develop in a response to the primary trigger point. These satellite points often develop along lines of stress within the warp & weft of the musculo-skeletal framework.

External factors such as aging, body morphology, posture, weight gain or congenital malformation will influence the development and location of these points.

Simeon Niel-Asher is the author of the best selling “Concise Book of Trigger Points”.
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