Trigger Point Therapy for Pelvic Pain

Trigger_Point_therapy-painSkeletal muscle accounts for 40% of our body weight. Each one of us has over 400 muscles but unfortunately any one those muscles can develop “knots”. 

During workouts and other movement activities, muscle is damaged and breaks down. As a result, adhesions and trigger points can build up in the muscle and fascia. This can lead to discomfort and tightness, restrict joint range of motion, and cause muscular imbalance. These imbalances can cause faulty movement mechanics and over time injury can occur. Performing soft tissue work called self-myofascial release can help improve and maintain the integrity of the muscle and fascia.

Myofascial trigger points, also known as trigger points, trigger sites, or muscle knots, are hyper – irritable spots in the fascia surrounding skeletal muscle. They are associated with palpablenodules in taut bands of muscle fibers.[1]

Trigger Point Therapy is used when Myofascial Trigger Points are present in a person’s muscles.  Trigger Points are painful on compression and can refer pain and tenderness to other areas. Trigger Points are usually ischemic and often cause an entire muscle to be painful, too tight, weak, and more easily fatigued.

Trigger points do not appear randomly in our bodies, but rather occur in predictable locations. Symptoms of trigger points can include dull ache, localized tenderness, burning feeling, reduced range of motion, or even sharp, point-specific pain. Trigger points can also refer pain is to another location on the body.

Trigger points happen in predictable locations. Trigger points can rise to the surface and increase in size mainly due to trauma, strain, poor posture, bad ergonomics, overworking or over stressing muscles, structural imbalances, improper body mechanics, or even such things as poor nutrition and psycho-emotional stress or exposure to cold temperature.

Trigger points are capable of producing neurological symptoms including headache, dizziness, and sensory disturbances. As such, they can imitate more serious neurological disorders such as intracranial mass, vestibular neuronitis, nerve injury, radiculopathy, and multiple sclerosis. If you have neurological symptoms that are not explained by any other cause should have the appropriate musculature carefully examined for trigger points. See this article for more on neurological symptoms and trigger points.

Releasing trigger points helps to reestablish proper movement patterns, pain free movement, and it ultimately enhances performance. You can assist in breaking up these muscle knots, resuming normal blood flow and function by treating your own trigger points.

Consider trying self-myofascial release! It provides YOU, the user, the ability to control the healing and recovery process by applying pressure in precise locations, because only you can feel exactly what is happening.

Trigger points respond best to four things; heat, pressure, massage, and stretching. Below is a video explaining the trigger point therapy process.

Various Ways To Treat Trigger Points (TP’s)

  1. Heat up a grain (magic) bag in the microwave and then place it on the areafoam-rolling-pelvic-pain
  2. Massage the area. To do this, put a little lotion or oil on the area and rub it until the sensitivity in the area decreases. 
  3. Visit a massage therapist. Trigger points are hard to reach on our own bodies. Massage therapists can get at all of these spots as well as find other trigger points that are contributing to your pain.
  4. Dry Needling. Uses a thin filiform needle to penetrate skin and stimulate underlying trigger points, muscular and connective tissues for the management of neuromusculoskeletal pain and movement impairments. Here is how they do dry needling in the US.
  5. Self-myofascial release. Which basically means self-massage to release muscle tightness or trigger points. This method can be performed with a foam roller, lacrosse ball, Theracane, YogaTuneUP balls, Massage Blocks or your own hands. This greatly assists in breaking up these muscle knots, resuming normal blood flow and function.

Foam Rolling

Rolling out – using a foam roller, stretches muscles and tendons and releases the fascia. This increases blood flow and circulation to the soft tissues, and helps to relax your muscles. It warms up the muscles and increases flexibility by breaking down adhesions between muscle fibers allowing more blood to pump through your body. Consistency with rolling out is one of the most effective ways to improve the appearance and function of your body.

Foam rolling can cause some problems if you are not doing it right. Consider reading this article and watching the accompanying video to help you from foam rolling mistakes. Here is great PDF by Ashley Borden that has fantastic photos and “how to” roll specific areas.

Tips For Foam Rolling Safely

Stay on soft tissue, avoid rolling directly over bone or joints

Roll over each area ten times to a maximum of 20 times

If you find a particularly painful area (trigger point TRp), hold on that position for up to 8 seconds to allow it to soften, but don’t allow the pain to go above a 7/10

Expect some discomfort. It may feel very tender or bruised at first. As you continue is should get easier. Although I find my IT Band is always really sore.

Tennis Ball for Trigger Points

This is a great article by Jenn Zerling on using a tennis ball to work on trigger points.  She states, “A tennis ball is cheap, portable and excellent for trigger point therapy. According to doctor of physical therapy and owner of Joint Wellness Medical Center, Dr Mike Shapow, DPT, PhD, “Holding a tennis ball on a muscle for 30 seconds inhibits the motor nerves in the muscle which is responsible for cramps and knots along the muscle fibers. This sustained stretch can break up these spasms, causing the muscle to release and relax. ” Check out her article as she has great pictures on how to do it.

How Do I Know it is a Trigger Point?

According to GUS (fantastic site for TP help) – ” When you feel pain in an area and press on that area, if the pain does not increase then it is more likely to be referred pain from a trigger point. From there you will need to use a trigger point resource to help you identify where the trigger point may be located. But if you press on the painful area and the pain gets worse, then it is not referred pain and is less likely to be a trigger point and more likely to be a local injury or problem with the tissues. However, this is but a general rule because it is possible to encounter a secondary or “satellite” trigger point in the referred pain area of a trigger point, because they can tend to occur in these areas. “

Trigger Point Release Self Treatment Cautions and Tips

  1. Going straight to trigger point treatment is fine, but let’s not ignore underlying causes that are causing you to flare up. Seek help from a qualified Osteopath, Physiotherapist or Massage Therapist to look at why you are tight in these areas.
  2. Don’t apply too much pressure at first, start off with just as much as you can stand, then gradually increase the pressure and go deeper into the tissues.
  3. Do not try to identify and treat every trigger point you have all at once. This can be very overwhelming to you and your body. Deal with your worst pain area first and then gradually move on to other areas. I like to watch TV and work on different areas, it is great time management.
  4. I really like this article! Kickstart Your Workout Routine: Tips To Get (And Stay) On A Roll

Using a Thera Cane to Relieve Trigger Points

Articles and Blogs on Trigger Points Worth Viewing

Massagtrigger point booke Therapy for Back Pain, Hip Pain, Sciatica By Paul Ingraham

Trigger Points & Myofascial Pain Syndrome (Online E-Book)

Trigger Point Pain Relief Techniques

Trigger Point Products at the TriggerPoint Shop

Trigger Point Pain and Referral Guide (excellent resource)

The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief

 The Roll Model by Jill Miller (Excellent way to get at TP’s)

Myofascial Trigger Points: An Evidence-Informed Review  (This article provides a detailed and technical overview of current theories and studies on trigger points.)

Trigger Point Pain  by Ground Up Strength (Deals with specific trigger point areas)

Pain Trigger Points Explained by Pelvic Floor Rehab

Myofascial Pain and Dysfunction: The Trigger Point Manual, Volume 2 (read online)

Trigger Point Massage Therapy Techniques Neck Pain Relief & Release – Relaxation Music & ASMR – grab a friend/partner and teach them how to find and treat your trigger points

Musculoskeletal Causes of Chronic Pelvic Pain – What a Gynecologist Should Know – American College of Obstetricians and Gynecologists

Myofascial Pelvic Pain – Dr. J. Weiss – This is an excellent article!

Why All Athletes Should Do Soft Tissue Work – STACK article

Home based MFR managements for pelvic floor dysfunctions: Part V – How to guide, this is well done.

Hurts So Good: A Beginner’s Guide Self-Myofascial/Trigger Point Release – How to guide from The Art of Manliness

The Top 10 Trigger Points Every Health and Fitness Professional Should Know!

LET WHO PUT WHAT WHERE? FINDING A CURE FOR PELVIC PAIN – Do you have to suddenly pee, or have a hard time holding it? This lady did, find out what she learned at her physical therapist appointment regarding pelvic floor muscles and the urgency to pee.

Do You Know about Fibromyalgia Trigger Points and What are the Causes?