He had just finished his off-season conditioning and was about to begin his senior year as a high school. He was a starter on the soccer team. His complaint was pain in the front of his shoulder. He had endured this debilitating pain during the last few weeks of weight training at a local fitness facility but kept it to himself until he had to do something about the pain. When he asked the fitness trainer what he thought it was the answer was “no pain – no gain” – the typical answer given by many coaches and others. He finally when to a local orthopedist and was immediately given pain medication, a muscle relaxant, three weeks of PT, and rest – nothing relieved his pain. Now he was desperate.
I asked him to lie facedown on the table. His questioning look suggested that he thought I was nuts! After all, the pain was near the front of his shoulder. How could I work on his pain if I couldn’t touch it?
I touched a spot on the medial border of his shoulder blade. He winced. I asked him to rate the pain on a scale of 1-10, ten being the worst.
“10!” he said, without hesitation.
I applied more direct pressure, then some cross-fiber friction for a minute or two.
“How’s the pain now?” I asked.
“Gone!” he said, incredulously. I worked around his upper back and shoulders to assure everything was ok before he got off the table. He started moving his shoulder in all directions. He and his dad just stood there speechless.
I pulled the trigger and killed the pain.
“I can’t believe this.” His dad said. “Why don’t the doctors use this technique. It sure works fast and well. We are really grateful we found you.”
The pain was caused by trigger points in his rhomboid muscles near the attachment to the medial border of the scapula.
Trigger points are hypersensitive knots of tissue that form in muscle tissue causing contraction of the surrounding soft tissue. Each trigger point has its own distinct pattern of pain. Trigger points can form anywhere in the body and each one of them, once activated, can cause pain, inflexibility, and can affect the work of other muscles.
It is commonly believed in the complimentary therapy world that trigger points contribute to about 75% of all soft tissue injuries and chronic myofascial pain conditions.
When a muscle is traumatized from an injury or physical or emotional stress, the trigger points become 'hot' or active. The belly of the muscle forms an adhesion within the muscle fibers in response to the trauma and creates a "knot." On the cellular level, the exchange of oxygen, fresh blood and the waste removal slows down and lactic acid builds up, causing decreased circulation, inflammation and pain in the area. Because trigger points are full of toxins, they feel sore to the touch.
High school athletes, in particular, suffer from trigger points for a variety of reasons including improper stretching, overuse, poor hydration and nutrition, stress and fatigue. Trigger points can be found in hamstrings and quads, often causing knee pain. Triggers in the shoulders can cause pain in the arms, neck and chest. Low back and hip pain is often the result of trigger points. These muscle contractions cause postural problems and poor posture causes injuries. Athletes try to play through these issues but could improve their performance dramatically once trigger points are identified and erased.