Minimising mental and physical stress is important for optimal health, function and performance — making soft tissue manipulation (STM) an integral part of any athletes regime.

STM refers to the handling and changing of tension or unnatural firmness (hypertonia) present in muscles.

Recognised as hard, stiff or tight, tense muscles can be transformed into a relaxed, supple state via manipulation using: body parts (thumbs, fingers, hands, elbows) or some form of apparatus and/or machine.

The purpose of any STM is to create relief and relaxation from pain, anxiety associated with pain, tension and byproducts of tension such as muscle and joint restriction.

Attaining optimal athletic performance requires relaxed, supple and injury free muscles and joints, making the application of STM imperative.

Triangle of Health (TOH) regards STM important for injury prevention, rehabilitation and as a means for gauging progress.

Any athlete looking for a competitive edge should embrace STM as a performance enhancing tool.

The most common form of STM is traditional massage, whereby the hands, fingers, elbows or even various apparatus’s are utilized — to rub, stroke, stretch and pinch muscles in various directions — in an attempt to create relaxation or pain relief.

TOH is of the opinion that this form of STM falls short in its ability to deliver the required long term results.
Through experience TOH recognises that most muscular and joint related issues are trigger point and referred pain related – making Trigger Point Therapy the most appropriate solution.

What is a Trigger Point? A trigger point is a bundle of muscle fibres that have shortened, identified by a constant firm contraction which can be felt as a knot or lump.

Trigger point characteristics:

1. Painful to touch, located within a muscle and can range from pea to thumb size in structure depending on the muscle.
2. Created due to injury sustained via: impact, poor biomechanics and/or lack of proper muscle development, strength & conditioning.
3. Can be acute or chronic (possibly lasting years) create pain, weakness and tightness – and will restrict range of motion, subsequently affecting normal biomechanics.
4. Can be active or dormant, only producing pain when pressure is applied.
5. Generates referred pain (pain felt at a location on the body away from its source), creating confusion as to the location of the source (of pain) – source-site conflict.

Characterised as a deep ache that can be intense and intolerable, referred pain is the reason why TOH believes normal or traditional massage of rubbing and kneading can be a waste of time and even possibly damaging. Common examples of referred pain: headaches, migraines, sinus and jaw pain, ear aches and sore throats.

The most effective way of alleviating a trigger point is by applying direct pressure upon it through either a finger, elbow or apparatus – maintaining pressure until the referred pain has stopped and tightness or tension in the muscle has dissipated – resulting (releasing or relaxing a trigger point) in a soft, relaxed and supple muscle that has resumed its normal length.
A trigger point that has been present in the body for a long period of time will require multiple treatments (by a qualified therapist) of pressure applied to it for the muscle fibres to relax.

Alleviating a trigger point re-establishes the proper lines of communication between the brain and muscle, creating normal muscle tone. In some ways a trigger point can be viewed as a tension releasing button.

TOH recognises that the key to success with Trigger Point Therapy is its application of pressure. Pressure must be applied in a slow easing manner, while continued feedback is relayed on pain tolerance and status of dissipation — as it each person has a unique level of pain tolerance and must be addressed accordingly.

Accidents and injuries are inevitable and consequently so are trigger points. Trigger Point Therapy is a great way to alleviate trigger points but should not be viewed as a long term or continuous solution.

Ultimately the ideal way to deal with trigger points is through minimisation and control of their development.

Strong, conditioned and balanced muscles reduce trigger point which is best accomplished through proper nutrition, exercise and adequate rest.

(Note: This article is only to inform the reader about trigger point therapy. Trigger Point Therapy should only be carried by someone who is qualified.)

1. James H. Clay MMH, NCTMB, David M. Pounds MA, BS. 2008. Basic clinical massage therapy: integrating anatomy and treatment. 2nd edn. Lippincott Williams & Wilkins. pp. 12-33.
2. Clair Davies, NCTMB. 2001. The trigger point therapy workbook: your self-treatment guide for pain relief. New Harbinger Publications Inc. Oakland, CA. p. 22.
3. Clair Davies, NCTMB. 2001. The trigger point therapy workbook: your self-treatment guide for pain relief. New Harbinger Publications Inc. Oakland, CA. p. 2.
4. Clair Davies, NCTMB. 2001. The trigger point therapy workbook: your self-treatment guide for pain relief. New Harbinger Publications Inc. Oakland, CA. p. 19.
5. Clair Davies, NCTMB. 2001. The trigger point therapy workbook: your self-treatment guide for pain relief. New Harbinger Publications Inc. Oakland, CA. pp. 25-6.
6. Clair Davies, NCTMB. 2001. The trigger point therapy workbook: your self-treatment guide for pain relief. New Harbinger Publications Inc. Oakland, CA. p. 3.
7. James H. Clay MMH, NCTMB, David M. Pounds MA, BS. 2008. Basic clinical massage therapy: integrating anatomy and treatment. 2nd edn. Lippincott Williams & Wilkins. P. 10.
8. Clair Davies, NCTMB. 2001. The trigger point therapy workbook: your self-treatment guide for pain relief. New Harbinger Publications Inc. Oakland, CA. p. 7.
9. Clair Davies, NCTMB. 2001. The trigger point therapy workbook: your self-treatment guide for pain relief. New Harbinger Publications Inc. Oakland, CA. p. 33.
10. James H. Clay MMH, NCTMB, David M. Pounds MA, BS. 2008. Basic clinical massage therapy: integrating anatomy and treatment. 2nd edn. Lippincott Williams & Wilkins. p. 10.
11. Clair Davies, NCTMB. 2001. The trigger point therapy workbook: your self-treatment guide for pain relief. New Harbinger Publications Inc. Oakland, CA. p. 3.