KO Performance: Addressing Tension and Tissue Quality

For the second installment of addressing tension and tissue quality we are going to take a look at trigger points. The inception of a trigger point is very much debatable, but we do know they are tight areas (knots) of muscle that are tender to touch and often refer pain to other areas upon palpation. Regardless of their genesis they exist and can cause a host of problems.

Trigger points can be active or latent so just because you aren’t experiencing any pain doesn’t mean all is well. A latent trigger point will only hurt when touched, however, it can still create movement dysfunction. Think of driving your car with the e-brake slightly on, you may not feel it but there is a definite drag that will affect the performance of your car. A similar thing happens in the body when part of a muscle is consistently “on”. Let's take the shoulder for example; generally speaking, the muscles on the backside of the shoulder are responsible for slowing the arm down when we throw. If one of the posterior shoulder muscles has a latent trigger point we may not feel it, but when we throw that muscle creates drag on the forward movement of the arm. While we want the shoulder muscles to slow the arm down at some point, this braking action is happening through the entire range of motion, which is not optimal.

This leads us to active trigger points. Active points not only create movement dysfunction but they flat out hurt. The traps are an area commonly loaded with trigger points. If you’ve ever had discomfort or tension in the upper shoulders and found the pain became worse or referred to other areas of the body when touched then you’ve found a trigger point.

Addressing trigger points can be done in a number of ways. When you go to a massage therapist they usually use their hands to work tension out of the muscles. For those that can’t afford massage on a regular basis there are many inexpensive ways to get a similar effect. I have had great success using a lacrosse ball, though many massage tools can do the trick as well.

Lacrosse balls come in an assortment of colors and resemble a super hard racquet ball.

And now some common trouble spots; the "X" illustrates the trigger point itself while the red highlights the areas of referred pain. In other words, when these trigger points are depressed there will often be discomfort in the areas highlighted in red also.

Trapezius - A common area of tension that can cause headaches due it's origin at the occipital bone of the skull. Using a lacross ball and running it straight up the back on either side of the spine can be a good way to address multiple trouble spots. Another easy and inexpensive way to hit this area is by using a "peanut"; two tennis balls taped together with athletic tape.

The "peanut"

Rhomboids - The rhomboids sit deep to the trapezius and can often be addressed at the same time.

Levator Scapulae - Also deep to the trapezius, the levator scapulae contribute to that familiar tension in the upper back and neck that many experience.

Supraspinatus - Another muscle that is deep to the trapezius as well as the deltoid. The supraspinatus is one of four muscles that comprise the rotator cuff. This grouping of muscles affects the movement of the arm and stability of the shoulder so when dysfunction appears there can be far reaching consequences.

Infraspinatus - Another of the rotator cuff muscles that can affect the arm and shoulder similarly to the supraspinatus.

Teres Minor - A third rotator cuff muscle that can be palpated at the posterior shoulder.

Teres Major - While not part of the rotator cuff, this muscle sits very close to the shoulder and helps make part of the arm pit. It can be palpated on both the anterior and posterior sides of the body as seen in the graphic.

Pectoralis Minor - Sitting deep to the pec major, the pec minor can cause a host of problems due to it's attachment on the scapula. This means that when it becomes tight, or in chronic cases adaptively short, it encourages anterior rounding of the shoulder. Hunchback anyone?

Gluteus Medius - The glute medius, as seen in the graphic, can cause all kinds of discomfort. This is most easily addressed by pinning a lacrosse ball between this muscle and a wall.

Piriformis - The piriformis sits deep to the gluteus maximus and is part of a group of hip external rotators. If you recall from part 1 this muscle can create sciatic like pain if chronically tight as well as adding to an externally rotated standing posture and gait pattern.

Iliopsoas - The iliacus and psoas major are two main hip flexors and can become chronically tight due to extended periods of sitting. In the graphic you can see that the psoas major has a direct attachment to the spine so when these muscles become tight they often cause low back pain. If you suffer from low back pain, releasing tension in these muscles would be a good starting point due to ease and low cost.

Rectus Femoris - The only thigh muscle that crosses both the hip and knee. Excess tension in this muscle can cause knee pain, however, since there is also an attachement on the pelvis it can add to an anterior pelvic tilt, along with a tight iliopsoas, and contribute to low back pain.