Trigger Point Therapy: What It Is and When Your Therapist Uses It
You have probably heard someone describe a “knot” in their muscle. Maybe you have felt one yourself. A hard, tender spot in your shoulder or upper back that hurts when you press on it and sends pain somewhere else when pressure is applied.
That is a trigger point. And trigger point therapy is one of the techniques I use most often during a deep tissue or sports massage session to address chronic pain patterns. In my clinical experience, it is one of the most reliable tools for resolving referred pain that does not respond to general massage.
This is not a separate service you book. It is a technique that your therapist integrates into your session when the tissue calls for it. Here is what it is, how it works, and why it matters.
Written by Ken at KEN Mobile Massage, serving the Antelope Valley since 2017.
What a Trigger Point Actually Is
A trigger point is a hyperirritable spot within a taut band of skeletal muscle. In simpler terms, it is a small area of muscle fibers that have contracted and will not release.
Here is how it develops:
- A muscle is overloaded through repetitive use, sustained posture, or acute strain
- Some muscle fibers within that muscle contract but do not fully release
- The contracted fibers form a palpable nodule (the “knot” you can feel)
- Local blood flow decreases because the contraction compresses the small blood vessels feeding that area
- Metabolic waste accumulates and the tissue becomes irritated
- The nervous system interprets the irritation as pain, often referring it to a predictable distant location
The key word is referred pain. A trigger point in your upper trapezius can send pain up into your temple. A trigger point in your infraspinatus (a rotator cuff muscle) can send pain down your arm. A trigger point in your gluteus minimus can mimic sciatica, sending pain down the back of your leg.
This is why people often chase pain in the wrong location. Your head hurts, so you think the problem is in your head. Your arm aches, so you think the problem is in your arm. But the source is a trigger point in a completely different muscle.
How Trigger Points Form
Trigger points develop from a few common causes:
Sustained posture. Sitting at a desk for eight hours with your shoulders slightly elevated keeps the upper trapezius in constant low-level contraction. Over days and weeks, trigger points form in the sustained muscle. This is the most common trigger point pattern I see in clients across Palmdale, Lancaster, and the Santa Clarita Valley.
Repetitive motion. Athletes who perform the same movement thousands of times (runners, cyclists, swimmers, CrossFit athletes) develop trigger points in the muscles that handle the repetitive load. A cyclist’s hip flexors and IT band. A swimmer’s rotator cuff. A runner’s calves and hamstrings.
Acute overload. You lifted something too heavy, moved too fast, or pushed a workout beyond what your muscles could handle. Some fibers contracted hard during the overload and did not fully release afterward.
Stress. The jaw muscles (masseter, temporalis), upper trapezius, and scalenes are common stress-response muscles. When you are chronically stressed, these muscles carry low-level tension that produces trigger points over time.
Injury compensation. When one area is injured, the surrounding muscles compensate. The compensating muscles overwork and develop their own trigger points. This is how a knee injury leads to hip pain, which leads to lower back pain. The trigger points cascade.
Common Trigger Points and Their Referral Patterns
| Muscle | Location | Where It Sends Pain |
|---|---|---|
| Upper trapezius | Top of the shoulder | Side and back of the head (tension headache pattern) |
| SCM | Side of the neck | Behind the eye, across the forehead, around the ear |
| Infraspinatus | Back of the shoulder blade | Down the front and side of the arm |
| Quadratus lumborum | Deep lower back | Hip, buttock, and lower abdomen |
| Gluteus minimus | Side of the hip | Down the back or side of the leg (mimics sciatica) |
| Piriformis | Deep in the buttock | Down the back of the leg (compresses sciatic nerve) |
| Scalenes | Side of the neck | Down the arm into the hand (mimics carpal tunnel) |
This referral pattern map is what makes trigger point therapy different from general massage. Your therapist is not just finding tight spots and pressing on them. They are finding specific points that produce specific pain patterns and targeting them with specific techniques.
How Your Therapist Finds and Releases Them
During a deep tissue or sports massage session, I am constantly assessing the tissue under my hands. When I find a taut band with a nodule that produces a twitch response or referred pain, that is a trigger point.
The release process:
- Locate the taut band. My fingers glide across the muscle fibers feeling for areas that are tighter than the surrounding tissue.
- Identify the nodule. Within the taut band, the trigger point itself feels like a small, hard pea or marble embedded in the muscle.
- Apply sustained pressure. Direct, sustained pressure on the trigger point is the standard clinical approach. In my experience, the pressure appears to interrupt the contraction cycle and restore local blood flow when released.
- Wait for the release. Under sustained pressure, the trigger point will gradually soften. This can take 30 seconds to two minutes. You may feel the referred pain pattern intensify briefly and then fade as the point releases.
- Follow with tissue work. After the trigger point releases, I work the surrounding muscle to restore blood flow and length to the area.
Some trigger points release in a single session. Chronic trigger points that have been active for months or years may need multiple sessions. The tissue builds these patterns over time, and it takes time to fully resolve them.
What It Feels Like
Trigger point work is not gentle. When your therapist presses on an active trigger point, you will feel a distinct, intense sensation. It often feels like a “good hurt” paired with a familiar pain pattern. You might say “that is exactly where my headache comes from” or “that is the pain I feel in my hip.” That recognition is a good sign. It means we found the source.
The pressure should be strong but tolerable. I always communicate with my clients during trigger point work. If the pressure is too much, the muscle tenses against it and the trigger point will not release. We need to find the level where the pressure is intense enough to create change but not so intense that your nervous system fights back.
After the session, the area may be sore for 24 to 48 hours. This is normal. It is similar to the soreness you feel after a hard workout. Drink water, move gently, and the soreness will pass. After that, the referred pain pattern should be reduced or eliminated.
When Your Therapist Uses It
Trigger point therapy is not something you need to request. It is a technique your therapist applies when the tissue warrants it. During a typical deep tissue session, I might spend five minutes on trigger points in one area and zero minutes in another, depending on what the tissue is doing that day.
Common situations where trigger point work becomes part of the session:
- You report headaches, and I find active trigger points in the suboccipitals or upper trapezius
- You report arm pain, and the infraspinatus has a textbook referral pattern
- You report hip or leg pain, and the gluteus minimus or piriformis contains active trigger points
- You are an athlete with recurring tightness in specific muscles despite stretching and foam rolling
Trigger point therapy is not a standalone booking. It is a tool within the larger session. The right therapist knows when to use it and how to integrate it with the broader work.
The Bottom Line
Trigger points are a common source of chronic pain that often gets misdiagnosed or treated in the wrong location. The pain in your head may come from your neck. The pain in your arm may come from your shoulder blade. The pain in your leg may come from your hip.
Your massage therapist is trained to identify these patterns and work to release the trigger points contributing to them. In my practice, it is one of the techniques that produces the most consistent client-reported relief, and it works best as part of a comprehensive approach to your soft tissue health.
Want to address trigger points and chronic tension? Deep tissue massage and sports massage are the sessions where this work happens. Check pricing for your area and book a session. Read about deep tissue vs Swedish if you are not sure which session type to start with.
