Needles or Tapes on Trigger Points?

Today I would like to take a look at the functional disorders. The prevalence of these disorders in the current population is really huge, practically everyone has one. Although only minor. Even up to 90% of the pain in our musculoskeletal system arises on the basis of functional disorders, only 10% remain on the structural ones. In the long term, functional disorders of the musculoskeletal system stimulate and accentuate the emergence of structural disorders. These are far more serious and especially irreversible. New cartilage will not grow in your joint again. Functional disorders, on the other hand, are still reversible and can be eliminated with proper therapy. And thus prevent more serious problems in the future, which they would be involved in causing.

Myofascial Trigger Point

Trigger point is a functional disorder affecting the skeletal muscle of our musculoskeletal system. It is a local disorder of muscle tension. Thus, this disorder does not affect the entire muscle or muscle group, but only a certain portion of the striated muscle - typically a few muscle fibers. By trigger point we mean a small delimited point of increased irritability located in a rigid muscle bundle of transversely striated muscles. This nodule is essentially nothing more than a cluster of contracted (shortened) sarcomeres in several muscle fibers. The actin and myosin fibers are still attached to each other and deeply inserted into each other - in fact, it is a local permanent muscle contraction. In the modern world there exist several ways how to treat trigger points. I would like to focus today on 2 most popular in the UK.

1/ Dry Needling

Dry needling, or so-called dry needle therapy , is the only invasive technique of all techniques physical therapist can offer. This means that the integrity of the skin cover is compromised. During the actual therapy, a very thin (0.25 - 0.35 mm) flexible needle is inserted into the trigger point in the muscle. This will inactivate the trigger point and should subsequently relax the muscle and relieve the pain caused by the affected trigger point. The therapeutic effect should therefore be immediate. The actual process of relaxation has not yet been fully elucidated (the effects of histamine leaching and influencing the spinal reflex arc have been reported in the literature), but this does not change the effectiveness of this method.

There are two different methods of applying dry needles:

Superficial dry needling - is a method of application suitable for risky parts of the body, such as neck muscles. The needle is applied to the muscle to a depth of 5 - 10 mm above the trigger point and then left there for up to 3 minutes.

Deep dry needling - as the name suggests, it is a method used to treat deep-seated muscles, in this case, the needle can penetrate even more superficially stored muscles and adipose tissue. The needles are inserted directly into the trigger point itself, even repeatedly, until a local muscle twitch occurs. After that, they can be left in place again for some time. Of course, re-insertion does not mean frantic piercing of a muscle with one needle after another. Only one needle is inserted, which is then manipulated with small "up and down" moves.

The advantages of this method certainly include its above-mentioned immediate effectiveness. It can also very well remove trigger points in deep muscles and those in which attempts to remove by conventional methods have failed.

However, there are also several disadvantages:

It is not a 100% safe therapy. Very professional application is necessary to avoid damage to vascular or nerve structures. A poorly inserted needle into the muscles in the chest area (eg into the anterior serratus or rhomboid muscle) can also cause pneumothorax.

Many patients also experience post-application pain in the treated area, which can last for several days. It depends on the sensitivity of the individual and the number of needles inserted.

If you do not mind these negative aspects of therapy and you have a capable therapist working with this method in your area, I will certainly not discourage you from undergoing this procedure, it has its place in therapy. After undergoing it, however, it is advisable to continue working on a comprehensive active relaxation of the affected muscle groups.

2/Kinesio tapes

If dry needling is something new for you, then Kinesiotaping is definitely not. After all, it has been written about several times on this website as well. Lately, the bag has really torn with the taping, and who is not glued from head to toe, as if he did not even exist. Especially some crossfiters resemble a rainbow. :) I also sometimes use tapes when working with clients. Right now, I'm even wearing one.

In this article, I certainly do not want to discuss the complex issues of using kinesiological tapes (there are also fixation tapes). I will assume that they perform exactly as they should. The mechanism of their effect (or even whether they have any effect at all) is debated, even though they have been used since the 1970s. When working with trigger points, we will mainly focus on their ability to influence muscle tone. We can influence it both positively (to tone the muscle more) and negatively (to detonate the muscle). And since the trigger point is an area of ​​increased muscle tension, it will be desirable to apply the tape in a detonating manner.

If we want to apply muscle to the muscle tension negatively, it is necessary to follow several principles.

Tapes must be glued in the maximum, currently achievable, elongation of the muscle that we want to influence.

Tapes are glued so-called without tension. This means that we do not stretch the tape during gluing, but only on the skin when peeling it off the substrate. In addition, the skin should be hairless and degreased.

We glue the tape from the attachment of the muscle to its beginning. This rule, like most rules, has a few exceptions where it is necessary to glue the other way around in order to achieve a detonating effect on the muscle. These are the biceps brachii muscle, the biceps femoris muscle and the so-called semi-thigh muscles.

The kinesiological tape glued in this way should help reduce the tone of the muscle. The effect is certainly desirable, but unfortunately it is insufficient to remove the trigger point in an overwhelming number of cases. All previous and following techniques always require a specific focus for successful therapy. However, this does not mean that the use of tape in these cases has no benefits. On the contrary. Influencing the increased muscle tension of the muscle with the occurrence of trigger points can significantly facilitate their removal by other techniques, and mainly normotonizated muscles are far less prone to their re-formation.

The disadvantage of Kinesio-taping is its financial complexity. The prices of quality taping material range from 5-7 GBP for a roll with a length of 5 meters. Since I had the honor of taping a few bodybuilders, I can confirm that this role sometimes disappears really fast. Then someone's help is needed. You cannot usually stick a quality tape on yourself. The last disadvantage is the inability to combine taping with some other treatment procedures.

On the contrary, the advantage is painlessness and simple application. After a short instruction, a person is able to glue a basic tape (eg detonation tape to extensors of the wrist and fingers), or to instruct a family member to stick. So I see Kinesio-taping as a possible suitable adjunctive therapy. But it is not the basic building block of care.

In conclusion, it must be said that it is always necessary to look at the problem comprehensively when solving the problems of our musculoskeletal system. Eliminating the pain and other problems caused by trigger points is only one side of the coin - yes, very important. After all, it is precisely because of pain and its removal that one most often seeks professional help. But no less important is the subsequent prevention of the recurrence of the problem. Which of you would like to undergo painful ischemic compression or dry needling every other week? Or will you enjoy constantly relaxing tense muscles with post-isometric relaxation?