How to Find a Trigger Point

Finding a trigger point is a vital skill in itself. It requires sensitivity and attention, but most importantly you need to know what you’re looking for. This video gives you techniques for how to find trigger points.

If you have pain somewhere in a muscle, how do you know the pain is coming from a trigger point?

To answer this, you need to examine the area with your fingers. You can’t answer this question in any other way. You have to answer it through the tips of your fingers.

When you search for a trigger point, what you’re looking for is a tender point in the muscle.

If the trigger point is very active, you’ll feel a tight band within the muscle, almost like a guitar string. When you press on it, you may feel it jump under your fingers.

Usually the trigger point will be located somewhere within this band. When you press really firmly on the exact place where the trigger point is, you’ll feel tenderness there. And then, depending on the referral pattern for that point, you’ll also feel pain somewhere else.

These pain referral pathways are specific to each trigger point. Sometimes it can be hard to find the point that’s causing your specific pain, because it’s located far away from where you’re feeling the pain.

For example, trigger points in the shoulder can cause pain in the arm, trigger points in the neck can cause pain in the head. Points in the thigh can refer pain down into the knee, and triggers in the calf can refer pain down into the feet.

The referral patterns of each trigger have been mapped out and you can find all the major trigger point charts for free here.

Free Trigger Point Charts
lisa September 16, 2009

i really appreciate your videos. i wish you lived in maryland, usa, so i could have you work on me! if you ever come to the us to do workshops, let me know- your videos are a great service.

[…] how do you self treat neck triggers? Firstly, you need to be able to find trigger points. You’ll be looking for tight or thickened bands of muscle within an area that feels […]

gabriela February 6, 2010

Better yet, come to Atlanta, and Lisa could come down here too. :):):)
I am learning from your videos, and emails. Thank you.

yogaME February 12, 2010

I just recently joined your site and have gained alot of knowledge, thank you. I have pain in both my arms where you where demonstrating, in my shoulders, and in the buttocks/IT band area. I am a yoga instructor and a runner. These treatments do bring me relief and feel very good, even tho, very tender. How often should I be treating myself, daily? twice daily? is heat/cold something I should add? Do I need professional help? Thanks — grat video!

Jonathan February 14, 2010

Hi there

I am pleased you have found the treatments bring relief. One of the keys is to be very gentle and patient when you treat the painful areas.

Therefore once you have found the trigger point- reduce the pressure [whilst staying on the precise point] until you are below the pain threshold – so there is now no pain. Then slowly increase the pressure always keeping below the pain threshold. It is now that you need to be patient because often people increase the pressure thinking that it will work better- it doesn’t and just causes you more pain. If you very slowly increase the pressure, the TrP just seems to melt away. It can be quite profound. You then need to stretch the affected muscles. You can then put local heat over the muscle which will further relax it.

You can do this treatment as often as you like. If possible a few times/day in teh actue phase. Each time will be easier and quicker. The beneficial effect will last longer.

Cold- followed by heat is one of the effective treatments of TrPs. This needs to be done in the correct manner. The cold [ originally Fluoromethane spray, but you can use an ice pack] is placed over the muscle origin and then run down the length of the muscle to the insertion and into the pain reference zone. This is followed by heat and a stretch.

You may benefit from a professional if they understand about treating TrP.

Kind Regards
Jonathan

[Please note- I cannot suggest a specific treatment for your complaint as I have not taken a full history, examined you or reviewed your investigations.
Therefore all comments I make can only be general – relating broadly to the problem you have described. ]

faehad February 18, 2010

i have entered newly to this field and am quite fresh. i found your lessons absolutely informative and you are generous to let us use your priceless experience.
may God bless you Sir!

frank pontillo March 7, 2010

when useing a back buddy or thermacane/pressurpointer
how can you find a triggerpoing in the back or neck?

Jonathan March 13, 2010

Hi Frank

The theracane is a very clever tool and the use of it is often instinctive. I am in the process of making videos of diagnosis and treatment of the rest of the body. In these videos I show how to use the theracane with treating each area. I haven’t shown the use of the back buddy- but you shift your body up and over the knobs and gently search for the TrPs.
The new videos should be on this site in 2-3 weeks and are free for your use. I think you will find them fascinating and very helpful.

regards
Jonathan

Pam Smith March 25, 2010

Hi Jonathan,
I have been on a 10 yr. journey with fibro pain and trigger points. Your informative
website and videos are an answer to prayer for me! Bless you for sharing your gift of pain management. Pam

istvan szabo April 8, 2010

after i watched your video, i tried to find the frigger point, in vain. i watched it over and over again and followed the instruction but i still couldn’t find the trigger point. i wasin coma several months ago after having a stroke and i was left with a stiff left hand and numbness in my arm /fingers/ and face. could it mean that i do not have a trigger point? please tell me this if you have a chancel. maybe not every body have a trigger pointcould it be? many thanks

cal wilson May 3, 2010

I have 2 degenerative discs in my lower back they say that they are those of a 70 year old. I am in my mid thirties. I am in constant pain I am waiting for an MRI . Do you have any suggestions on how I can corrrect or prevent further damage. Are there any trigger points I could be working on as well that might help relieve the pain

Where are the trigger points for headaches and the tension in the back of the neck?

Thank-you in advance. Cal

Jonathan May 18, 2010

hello Cal
there are often trigger points found in the erector spinae muscles, which lie on either side of the spine, or in the quadratus lumborum muscle which lies further laterally on either side. You can treat these using the principles found in the following link – http://lifeafterpain.com/info/muscles/trigger-point-treatment/.
My new course shows a number of techniques that you can use to get too hard to treat muscles in this area. Sometimes the pain may not come from areas of degeneration in the spine, but maybe caused more by trigger points.

And they definitely are trigger points for headaches and tension which occur in the upper cervical spine. These are explained in my first course just look up sub-occipital muscles, sternocleidomastoid and trapezius muscles. You will see how to diagnose and find that trigger points in these muscles and then out to treat them

regards
Jonathan

Please note- I cannot suggest a specific treatment for your complaint as I have not taken a full history, examined you or reviewed your investigations.
Therefore all comments I make can only be general – relating broadly to the problem you have described. You may choose to pursue these further with your own medical practitioner.

Jonathan May 18, 2010

hello Pam

I’m really pleased that you’re finding useful information in my website. Fibromyalgia is a difficult problem to live with. however with understanding and applying best principles you can manage it surprisingly well. Accurately and effectively treating your trigger points can make quite a difference.

Kind regards
Jonathan

Jonathan May 18, 2010

hello Istvan

It if most likely that the stiffness and numbness in your arm and fingers and face our a result of the stroke that you have had. This is due to damage in your brain in the areas that supply feeling and motor function in the arm, fingers and face. this problem in the central nervous system is another cause of stiff areas in muscle. if you cannot find trigger points, then they probably are not there. however it may be worth seeing a massage therapist or someone who has expertise to make sure that trigger points are not they, because you would not want to miss out on the opportunity to have them switched off.

Kind regards
Jonathan

Please note- I cannot suggest a specific treatment for your complaint as I have not taken a full history, examined you or reviewed your investigations.
Therefore all comments I make can only be general – relating broadly to the problem you have described.

[…] relieve pain in your wrist, you first need to figure out where to find the trigger points.  Or you could have a look at […]

[…] Both these muscles can be treated using ischemic pressure, myofascial release and trigger point therapy. It’s important to check out first that these is nothing wrong with the sore tooth. If the tooth checks out fine, then definitely examine these muscles to see if you can find trigger points. […]

Dr. Larry Gibson June 27, 2010

Dr. K,

Do you approach diagnosis and/or treatment of the elderly individual any differently than you do for the younger or middle-aged individual?

Thanking you in advance for your knowledge.

Dr. G

Kothai July 19, 2010

I’ve been trying to treat painful ankles by trying to locate trigger points. I did sprain one of my ankles and it’s never healed properly since then, a couple of months or more ago. But both my ankles have for many years now been painful on walking, making exercise impossible. It’s a pain at the back and bottom of my ankle, like at the achilles heel tendon, but right at the bottom of that, closer towards the heel. Where would I find appropriate trigger points for that? Nothing I do seems to work.

Zahoor Ahmed August 20, 2010

please help me. Two years ago i had stomach ulcer( H.pylori). During treatment i became very weak and one night my neck muscles got severly contracted and i went to doctor in emergency. but from that time i am suffering from neck and shoulder pain (right side of body) and this seems to be that pain is travelling from shoulder towards neck and from neck to shoulder an also in my left leg below knee. it also seems that my right tonsil is dislocated and there is pain in it. plz tell me that it is a trigger point problem or something else and also tell me the appropriate treatment. thanks

Ana Crispino September 10, 2010

Thanks so much for your e-mails, I was worry for applying deep tissue constantly, believe me, your information was, is and will be very useful for me, Thanks for to share your knowledge with us.
God bless you abundantly. 🙂
Ana.

SARLA BHOLE October 23, 2010

Hi Jonathan
While observing video just I follow your instructions;press below platysma where I have pains
and get relief. How many time and how many days Iwant to do the same treatment?
Thank you for sending the video.
(1)I have osteoarthraitis i.e.Ihave tenderness&pains near sternum bone(right breast).Pleasetell me
how Itreat on that point.
Thanking you,
sarla bhole

Teresa King November 2, 2010

Hello Jonathan!

I am a PT who is incorporating trigger point therapy into my private practice. As I study various practitioner’s treatment approaches, I am finding some major differences in what is done. You advocate below pain threshhold, steady pressure over points, followed by stretching (and then heat or cold perhaps). Claire Davies (Trigger Point Work Book) advocates 7/10 pain (0 is no pain, 10 is terrible pain), with slow strokes across the trigger point, and no stretching at all until later when trigger points are de-activated. I am hoping you might give your position on the steady pressure with below pain-threshold, plus stretching treatment you advise.

Thank you so much!

Teresa King, MPT

dave November 11, 2010

Pain makes me sensitive, and weary of looking for causes [and almost agreeing with the practitioners that I am a ‘crock’]. So your knowledge and delivery style has encouraged me and provided hope and some practical approaches and – for that – I am grateful. Dave

Caral December 4, 2010

I have just watched your video and participated in “feeling” with the tips of my fingers my arm to locate the triger points. I found this to be very helpful in understanding and locating a point so I can relieve some of my pain. I have prolapsed discs in my mid and lower back and have been in constant pain for the last 3 years. Can you PLEASE help with more video demostrations on how I can relieve my back, neck, legs, arms and head pain. I have constant pins and needles down the whole right side of my body 95% of the time, I sometimes can’t feel things with my feet, especially my right foot when I am driving, and I have very little strength in my wrists and arms. I have tried yoga, meditation, chiropractic, physio, hydro therapy, massage, swimming, gentle weight exercises, pilaties, walking, inversion beds, saunas, steam rooms, natural medicines, prescription medicines, over the counter pain killers and alchol, and then my whole body just gives up on me and I end up spending a lot of time flat on my back in bed, which is EXTREAMLY frustrating and depressing. I have been to see specialists and “natural” healers who tell me they can fix me, but up until now and the amount of money spent, I am no better, I just seem to be getting worse. I have been on the ‘medication roundabout’ and I managed to get myself off of it, but sometimes it seems that it is the only way I can get some part-time relief from my pain. Can you please help me?

[…] 4. Watch the video on How to Find Trigger Points. […]

asai December 16, 2010

hi , i am a sports physiotherapist from india. recently i joined in your site. it was very useful for me . thaks a lot. may god bless u

Chuck December 27, 2010

I’m a Registered Nurse, doing education for a home health care agency. Almost 2 years ago, I had surgery for a thoracic-abdominal aortic aneurysm (open repair with a graft). I was on the table bent to the right side for 11 hours, and happily recovered very well with no permanent neurological deficits. I do, however, have a lot of residual weakness and pain in the lower back and right side. I started doing research for my agency on pain management about a month ago, and came across your web site on line. I have had only minimal success finding alternative pain relief methods that our nurses and therapist could learn and teach our clients (we are looking for ways to help elderly patients relieve pain other than more medication). Finding your web site was a double blessing, as it helped me formulate care plans that our staff can use to teach clients, and I’ve located trigger points on my right side that are beginning to relieve the back spasms I had when I exercised after the surgery. Just wanted to say thank you, and keep up the good work. I’ll be looking forward to learning more.

avad February 17, 2011

Hi,
I am a weight lifter who had a elbow injury about a year back while pulling heavy weight. First 6 months went by while i was told by docs to rest the ara. I found about trigger points and have treated the condition partially.But the problem is that it comes back and i am at a loss to find where the trigger points are located. I fear that my lifting career is in danger. The pain comes when i do curls for my biceps.

Thanks.

jim February 24, 2011

hi there.
I have cronic achilles tendonitus which ive had for years. The tendon on the right foot now bows outwards and is only made worse from running and walking. Is there anything you can recommend, i have recently bought accupressure book , any info would be great. many thanks jim

Shatha February 24, 2011

It was interesting to read about your articles, It took me one and ahalf year to find out the main problem that I have in my muscles!!!!!
special thanks for you.
I am a highly active person, I have master degree in physical education, and I took workshops in massage therepy. even though they didn’t notice any information about the trigger points!!!! I had lots of quistions before! but now totaly I have the answers. so thanks alot.

Sarfaraz Patanwala February 25, 2011

Hi Jonathan,

I have been facing lot of pain in my upper trapezius muscle from the last 2 yrs from the top till the bottom of the neck and sometimes to the shoulder as well. I have done an MRI of Cervical Spine and it is clean with the help of God’s grace. I have done physiotherapy, had anti inflammatory medicines but nothing seems to work. I can feel the hardness. stiffness and the pain when I touch the area where it pains. I have visited a doctor and he advised me that I need to take injections of the part where it pains wanted to take your advice on it.

RICHARD CAMPBELL March 10, 2011

I HAVE NUMBNESS IN BOTH FEET AND TOES. DO WE HAVE TRIGGER POINTS
ON OUR FEET THAT DEALS WITH PERIPHERAL NEUROPATHY?

Millie Manka March 18, 2011

your a blessing to many

James D. Lauckner April 7, 2011

Thank you, sir.

Richard Cantu April 13, 2011

Hi Doc,
I’ve been working as a massage therapist for 14 years, mixing Swedish American and
Accupressure in my work . With great success in relieving my clients from their pain.
Many of my clients don’t understand trigger point work, I’m glad I found your site.
I will be recommending your site to further their knowledge on this valuable treatment.
thank you. Rich

Bashar May 17, 2011

Hi Johnathon,

I have Plantar Fasciatis and have tried practically everything possible to heal it but no luck. It has been an annoying 8 months. PLEASE HELP!

MJ July 31, 2011

I’ve had achiness in the upper hamstrings in both legs for several years. I’ve always been active. Been to a couple osteopaths for this issue with no success after several sessions. Massage therapist didn’t help either. (Not sure if there is a trigger point expert near me.) Never had a hamstring injury. Seemed to develop after going back to school where I had to sit (classroom and travel) for 9 hours a day for 5 weeks. Not sure this is the cause, but it is when I seemed to notice this. I’ve been stretching all the time, and using a 4″ inflatable ball to massage the hamstrings sitting on the floor. If there are trigger point here how would I find them? Are they deep into the muscle or more close to the surface. I surely can’t feel any lump or bump if this is what the trigger point should feel like. Also, I have numbness in my hands when I sleep on my back and doing minor tasks during the day. I seem to have found trigger points in my upper arms (brachialis). But to press on them is very painful, so I use a squeegie action on the t.p. It seems to be helping. After 2 days doing this I had very little numbness/tingling in the hands. It’s not over yet, but I’m very hopeful and grateful to have found your site. Any suggestions on the hamstrings? Thank you so so much!
MJ

Wanda Wells September 6, 2011

I have had moderate to severe pain in different areas of back for 4 years. I’ve had CT scans, MRIs, lab work, Physical Therapy, chiropractic massage and still no definite diagnosis other than possible fibromyalgia. I take 3 Hydrocodone 10 mg with 650 Acetaminophen spaced out daily with fair to moderate relief of the pain. I continue to be as active as possible and have been massaging the areas that hurt and using heat and/or ice. I have not found your video that shows how to find trigger points on yourself in the low back, upper mid back, right shoulder and left sciatic region where most of my pain is. What I have read and seen as restored some hope for feeling better about this problem.

kevin September 11, 2011

CAn anyone give me feedback on when i can expect relief(piriform butt muscles that seems spasmed..radiatng pain …similar to sciatica route–lateral hip flexor,,below my knee on side (exactly graph 11 on jonathons intro..)Has anyone had success applying the triggger point THEORY into practice?? I wAS THINKING doing 2-3
times a day for a few weeks?doe sthe muscles contrcation suddenly happen or is this lengthy process which gradually disappears 2-3 -5% every time??

Liz October 26, 2011

For those of us w/ IPAD’s, what’s another way to download videos, as Apple doesn’t support Flash. Thx

Heidi Schonfeldt January 2, 2012

I am so phenomenally happy that i found your website and have received your manuals and have watched your videos. I have suffered from MPS and FMS for two and a half years and it has killed me. I have tried every diet, every exercise, medicationa and nothing has worked. Until i found you.

Thank you so much for inspiring me to finally be pain free, i have only just started using your methods and already i am feeling much better. I am ecstatic and cannot thank you enough for changing my life. I wish i had known about you sooner.

I hear you are south african, me too.

You have saved my life, thank you so much

Ulla H Hansen January 7, 2012

Tank You very must. It helps. With great success in relieving my body from pain. Great work.

joy allen January 13, 2012

I have known about trigger points for a while, ever since I read about Dr. Travell while researching JFK. However, your videos and pictures make everything much clearer than any other resource I’ve found. The book I was using recommends same-direction massage rather than pressure, and I have found that pressure followed by stretching works better.

Recently, I was having trouble lifting my arm; so, I went to an orthopedic doctor just for kicks to see what he’d recommend. He didn’t listen to much of anything I said and was more interested in his speech-to-text software. He examined me, rapidly lifting and moving my arm, practically telling me what hurt or didn’t rather than asking.

He decided I probably had a problem with the radial nerve and told me I needed a nerve study and an MRI. At the desk, I told them I’d schedule those if I couldn’t fix the problem myself.

I went home and located horrible trigger points in the scalenes muscle in my neck. After treating those a few times a day for a couple weeks, I can lift my arm without pain. Fixed.
Trigger points.

Jee May 29, 2012

I have been suffering from chronic MPS 3 yrs. ago. I’d like to ask if corticosteroids injection can do help treating pain and stiffness. Is it common for me to exprience vertigo? I have mps on my left trapz, pain radiating from suboccipital muscle down the left upper back. I’m beginning to lose balance.

Jenny B June 8, 2012

Hello, I am new to your site and newsletters but I’m very excited with the info I have read so far. I was wondering if you have any videos that demonstrate how to find trigger points in the sub occipitals? I’ve had several whiplash injuries and this is where my pain is located.

Thank you!

Jonathan June 8, 2012

Hi,

you can use the same techniques in this video to find trigger points in the suboccipitals – and the charts on http://www.triggerpointmaps.com to locate them. I don’t have any specific videos on this muscle on this site – though they are covered in the Trigger Point Course

John Andrews June 19, 2012

Thanks for your videos. Please tell how to stop the degeneration of lumbar disc muscles?

Grace July 8, 2012

Hi, I’m 67 yr. old, and I’m having a very hard time driving, the moment I sat down in the car I say less than a minute, I get this sharp pain, on the left side of my leg joint, and now it is shooting down my calf, it is a scrubs hitting pain that I can not find the right position to aliviate the pain, and the problem is I have to drive to wrk and is 81 miles away, which it makes it so,nerd for me.

How can I find the trigger point? To stop this pain?

Grace Stroup

Jonathan July 8, 2012

Hi Grace,

this website has charts for all the major trigger points: http://triggerpointmaps.com/

And you can use the techniques in the video above to look for the triggers.

Dianne August 17, 2012

After having a cast on for 8 weeks, my fingers have been very stiff. I’m slowly
getting rid of the stiffness, with trigger points where do I look and will that clear
up the stiffness?
Thank-you! Dianne

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