What Is Trigger Point Therapy in Sports Massage?
Trigger point therapy is a hands-on technique in which a therapist applies sustained pressure to a tight, tender spot in a muscle, called a trigger point, to reduce local tension and the pain it can send to other areas. In a sports massage it is one tool among several, used on the specific knots that keep tightening after training rather than across the whole body. Knowing what trigger point therapy can and cannot do matters, because the research supports short-term changes in muscle tenderness and flexibility, not a permanent solution, and booking with the wrong expectations costs you time and money.
This guide is written by Dr Ruth Abisset, Doctor of Chiropractic and founder of Sona Chiropractic in Kirriemuir, where trigger point therapy is part of our sports massage service. It is written for runners, footballers, gym-goers and desk workers in Angus who want to know whether trigger point work is worth booking. It explains what happens in a session, what the evidence shows, and how trigger point work differs from other massage and from chiropractic care.
Trigger point therapy is sustained pressure on a tender knot in a muscle. Research links it to better pressure tolerance and short-term flexibility gains when used within sports massage, but not to lasting change on its own.
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What is trigger point therapy?
Trigger point therapy is a manual technique that uses direct, controlled pressure on a hyperirritable point in skeletal muscle until the tissue softens and the tenderness eases. The approach was set out by the American physician Janet Travell, who co-wrote Myofascial Pain and Dysfunction: The Trigger Point Manual with David Simons in 1983. Their charts, often called referred pain maps, still guide where therapists look for trigger points today.
Therapists use several names for the same technique: trigger point release, ischaemic compression and pressure release. Within a sports massage, trigger point therapy sits alongside broader strokes such as effleurage and petrissage, myofascial release and muscle energy techniques.
What is a trigger point?
A trigger point is a small, tender spot inside a taut band of muscle fibres that hurts when pressed and can cause pain somewhere else in the body. The International Association for the Study of Pain (IASP) describes myofascial pain syndrome as a musculoskeletal condition with local and referred pain involving trigger points, and notes that trigger points can occur in any part of the body (IASP fact sheet, 2017). Under the fingers, therapists usually describe them as palpable nodules or a ropey band within the muscle belly.
Active and latent trigger points
Trigger points are usually grouped into two main types: active trigger points, which cause pain you notice day to day, and latent (sometimes called passive) trigger points, which only hurt when pressed but can still refer pain, stiffen a muscle, alter muscle function and reduce its range of motion. The IASP notes that higher levels of inflammatory chemicals have been found in active trigger points. Some therapists also describe satellite trigger points, which form in the referral zone of another trigger point and are usually less painful, and attachment trigger points, which sit where a muscle joins tendon or bone. Muscle belly pain is felt in the central region of a muscle, while origin and insertion pain is felt at those attachment points.
What is referred pain from a trigger point?
Referred pain is pain felt away from the trigger point itself, and it is the feature that makes trigger points easy to misread. The IASP states that trigger points characteristically refer pain when stimulated, and that referred pain can last seconds, hours or days. One example in the Travell and Simons charts is the gluteus minimus in the hip, which can refer pain down the outer thigh and lower leg. Radiating pain like this can resemble sciatica, which arises from irritated nerve roots in the lumbar spine, and that is why a therapist assesses the whole pain pattern before working on one spot.
What causes trigger points in active people?
Trigger points commonly develop where a muscle is loaded repeatedly without enough recovery: muscle overuse in training, repetitive tasks at work, sustained postures such as forward head posture at a desk, and minor muscle injury. Many people notice morning stiffness or a reduced range of movement in one muscle before they notice pain. The exact mechanism is not settled. The IASP lists increased stiffness within the taut band, altered muscle activation and raised neurochemical levels as findings, and states that the underlying mechanisms are incompletely understood. One older idea, sometimes called the energy crisis theory, proposes that a contracted band squeezes local blood flow and keeps the muscle starved of oxygen, but this has not been confirmed.
In sport, the pattern tends to follow the activity. Runners often report tight calves and hamstrings, footballers report hip and thigh tightness, and swimmers and gym-goers report tension and shoulder pain across the shoulder muscles. These are the muscle groups a sports massage therapist checks first.
How does trigger point therapy work in a sports massage session?
Trigger point therapy in a sports massage works by warming the muscle first, then holding firm pressure on each tender point until the therapist feels the tissue soften. The aim is to return the muscle to normal function, not to chase every tender spot. At Sona, a typical session follows five steps:
Ask about your training, medical history and where you feel tension, and check how far each joint moves.
Warm the area with broader massage strokes so the surrounding muscles relax.
Locate the taut band and the specific trigger points within it by touch, asking you whether the pressure reproduces your familiar pain pattern.
Apply pressure to each point, usually for 30 to 90 seconds and occasionally up to 2 minutes, easing deeper as the tissue softens.
Stretch the affected muscle and recheck your range of motion before moving on.
Firm pressure briefly reduces blood flow through the muscle tissue under the therapist's thumb. When the pressure is released, blood circulation to the affected area returns, which is one proposed reason the local tenderness eases, although the exact mechanism has not been proven. Our sports massage therapist, Maya Irvine, is a Level 4 Sports Massage Practitioner and often combines trigger point work with Instrument Assisted Soft Tissue Mobilisation (IASTM).
Does trigger point therapy hurt?
Trigger point therapy is usually uncomfortable while the pressure is applied, but it should never be extremely painful. Pressure on an active trigger point feels like a deep ache, and many people find the pain decreases during the hold. Tell your therapist if the pressure is too strong, because pushing through severe pain makes muscles guard rather than relax. Mild soreness for 24 to 48 hours afterwards is normal, and we recommend resting the area and drinking plenty of water during that time.
Trigger point therapy vs massage: what is the difference?
Trigger point therapy differs from general massage in scope: it targets individual tender points with held pressure, while massage treats whole muscles or regions with moving strokes. Sports massage combines both. The table below compares the options people most often weigh up.
| Approach | What it targets | Main technique | Who delivers it |
|---|---|---|---|
| Trigger point therapy | Individual tender points in a taut band | Sustained pressure, then stretch | Massage therapists, physiotherapists, some chiropractors |
| Sports massage | Muscles used in training and their surrounding soft tissue | Effleurage, petrissage, myofascial release, trigger point therapy, muscle energy techniques | Sports massage practitioners |
| Deep tissue massage | Deeper layers of long-standing muscle tightness | Slow, firm strokes across whole muscles | Massage therapists |
| Swedish massage | General tension and relaxation | Light to medium flowing strokes | Massage therapists |
| Dry needling | Trigger points reached with a fine needle | Fine needle inserted to stimulate the trigger point | Trained clinicians such as physiotherapists |
| Spray and stretch | Trigger points in a muscle that is hard to stretch | Cooling spray on the skin while the muscle is stretched | Doctors and some physiotherapists |
| Trigger point injections | Painful trigger points in a medical setting | Local anaesthetic injected to relieve muscle pain, often with a small amount of steroid | Doctors (see Guy's and St Thomas' NHS) |
The practical difference is focus. If your whole body feels heavy after a hard training block, a full sports massage or deep tissue massage suits better. If one spot keeps tightening in the same place, a session that spends more time on trigger point release is the better fit.
What are the benefits of trigger point therapy?
The best-supported benefits of trigger point therapy are better tolerance to pressure on a sore muscle and short-term gains in flexibility when it forms part of sports massage. Evidence that it can relieve pain over the longer term is weaker. The table summarises what controlled research has found so far.
| Outcome | What the research found | Source |
|---|---|---|
| Pressure pain tolerance | Clearly better than sham, placebo or usual care straight after ischaemic compression (11 trials, 427 people) | Lu et al., 2022 |
| Self-reported pain intensity | No clear difference from control straight after treatment (7 trials, 251 people) | Lu et al., 2022 |
| Immediate relief from manual therapy | Moderately strong evidence for massage, ischaemic compression and pressure release | IASP, 2017 |
| Flexibility after sports massage | About 7% better than no massage | Davis et al., 2020 |
| Post-exercise muscle soreness (DOMS) | About 13% better than no massage | Davis et al., 2020 |
| Strength, sprint, jump and endurance | No measurable effect | Davis et al., 2020 |
The sports massage figures come from a 2020 review of 29 randomised studies with 1,012 participants. Its authors concluded that massage may somewhat improve flexibility and post-exercise soreness, but does not improve performance. For an active person, that makes trigger point work a recovery and comfort tool rather than a way to run faster or lift more.
Within those limits, trigger point therapy as part of sports massage may help with muscle spasms, cramp, generalised aches and pains, minor sports injuries, and muscle tension that makes it hard to relax. Results vary from person to person, and no single session should be expected to change a long-standing problem. Trigger points are also only one source of musculoskeletal pain, so for anyone managing chronic pain, trigger point work belongs inside a wider plan that includes strengthening exercises and a review of training load.
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Does trigger point therapy actually work?
Trigger point therapy has evidence for short-term effects, but the theory behind it is debated, and an honest answer includes both points. A 2015 paper in Rheumatology argued that most experiments do not support the existence of trigger points as distinct structures (Quintner, Bove and Cohen). A 2009 systematic review found that examiners do not reliably agree on where trigger points are (Lucas et al.). Against that, the IASP recognises myofascial pain syndrome as a cause of muscle pain, reporting that trigger points were the source of pain in 30% of people consulting a primary care clinician for pain, and controlled trials show measurable changes in pressure tolerance.
Our reading is practical: whatever the exact biology, tender bands in overworked muscles are real to the person feeling them, and held pressure is a low-risk way to ease that tenderness for a while. The value comes from combining it with movement, load management and recovery, not from the pressure alone.
What is trigger point therapy in chiropractic?
Trigger point therapy in chiropractic means a chiropractor applying the same manual pressure to muscle trigger points, usually alongside joint and spinal care rather than as a stand-alone treatment. Some chiropractors treating trigger points use it routinely, and others refer soft tissue work to a massage therapist. The 2022 ischaemic compression review cited above was published in Chiropractic & Manual Therapies, which shows the technique is studied within the profession.
At Sona, chiropractic care with Dr Ruth Abisset focuses on how the spine, joints and nervous system work together, for problems such as mechanical neck pain and back pain not caused by an accident or injury. Trigger point work happens mainly within sports massage with Maya. If your muscles and joints both need attention, the team can plan the two together.
Who should avoid trigger point therapy?
Trigger point therapy is unsuitable over areas of recent injury, broken or infected skin, and for anyone whose pain has not been checked by a health professional. Tell your therapist before a session if any of the following apply:
Pain that started after an accident, fall or impact, which needs a medical assessment first.
Numbness, pins and needles or muscle weakness, especially if it is getting worse.
A bleeding disorder or blood-thinning medication, which raises the risk of bruising.
Pregnancy, so the therapist can adapt positions and pressure.
Pain that is constant, worsening, or present at night, which should be seen by your GP.
How often should you have trigger point therapy?
No research sets an ideal frequency for trigger point therapy, so the number of sessions depends on your training load and how your muscles respond. At Sona, first-time clients usually book a 60-minute sports massage so the therapist can assess before treating, and returning clients often book 30 minutes to target one problem area. A sensible rule: if a muscle feels no different after two or three sessions, change the plan rather than repeating the same treatment.
Can you release trigger points yourself?
You can apply trigger point pressure yourself between sessions using a massage ball or your thumb, which keeps a tight muscle comfortable until your next appointment. Lean into the tender spot until you feel a firm ache, hold for around 30 to 60 seconds while breathing slowly, then gently stretch the muscle. Stop if the pain sharpens, spreads or causes numbness, and avoid pressing on the front and sides of the neck or over bony areas. Self-release suits minor muscle tightness; trigger point pain that keeps returning deserves a proper assessment.
Is trigger point therapy right for you? A five question check
Trigger point therapy is most likely to be worth booking if you can answer yes to the first three questions below and no to the last two:
Do you have one or two tender spots that tighten in the same place after training or work?
Does pressing on the spot reproduce a familiar ache, either locally or nearby?
Are you willing to pair sessions with stretching, strength work or changes to your training load?
Did the pain start after an accident, fall or impact?
Do you have numbness, weakness, or pain that keeps you awake at night?
If you answered yes to either of the last two questions, see your GP before booking any massage. If the first three fit, book a 60-minute sports massage with Maya at our Kirriemuir clinic and mention the spots you want her to assess. You can read about the wider team on our meet the team page.