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A couple weeks ago, I wrote about the differences between acupuncture and “dry needling” to alleviate pain, and in that article I explained a bit about the phenomenon of myofascial trigger points. After I said I believe these are the cause of most of the physical pain humans experience, a number of readers asked me to explain more. For the science lovers out there, I’m going to dive deeper this week.
Besides the most common forms of pain, like lower back and headaches, I’ve had patients with digestive problems, sinus congestion, chest pain, ear ringing, numb hands, painful intercourse, acid reflux, vision changes, and other health issues that were eventually discovered to be due to myofascial trigger points. I believe everyone should know about them and how they work – it could save us a lot of time and worry.
Basically, a trigger point is a small, irritable region in a muscle (or the surrounding connective tissue – “fascia”) that stays stuck in a contracted state, making the muscle fibers taut. This can cause reduced muscle strength and range of motion, pain, numbness, itching, and other forms of dysfunction. Sometimes a trigger point feels like a palpable nodule or “knot,” but to untrained fingers they’re often tricky to find.
A unique property of trigger points is that they’re able to produce symptoms in other parts of the body – from a few inches to a couple feet away. For instance, there’s a trigger point that can form in the soleus muscle of the calf that’s capable of producing pain in the lower back. For this reason, the work of Janet Travell, MD and her colleague David Simons, MD, was groundbreaking. For each muscle in the body, they mapped where trigger points tend to form and what kinds of symptoms they cause.
If you were experiencing pain along the outside of your leg, you might assume that something was wrong with that part of your leg, perhaps with the often-tight iliotibial band (IT band). But this diagram might be helpful. The X’s show where trigger points can occur in a muscle called gluteus minimus above the hip socket. The red shading shows the potential areas of pain that can result. You might not suspect this muscle because, as you can see, there’s no pain at the site of the problem!
There are a handful of mechanisms that can promote trigger point formation, such as irritation of nerves, chronic organ problems, nutritional deficiencies, and autoimmune disorders. Most often, though, the cause is trauma to our connective tissue. When a muscle is strained by being worked too hard, too fast, or beyond its natural range, there is frequently a sort of “recoil” that occurs as segments of the muscle fibers bunch up and remain that way.
This is especially common when someone works out without warming up; when someone does a very ambitious workout after not having exercised for a long time; when someone makes a sudden movement (like reaching out to catch something or trying to stop oneself from falling); and especially when someone does any of the above when in a state of diminished resilience (e.g, when stressed, upset, sleep deprived, eating poorly, etc.).
Even more commonly, the trauma is a form of “postural stress” that’s demanding on muscles in a way that’s difficult to perceive at the time – such as doing the same relatively motionless activity (like sitting at a desk or driving) for hours, days, months, or years. One possible mechanism is known as the “Cinderella hypothesis.” During static muscle exertion – holding a position for a long time, as dentists, musicians, typists, and others engaged in precision handwork do – the body tends to engage a certain group of small muscle fibers, called Cinderella fibers because they’re put to work first and are the last to be disengaged. Even though they’re not doing heavy lifting, these muscle fibers (often in the neck, shoulders, back, and forearms) are continually activated and overworked, which makes them susceptible to trigger point formation.
Whatever the cause, the result is that eventually the muscle never completely relaxes. Muscles are composed of numerous parallel fibers that work together to shorten (contraction of the muscle) and lengthen (the return of the muscle to its relaxed state). Within each of these fibers are many end-to-end contractile units called sarcomeres, and in the case of a trigger point, a group of sarcomeres gets “stuck” in a shortened state. This makes the affected fibers taut and often “stringy” feeling.
To make matters worse, the contracted region clamps down on tiny blood vessels causing local ischemia (inadequate blood supply), reducing in-flow of fresh, oxygenated blood and out-flow of toxins. This leads to a localized hypoxic state (not enough oxygen). The tissue pH changes, local metabolism is impaired, and fluid and waste products tend to build up in the area. This combination of factors ultimately activates pain receptors – it starts to hurt – and when this happens you use the affected muscle less.
Instead, you overload “synergists” – nearby helper muscles. The body makes the surrounding musculature tense as a protective mechanism. Meanwhile, there’s a disruption of the balance between the affected muscles and their “antagonists” – those muscles that lengthen when the primary muscles shorten and vice-versa (for example, the triceps is an antagonist of the biceps). Altogether, this restricts natural movement of the original muscle, which just perpetuates the imbalance. Finally, with longstanding trigger points, the body may deposit gooey lubricant compounds called glycosaminoglycans (GAGs) between these triggered muscle fibers, resulting in a gummy lump called a “myogelosis.”
The good news is that there are now books, charts, online tools, and practitioners that can help track down likely trigger points that may be implicated in your discomfort. I have such a tool in my online pain relief course, Live Pain Free, and I teach many approaches for deactivating trigger points.
The most basic methods involve simple mechanical disruption of this holding pattern. First, drink some water if you’re not well hydrated. Second, you or a friend can methodically feel around (ideally guided by a trigger point chart) for points that are sore, and ideally that reproduce the very sensation you’ve been experiencing. Third, maintain firm pressure on the epicenter of the point (with a finger, elbow, ball, or other tool) for about half a minute, consciously breathing into the area and intending to let it go, until there’s a palpable release. Then move on to all the other nearby points that are tight and tender and do the same.
This approach is called ischemic compression. By compressing the tissue enough to block blood flow, the body responds with reflex vasodilation, meaning it opens these vessels and flushes the tissue with a dramatic increase of blood. This will usually produce a significant improvement in the pain or dysfunction, though it will typically return sooner or later. These points tend to go from being active trigger points to “latent” trigger points, which have a certain “memory” (not the good kind of muscle memory) and are capable of getting reactivated. For this reason, persistence is important. The best results come from working on a trigger point consistently – usually from one to several short sessions per day (or less frequent if the sessions are intense) – and continuing for a while even after everything seems better.
As I said, this is a most basic approach, and while it’s often effective, sometimes a more nuanced intervention is required. There are many techniques that build on compression. We can replace fixed pressure with slow, deep strokes in the direction of the muscle fiber, as if re-lengthening this segment. We can work the trigger point back and forth across the direction of the muscle fibers. We can combine pressure on the trigger point with engagement of the affected muscle or antagonistic muscles. We can combine manual work on trigger points with topical herbs and/or internal herbs and nutrients that improve circulation and reduce inflammation. We can utilize release points on the same acupuncture meridian as where the trigger point occurs - or complementary points on other parts of the body. And more.
If all of this sounds interesting and relevant to you, I encourage you to do a little research. It might well be the end of a problem you thought had no solution. And if you need more guidance, check out my online course, Live Pain Free, where I go deeper into trigger points and much, much more to help people get out of pain of all kinds.
While I said I believe trigger points are the cause of most of our physical pain, I think it’s worth mentioning there are usually even deeper causes, such as stress and withheld emotions, poor body mechanics, dehydration, and an inflammatory diet. Holistically addressing these issues will lead to a more complete resolution of the condition. Always look at the big picture.
Be well,
Dr. Peter Borten
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No matter where you are on your journey, the Dragontree candle collection offers an inspiring tool to help light the way. Our new candles are thoughtfully designed and hand-crafted with intention and quality ingredients.
We. Love. Candles. As owners of spas and teachers of ritual, we go through a LOT of candles. Think of a big number and multiply it by a zillion – that’s how many candles we burn. A day.
There are plenty of things we love about candles, but the central reason we use them is to bring the Fire Element into our space.
From the beginning of recorded time, fire has been a powerful symbol and a central part of our lives. Our relationship to it is embedded deep in our collective consciousness.
Fire’s light and warmth has long been a source of comfort and safety, and has been used to initiate rituals, to carry prayers, to promote transformation, to celebrate our connection with each other, and to remember and honor the light of awareness that unites us and transcends the mundane.
For millennia we tended fires and gazed into flames on a daily basis, which facilitated a gentle meditative state in which we readily let go of our troubles and became realigned. Deprived of that routine, we find ourselves habitually staring at glowing screens instead . . . an inferior replacement that tends to have the opposite effect on us.
The moment we light a candle, it shifts our consciousness. It takes us out of the whirlwind and brings us back into the present moment.
Every detail of our Dragontree candles was painstakingly considered to ensure they’d be inspiring, supportive, and simply the best candles we’ve ever used.
Why they’re so great:
- Made with 100% beeswax
- Higher melting point so they emit the cleanest, brightest flame
- Cleanest burning wax produces no soot or toxic chemicals
- Releases negative ions into the air, helps purify and elevate sacred spaces
- The dense composition of beeswax burns slower and lasts longer than other candles
- Individually hand poured by craftspeople in Cape Cod.
- Presented in a luxurious box with gold foil lettering – perfect for gifting
- Made with natural essential oils for an aromatherapeutic – but never overpowering or perfumy – experience
- Poured in beautiful glass vessels imprinted with an affirmation
- Vessels can be reused as an elegant pen holder, vase, or a hundred other uses
- Ethically and sustainably created
- No dyes, additives, or parabens
- 3"D x 3.5"H
- 8 oz.
- Up to 50 hours burn time
- Made in the USA
Why not paraffin, soy, or palm wax?
Paraffin is a byproduct of the petroleum industry, and burning paraffin candles releases toxic compounds into your living space, including known carcinogens. Soy wax comes from soybeans, 96% of which are genetically modified to tolerate application of the pesticide Roundup. We don’t want to contribute to the soy industry and its ecological impacts. Palm wax comes from palm plantations which require massive-scale deforestation, endangering orangutans and other species, and contributing to climate change. Beeswax, in contrast, requires raising millions of healthy bees, which pollinate our crops and are a vital link in the ecosystem.
You Are Sacred
This elegant and soulful candle comes in a glossy black tumbler that is imprinted with a simple but powerful reminder: You Are Sacred. We know how easy it is for this crazy human ride to make you forget, to make you feel small and powerless. But that’s not who you really are. Remember? You Are Sacred. You are an expression of your Highest Self. You are a conscious creator. You can choose in every moment how to embody this sacredness. Light it daily before meditation, journaling, setting an intention, starting your day, or anytime you need some sacred space to get through a negative experience.
The spicy, earthy notes of Cardamon, Vetiver, and Cedarwood mix with the bright, clear scent of Cypress and Pine, and the addition of Amyris highlights the soft woodsy aroma with the slightest hint of sweetness. This custom scent was blended to foster a calm sense of wellbeing and connect you to the sacred spaces found in nature .
Our You Are Sacred candle makes a thoughtful gift for loved ones to show them you recognize their scaredness and want to be a part of their challenges, healing, and growth.
Be The Light
This bright and joyful candle is hand poured into a reflective white glass vessel and speaks to a powerful choice that is always available: “Be The Light” in noble gold lettering. This simple, yet life-changing statement reminds you there is a light within and your job is to let it shine into the world. Just as one candle can be used to light another, your light – pouring through your heart, your smile, your hands, giving purpose to your every task – sparks the light in others.
Be The Light means not just shining outward, but also inward. In order to be effective beacons in the world, we must not withhold light from any part of ourselves. Being the light means accepting and integrating all that we are. In a world with plenty of darkness, there is no service greater than being an embodiment of light, uplifting those around you and affirming that lightness is their true nature.
The fresh, cleansing fragrance of Sage and Pine blends artfully with soothing notes of Lavender and Vanilla and creates a sensory experience that supports emotional balance, blocks negative energies, and purifies your sacred space.
Brighten someone’s day by gifting them this lovely affirmation. It serves as a daily prompt and lets them know that you recognize their light and are warmed and inspired by knowing them.
Click here to check out our new candles!
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What makes a town or city appealing to you? The architecture? The landscape? The climate? The people? The cuisine? I love traveling and I’ve given a lot of thought to why some places feel so attractive to me and others don’t. My favorite towns have all these ingredients plus another: they’re full of small businesses.
Strolling the winding streets of Madrid, Pearl Street in Boulder, Hawthorne in Portland, Le Plateau in Montreal, and the downtowns of virtually all cool cities and towns, you’ll pass locally owned flower shops, unique restaurants, art galleries, and, of course, spas like The Dragontree. 😉
You could blindfold me and teleport me to downtown Missoula, Northampton, San Francisco, Marblehead, or Port Townsend. I’d know immediately where I was (and I’d ask to stay for a while). Drop me in a sea of Target, Walmart, Starbucks, Best Buy and giant parking lots, and I could be anywhere (but nowhere I’d want to live). Any sense of home or connection is greatly diminished when a region’s commerce is dominated by giant chains.
Small businesses make towns special. They give a community character and make the patron feel connected to the proprietor. They’re also important avenues for other small businesses – like artists, hair stylists, bakers – to do their craft and get compensated well for it.
So if you want to help preserve the specialness of a place, if you want your downtown to stay cool and vibrant, patronize its small businesses! Let’s all make a deal to do all our holiday shopping at small businesses this year! It’s a gift not just to the recipient but also to the small business owner and employees and the community it resides in.
Be well,
Peter
[post_title] => Think Small This Holiday Season
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A couple weeks ago, I wrote about the differences between acupuncture and “dry needling” to alleviate pain, and in that article I explained a bit about the phenomenon of myofascial trigger points. After I said I believe these are the cause of most of the physical pain humans experience, a number of readers asked me to explain more. For the science lovers out there, I’m going to dive deeper this week.
Besides the most common forms of pain, like lower back and headaches, I’ve had patients with digestive problems, sinus congestion, chest pain, ear ringing, numb hands, painful intercourse, acid reflux, vision changes, and other health issues that were eventually discovered to be due to myofascial trigger points. I believe everyone should know about them and how they work – it could save us a lot of time and worry.
Basically, a trigger point is a small, irritable region in a muscle (or the surrounding connective tissue – “fascia”) that stays stuck in a contracted state, making the muscle fibers taut. This can cause reduced muscle strength and range of motion, pain, numbness, itching, and other forms of dysfunction. Sometimes a trigger point feels like a palpable nodule or “knot,” but to untrained fingers they’re often tricky to find.
A unique property of trigger points is that they’re able to produce symptoms in other parts of the body – from a few inches to a couple feet away. For instance, there’s a trigger point that can form in the soleus muscle of the calf that’s capable of producing pain in the lower back. For this reason, the work of Janet Travell, MD and her colleague David Simons, MD, was groundbreaking. For each muscle in the body, they mapped where trigger points tend to form and what kinds of symptoms they cause.
If you were experiencing pain along the outside of your leg, you might assume that something was wrong with that part of your leg, perhaps with the often-tight iliotibial band (IT band). But this diagram might be helpful. The X’s show where trigger points can occur in a muscle called gluteus minimus above the hip socket. The red shading shows the potential areas of pain that can result. You might not suspect this muscle because, as you can see, there’s no pain at the site of the problem!
There are a handful of mechanisms that can promote trigger point formation, such as irritation of nerves, chronic organ problems, nutritional deficiencies, and autoimmune disorders. Most often, though, the cause is trauma to our connective tissue. When a muscle is strained by being worked too hard, too fast, or beyond its natural range, there is frequently a sort of “recoil” that occurs as segments of the muscle fibers bunch up and remain that way.
This is especially common when someone works out without warming up; when someone does a very ambitious workout after not having exercised for a long time; when someone makes a sudden movement (like reaching out to catch something or trying to stop oneself from falling); and especially when someone does any of the above when in a state of diminished resilience (e.g, when stressed, upset, sleep deprived, eating poorly, etc.).
Even more commonly, the trauma is a form of “postural stress” that’s demanding on muscles in a way that’s difficult to perceive at the time – such as doing the same relatively motionless activity (like sitting at a desk or driving) for hours, days, months, or years. One possible mechanism is known as the “Cinderella hypothesis.” During static muscle exertion – holding a position for a long time, as dentists, musicians, typists, and others engaged in precision handwork do – the body tends to engage a certain group of small muscle fibers, called Cinderella fibers because they’re put to work first and are the last to be disengaged. Even though they’re not doing heavy lifting, these muscle fibers (often in the neck, shoulders, back, and forearms) are continually activated and overworked, which makes them susceptible to trigger point formation.
Whatever the cause, the result is that eventually the muscle never completely relaxes. Muscles are composed of numerous parallel fibers that work together to shorten (contraction of the muscle) and lengthen (the return of the muscle to its relaxed state). Within each of these fibers are many end-to-end contractile units called sarcomeres, and in the case of a trigger point, a group of sarcomeres gets “stuck” in a shortened state. This makes the affected fibers taut and often “stringy” feeling.
To make matters worse, the contracted region clamps down on tiny blood vessels causing local ischemia (inadequate blood supply), reducing in-flow of fresh, oxygenated blood and out-flow of toxins. This leads to a localized hypoxic state (not enough oxygen). The tissue pH changes, local metabolism is impaired, and fluid and waste products tend to build up in the area. This combination of factors ultimately activates pain receptors – it starts to hurt – and when this happens you use the affected muscle less.
Instead, you overload “synergists” – nearby helper muscles. The body makes the surrounding musculature tense as a protective mechanism. Meanwhile, there’s a disruption of the balance between the affected muscles and their “antagonists” – those muscles that lengthen when the primary muscles shorten and vice-versa (for example, the triceps is an antagonist of the biceps). Altogether, this restricts natural movement of the original muscle, which just perpetuates the imbalance. Finally, with longstanding trigger points, the body may deposit gooey lubricant compounds called glycosaminoglycans (GAGs) between these triggered muscle fibers, resulting in a gummy lump called a “myogelosis.”
The good news is that there are now books, charts, online tools, and practitioners that can help track down likely trigger points that may be implicated in your discomfort. I have such a tool in my online pain relief course, Live Pain Free, and I teach many approaches for deactivating trigger points.
The most basic methods involve simple mechanical disruption of this holding pattern. First, drink some water if you’re not well hydrated. Second, you or a friend can methodically feel around (ideally guided by a trigger point chart) for points that are sore, and ideally that reproduce the very sensation you’ve been experiencing. Third, maintain firm pressure on the epicenter of the point (with a finger, elbow, ball, or other tool) for about half a minute, consciously breathing into the area and intending to let it go, until there’s a palpable release. Then move on to all the other nearby points that are tight and tender and do the same.
This approach is called ischemic compression. By compressing the tissue enough to block blood flow, the body responds with reflex vasodilation, meaning it opens these vessels and flushes the tissue with a dramatic increase of blood. This will usually produce a significant improvement in the pain or dysfunction, though it will typically return sooner or later. These points tend to go from being active trigger points to “latent” trigger points, which have a certain “memory” (not the good kind of muscle memory) and are capable of getting reactivated. For this reason, persistence is important. The best results come from working on a trigger point consistently – usually from one to several short sessions per day (or less frequent if the sessions are intense) – and continuing for a while even after everything seems better.
As I said, this is a most basic approach, and while it’s often effective, sometimes a more nuanced intervention is required. There are many techniques that build on compression. We can replace fixed pressure with slow, deep strokes in the direction of the muscle fiber, as if re-lengthening this segment. We can work the trigger point back and forth across the direction of the muscle fibers. We can combine pressure on the trigger point with engagement of the affected muscle or antagonistic muscles. We can combine manual work on trigger points with topical herbs and/or internal herbs and nutrients that improve circulation and reduce inflammation. We can utilize release points on the same acupuncture meridian as where the trigger point occurs - or complementary points on other parts of the body. And more.
If all of this sounds interesting and relevant to you, I encourage you to do a little research. It might well be the end of a problem you thought had no solution. And if you need more guidance, check out my online course, Live Pain Free, where I go deeper into trigger points and much, much more to help people get out of pain of all kinds.
While I said I believe trigger points are the cause of most of our physical pain, I think it’s worth mentioning there are usually even deeper causes, such as stress and withheld emotions, poor body mechanics, dehydration, and an inflammatory diet. Holistically addressing these issues will lead to a more complete resolution of the condition. Always look at the big picture.
Be well,
Dr. Peter Borten
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