Abstract
To date, most investigation of latent myofascial trigger points (LTrPs) has occurred in pain populations. Many have thought that LTrPs are clinically relevant as potential precursors to developing active myofascial trigger points and spontaneous pain. Nociceptive substances have been found in greater concentrations at LTrP sites compared with non-TrP sites, indicating the potential for group III and IV afferent fibers to provide input to the central nervous system from affected peripheral sites. Fatigue and neurophysiologic studies provide evidence as to the pathways via which group III and IV afferents can alter activity of the motoneuron pool and therefore affect muscle activation and performance. This article offers suggestions as to the mechanisms via which LTrP-related pathophysiology may explain the clinical examination findings associated with LTrP-containing and functionally related muscles.
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References and Recommended Reading
Couppe C, Torelli P, Fuglsang-Frederiksen A, et al.: Myofascial trigger points are very prevalent in patients with chronic tension-type headache: a double-blinded controlled study. Clin J Pain 2007, 23:23–27.
Kao MJ, Han TI, Kuan TS, et al.: Myofascial trigger points in early life. Arch Phys Med Rehabil 2007, 88:251–254.
Fernandez-de-las-Penas C, Alonso-Blanco C, Cuadrado ML, et al.: Trigger points in the suboccipital muscles and forward head posture in tension-type headache. Headache 2006, 46:454–460.
Fernandez-de-Las-Penas C, Alonso-Blanco C, Miangolarra JC: Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study. Man Ther 2006, Jun 10 (Epub ahead of print).
Fernandez-de-Las-Penas C, Alonso-Blanco C, Cuadrado M, et al.: Myofascial trigger points and their relationship to headache clinical parameters in chronic tension-type headache. Headache 2006, 46:1264–1272.
Farasyn A, Meeusen R: The influence of non-specific low back pain on pressure pain thresholds and disability. Eur J Pain 2005, 9:375–381.
Hong CZ, Simons DG: Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points. Arch Phys Med Rehabil 1998, 79:863–872.
Lucas K, Polus B, Rich P: Latent myofascial trigger points: their effects on muscle activation and movement efficiency. JBMT 2004, 8:160–166.
Ge HY, Zhang Y, Boudreau S, et al.: Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points. Exp Brain Res 2008, 187:623–629.
Sterling M, Jull G, Wright A: The effect of musculoskeletal pain on motor activity and control. J Pain 2001, 2:135–145.
Shah JP, Phillips TM, Danoff JV, et al.: An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol 2005, 99:1977–1984.
Shah JP, Danoff JV, Desai MJ, et al.: Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil 2008, 89:16–23.
Mense S, Simons DG, Hoheisel U, et al.: Lesions of rat skeletal muscle after local block of acetylcholinesterase and neuromuscular stimulation. J Appl Physiol 2003, 94:2494–2501.
Gerwin R, Dommerholt J, Shah JP: An expansion of Simons’ integrated hypothesis of trigger point formation. Curr Pain Headache Rep 2004, 8:468–475.
Fernandez HL, Chen M, Nadelhaft I, et al.: Calcitonin gene-related peptides: their binding sites and receptor accessory proteins in adult mammalian skeletal muscles. Neuroscience 2003, 199:335–345.
Hodges-Savola CA, Fernandez HL: A role for calcitonin gene-related peptide in the regulation of rat skeletal muscle G4 acetylcholinesterase. Neurosci Lett 1995, 90:117–120.
Simons D, Travell J, Simons L: Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams and Wilkins; 1999.
Mense S: Group III and IV receptors in skeletal muscle: are they specific or polymodal? Prog Brain Res 1986, 113:83–100.
Stokes M, Young A: The contribution of reflex inhibition to arthrogenous muscle weakness. Clin Sci (Lond) 1984, 67:7–14.
Shakespeare D, Stokes M, Sherman K, et al.: Reflex inhibition of the quadriceps after meniscectomy: lack of association with pain. Clin Physiol 1985, 5:137–144.
Kibler WB: The role of the scapula in athletic shoulder function. Am J Sports Med 1998, 26:325–337.
Bagg SD, Forrest WJ: A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J Phys Med Rehabil 1988, 67:238–245.
Wadsworth DJ, Bullock-Saxton JE: Recruitment patterns of the scapular rotator muscles in freestyle swimmers with subacromial impingement. Int J Sports Med 1997, 18:618–624.
Ludewig PM, Cook TM: Translations of the humerus in persons with shoulder impingement symptoms. J Orthop Sports Phys Ther 2002, 32:248–259.
Lucas KR, Rich PA, Polus BI: How common are latent myofascial trigger points in the scapular positioning muscles? J Musculoskel Pain 2008, In press.
Payne LZ, Deng XH, Craig EV, et al.: The combined dynamic and static contributions to subacromial impingement. A biomechanical analysis. Am J Sports Med 1997, 26:801–808.
Reddy AS, Mohr KJ, Pink MM, et al.: Electromyographic analysis of the deltoid and rotator cuff muscles in persons with subacromial impingement. J Shoulder Elbow Surg 2000, 9:519–523.
Sharkey NA, Marder RA: The rotator cuff opposes superior translation of the humeral head. Am J Sports Med 1995, 23:270–275.
Bandholm T, Rasmussen L, Aagaard P, et al.: Effects of experimental muscle pain on shoulder-abduction force steadiness and muscle activity in healthy subjects. Eur J Appl Physiol 2008, 102:643–650.
Farina D, Arendt-Nielsen L, Merletti R, et al.: Effect of experimental muscle pain on motor unit firing rate and conduction velocity. J Neurophysiol 2004, 91:1250–1259.
Ciubotariu A, Arendt-Nielsen L, Graven-Nielsen T: The influence of muscle pain and fatigue on the activity of synergistic muscles of the leg. Eur J Appl Physiol 2004, 91:604–614.
Graven-Nielsen T, Svensson P, Arendt-Nielsen L: Effects of experimental muscle pain on muscle activity and co-ordination during static and dynamic motor function. Electroencephalogr Clin Neurophysiol 1997, 105:156–164.
Ervilha UF, Farina D, Arendt-Nielsen L, et al.: Experimental muscle pain changes motor control strategies in dynamic contractions. Exp Brain Res 2005, 164:215–224.
Taylor JL, Todd G, Gandevia SC: Evidence for a supraspinal contribution to human muscle fatigue. Clin Exp Pharmacol Physiol 2006, 33:400–405.
Gandevia SC: Spinal and supraspinal factors in human muscle fatigue. Physiol Rev 2001, 81:1725–1789.
Taylor JL, Butler JE, Allen GM, et al.: Changes in motor cortical excitability during human muscle fatigue. J Physiol 1996, 490:519–528.
Windhorst U: On the role of recurrent inhibitory feedback in motor control. Prog Neurobiol 1996, 6949:517–587.
Rothwell J: Control of Human Voluntary Movement. London: Chapman and Hall; 1994.
Djupsjobacka M, Johansson H, Bergenheim M: Influences on the gamma-muscle-spindle system from muscle afferents stimulated by increased intramuscular concentrations of arachidonic acid. Brain Res 1994, 663:293–302.
Djupsjobacka M, Johansson H, Bergenheim M, et al.: Influences on the gamma-muscle spindle system from muscle afferents stimulated by increased intramuscular concentrations of bradykinin and 5-HT. Neurosci Res 1995, 22:325–333.
Sjolander P, Johansson H: Influences on the gamma muscle spindle system from mechanoreceptors. In Alpha and Gamma Motor Systems. Edited by Taylor A, Gladden M, Durbaba R. New York: Plenum Press; 1995: 137–144.
Hagbarth KE, Kunesch EJ, Nordin M, et al.: Gamma loop contributing to maximal voluntary contractions in man. J Physiol 1986, 380:585–591.
Rossi A, Decchi B, Ginanneschi F: Presynaptic excitability changes of group Ia fibres to muscle nociceptive stimulation in humans. Brain Res 1999, 818:12–22.
Thunberg J, Ljubisavljevic M, Djupsjobacka M, et al.: Effects on the fusimotor-muscle spindle system induced by intramuscular injections of hypertonic saline. Exp Brain Res 2002, 142:319–326.
Windhorst U, Kirmayer D, Soibelman F, et al.: Effects of neurochemically excited group III-IV muscle afferents on motoneuron afterhyperpolarization. Neuroscience 1997, 76:915–929.
Fitts RH: The cross-bridge cycle and skeletal muscle fatigue. J Appl Physiol 2007, 104:551–558.
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Lucas, K.R. The impact of latent trigger points on regional muscle function. Current Science Inc 12, 344–349 (2008). https://doi.org/10.1007/s11916-008-0058-6
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DOI: https://doi.org/10.1007/s11916-008-0058-6