Celeste Cooper / Author, Health Pro, Advocate


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A latent trigger is a dormant TrP that causes pain only when it is compressed or manipulated. Latent TrPs do all the same things as active TrPs and cause stiffness and weakness that persist for years after apparent recovery. They can go unnoticed only to be reactivated from a seemingly minor overstretching, overuse, or injury. In some people, a harmless event can cause dormant TrPs to light up like a firecracker instigating a cascade of events including referral of pain, and other symptoms. 

Active Trigger Point


A myofascial trigger point (MTrP) is a self-sustaining irritable area in a taut band of muscle fiber that is felt as a nodule or bump. This irritated spot causes gradual shortening of the muscle interfering with normal muscle function, and causing pressure on the surrounding nerves, lymph and blood vessels. Other related symptoms from untreated trigger points can result depending on the location of the trigger point (TrP). (Cooper and Miller, 2010).

A new application of ultrasound imaging and vibration soloelastography includes 2 dimensional greyscale and vibration sonoelastography imaging of a myofascial trigger point [in the upper trapezius] and specifically identifies MTrPs from surrounding tissue, more objective criteria. This new science will be a helpful tool to the clinician for evaluating palpable myofascial TrPs. 

Active TrPs hurt without being touched, radiate pain, restrict motion, and can cause other symptoms depending on the surrounding nerves, lymph system, and blood vessels. It can elicit a visible local twitch response when adequately stimulated by compression or needle insertion. It can also produce referred motor and an autonomic phenomenon. 

A satellite trigger point is a TrP located in the referral zone of the primary trigger point. 

Satellite TrP

Primary TrP

Common Abbreviations
MTrP = myofascial trigger point
MTP = myofascial trigger point
TrPs = trigger points

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A secondary TrP is one that develops in a second compensating muscle. This second (or third, or fourth…) muscle is attempting to compensate for the malfunction of the muscle affected by the primary trigger point(s). Yes, you can have more than one MTrP in a muscle. The location of each one in the same muscle is responsible for its own pattern of symptom referral.

Secondary TrP

The classification of trigger points (TrPs) include primary, secondary and/or satellite and they can all be active or latent. It’s important to know what a trigger point feels like, so get familiar with your body. Feel around to see if you find any lumps or bumps that reproduce your pain. Keep in mind, some muscles may have many TrPs in which case, the muscle will be extremely tight. Muscles around the face are very tiny. In this case, they may feel like a tight string, while larger muscles feel like a tight rope. If this is the case, massage the muscle until it relaxes so you can isolate the TrP.  

Classifications of Trigger points


What is a Myofascial Trigger Point?

CelesteCooper.com

Myofascial pain syndrome (MPS) is a disorder that develops in muscles that are overstretched, overused, or injured... prompt treatment for returning the muscle to its normal resting state...                        Read on >>

Latent Trigger Point

A primary TrP is the one that starts the painful event. Treating other TrPs without treating the primary trigger point will not solve your problem. It takes someone specifically trained in Travell and Simons work or following a self-treatment guide written according to Travell and Simons teachings. When not done properly, TrPs will reoccur leaving you and the therapist, or doctor, frustrated and you in pain.

Treating all the types is necessary for optimal recovery. Don't be lured into thinking you can only treat active trigger points (the ones screaming out). Even though a primary TrP is dormant, latent, it is still a villain. 

Celeste Cooper RN Author - Educator and Pain Advocate