Skip to main content
Skip to main content
Physio Energy

Treatment & self-care

What to train after a trigger point settles

Reduced pain is the start of the plan, not the end. Capacity in the treated muscle is what keeps the point from returning.

Published:

Week one: range and control

Start with pain-free full range twice daily and low-load isometrics for the treated muscle — around 30 to 45 seconds at a comfortable effort, three to five repetitions. The aim is confident use of the range you have just gained.

Keep the aggravating activity reduced but not stopped; complete rest tends to lower tolerance further.

Weeks two to four: load and endurance

Move to slow resistance work through full range, two to three sessions a week, eight to fifteen repetitions, stopping two or three repetitions short of failure. Endurance matters more than peak strength for muscles that hold postures.

Use the pattern the muscle actually has to do: scapular work for shoulder cases, hip abduction and single-leg stance for lateral hip cases, calf raises through full range for foot and ankle cases.

Judging progress honestly

Track one function, not just pain: minutes at the desk before symptoms, kilometres before the calf tightens, reps before the shoulder aches. Soreness during and shortly after loading that settles within 24 hours is acceptable; symptoms that build day on day are not.

If the point reactivates as soon as load rises, go back to the perpetuating-factors list before adding technique.

Studies cited

Every claim in this article traces back to one of the sources below.

  1. Bron 2011Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial. BMC Med 2011;9:8
  2. Cerezo-Téllez 2016Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain 2016;157(9):1905-17
  3. Gattie 2017The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2017;47(3):133-49
  4. Simons & TravellMyofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.). Williams & Wilkins, Baltimore

Related articles

Share: