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Yoga, “that good stretch feeling,” and trigger points

Stretching can be a useful daily ritual of relief. It changes a stiff body into something that has less pain and stiffness. I give it to my clients to manage their daily pain, and it helps. It can really ease your activities of daily living.

That Feeling

Client’s love “that good stretch feeling.” It really should be called, “that elicited referral pattern.” Well, if you were a trigger point geek, you’d call it that. When I ask my yoga friends about the sensation that they get from a stretch, they almost always describe the trigger point referral of the muscle that they are stretching.

Trigger points limit stretch, weaken contraction and generate a referral pattern. Latent and active trigger points don’t create those issues if we move gently and slowly. Instead of sudden pain and weakness, we gently stretch through the stiffness and get “that good stretch feeling.”

Hamstrings

reclined-hamstring-stretch

There are stretching sensations that make sense. Let’s look at a reclined hamstring stretch. You feel tension down the outside of your thigh and behind your knee when you’re stretching your hamstring. You feel it in your outside hamstring. This muscle’s referral pattern largely overlaps the muscle itself. If you’re getting sensation at the top of your thigh or on the inside of the knee, it’s the inside hamstring.

Something More Complicated

Odette Hughes

Then there’s the pigeon pose. There’s a multitude of sensations you can get, depending on which trigger points are latent or active. Let’s look at which trigger points might produce stiffness, pain, or “that good stretch feeling.”

Mid-Back Pain

You’ve stretched open your abdomen. But you don’t feel much of a sensation there. What you might feel is the referral from rectus abdominous. It creates a band of tension across the back. Trigger points in the upper rectus abdominous generate a band of tension across the lower ribs in the mid-back. Trigger points near the pubic bone generate a band of pain across the low back. Many people get this band of tension in the morning when they stretch open their abdomen after being curled up during sleep.

Hip Pain

There’s a good stretch in the hip on the front leg. You can feel that in the hip. It feels like it is pulling at the sacrum or the top of the femur. There may even be sensation down the hamstring of the leg in front, which is shortened in this pose. This pose stretches and elicits the referral of piriformis. It goes into the hip and down the hamstring. That tingly sensation in the bottom of the foot comes from piriformis too.

Knee Pain

Often, there is a pain in the front of the knee. The location tells a lot about the muscle. The most common spot is in the center of the kneecap with tension that extends up into the quad. This is the pattern of rectus femoris.  It is a trigger point just below the insertion on the lip of the acetabulum. Pain in the knee is always concerning, so stretch the quads and hip flexors before pigeon to reduce this discomfort.

Thigh and Lumbar Pain

Maybe there’s a painful stretch along the front of the leg that is behind you. That quad is not stretched as the knee is straight in this pose. That sensation comes from the lower trigger point of the iliopsoas, in the back of the pelvis. People try to get relief by turning the knee out to take some tension off of psoas. Is there tightness on one side of your low back? That’s not stretched here either. That’s comes from the upper trigger point of iliopsoas.

Lumbar Compression

Is there sharp pain across the top of your sacrum? That’s not a trigger point referral. You’re putting too much compression on L5/S1 because of your tight psoas.

Lighten up on that stretch. Get some bodywork for your psoas

Where the Pain is, It isn’t

Paying closer attention to the areas of sensation can help you understand which section of muscle is having trouble stretching. That information can lead you to better sequencing and more effective stretch routines. Stretching lengthens the taut band that contains the trigger point so that it doesn’t bother you when you move. If you don’t stretch, it reveals itself in the stiffness at the beginning of movements.

When properly used,  approaches like yoga and Active Isolated Stretching mobilize joints so that there is longer lasting relief.  Bodywork, especially therapies that mobilize the joints around the cranium, spine, and pelvis, change proprioceptive input that makes the entire system rebalance and become more self-correcting.

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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written materials and instructed classes since the mid-90s. This includes anatomy, trigger points, cranial, and neuromuscular.

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