Good Pain and “Trigger Points”

A few points, before you read on:

  1. In the manual therapy world, “muscle knots”, “trigger points”, and “MTP’s” (myofascial trigger points) are synonymous terms.
  2. There is such thing as “bad/ugly” pain, and this should be avoided.  It is not uncommon for therapists to inflict this sort of pain on clients.  There are veteran therapists out there that are guilty of this…this is simply the reality of the situation.

Ingraham, PainScience:

“Good pain. In massage, there is such a thing as “good pain.” It arises from a sensory contradiction between the sensitivity to pressure and the instinctive sense that it’s also a source of relief (probably mostly due to the phenomenon of trigger points: more about this below). So pressure can be an intense sensation that just feels right somehow. It’s strong, but it’s welcome. Good pains are usually dull and aching. It is often described as a “sweet” ache. The best good pain may be such a relief that really the only bad thing about it is just that it is breathtakingly intense.”


“Trigger points are fairly well-defined physiologically. We know what they are, and we know where they live. They are essentially a miniature spasm, a small patch of a muscle tissue that is super-clenched. They are common, and responsible for most of the garden variety aches and pains of humanity*, ranging from mild to crippling. And we know that they can, sometimes, be relieved simply by “ironing them out” with skillful thumbs.

When you press on a trigger point, it’s going to feel painful because it’s a swampy little patch of muscle in metabolic overdrive, its sensory nerve endings bathed in junk molecules. But it’s also going to feel like a relief to have any of that problem taken away! As discussed above, relief from trigger points may occur simply through crushing and destroying the cellular machinery of it. But there are numerous other possible mechanisms, such as a tiny, localized stretching of the spasm — a miniature version of what you do when you stretch out a big leg muscle to ease a charlie horse. Another likely mechanism is that the pressure squishes stagnant tissue fluids out of the spot, allowing them to be replaced by fresh circulation.”

*When Ingraham says “garden variety aches and pains of humanity”, he simply means ordinary muscle knots