When the myofascia is stressed from overuse or trauma it can tear and glue itself together to make small patches of tightly contracted muscle. When trigger points are present, on the microscopic level, part of the muscle fibre is contracted into a small thickened area, and the rest of the fibre is stretched thin. Several of these muscle fibre contractions in the same area, being ‘gummed up’ are probably what we feel as a “knot” in the muscle.

None of this is conducive to smooth muscle function. These patches build up and become “trigger points” which can prevent the muscles from working well and will need some care and attention to get smoothed out.

When pressed, trigger points feel like “knots” or tight bands in the muscle, and are usually very tender. Healthy muscles usually do not contain knots or tight bands, are not tender to pressure, and when relaxed, they feel soft and pliable to the touch, not hard and dense, even in a fit sport horse.

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 A successful treatment protocol relies on identifying trigger points, resolving them, and if all trigger points have been deactivated, elongating the structures affected along their natural range of motion and length. In the case of muscles, which is where most treatment occurs, this involves stretching the muscle using combinations of passive, active, active isolated, muscle energy techniques, and proprioceptive neuromuscular facilitation stretching to be effective. Fascia surrounding muscles should also be treated with myofascial release, to elongate and resolve strain patterns, otherwise muscles will simply be returned to positions where trigger points are likely to re-develop.

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