If you have come across the abbreviation TPT while reading about physiotherapy or rehabilitation, it stands for Trigger Point Therapy. It is a manual technique used to release tight, hyper irritable bands of muscle tissue, known as trigger points, that cause localized pain and often refer discomfort to other parts of the body. A tight band in the upper trapezius, for example, can refer pain up into the temple or behind the eye, which is one reason trigger points are so often mistaken for something else entirely.
At Revive Rehab, trigger point therapy is one of several manual techniques our physiotherapists use as part of a broader rehabilitation plan, alongside manual therapy, exercise therapy, and IMS dry needling. This article explains what trigger points actually are, how TPT works in a physiotherapy setting, the conditions it helps most, and how it differs from related techniques such as dry needling and general massage.
What Is a Trigger Point?
A myofascial trigger point is a small, hyperirritable spot located within a taut band of skeletal muscle. When compressed, it produces local tenderness and, in many cases, a referred pain pattern in a predictable area away from the point itself. Trigger points were first mapped systematically by physicians Janet Travell and David Simons, whose referred pain charts are still used today to help clinicians trace symptoms back to the muscle that is actually responsible.
Trigger points typically develop from a combination of causes, including:
- Sustained postural strain, such as prolonged desk work or forward head posture
- Muscle overload or overuse, common in repetitive occupational tasks or sport
- Acute injury or muscle guarding following a strain, sprain, or motor vehicle accident
- Chronic stress, which increases resting muscle tension throughout the neck and shoulders
- Poor sleep and general deconditioning, which lower a muscle's tolerance for normal daily load
How Trigger Point Therapy Works in Physiotherapy
In a physiotherapy setting, TPT begins with a hands on assessment to locate the taut band and confirm that pressure on the point reproduces your familiar pain, including any referred pattern. Once the trigger point is identified, your physiotherapist applies sustained, gradually increasing pressure directly on the spot, sometimes described as ischemic compression, until the tissue begins to soften and the referred pain eases.
Sustained Compression
Steady manual pressure is held on the trigger point for a period of time, allowing the taut muscle band to relax and local blood flow to improve. This is usually the first step and gives your physiotherapist direct feedback on how the tissue is responding.
Pin and Stretch
Once the point begins to release, the muscle is gently lengthened while pressure is maintained, encouraging the shortened fibres to return to a more normal resting length rather than simply reducing tenderness in isolation.
Active Movement Integration
Rather than ending treatment at the table, physiotherapy typically pairs trigger point release with targeted exercise therapy so the muscle is retrained under load, which helps prevent the same trigger point from reforming once you return to normal activity.
Conditions Trigger Point Therapy Helps With
Trigger point therapy is rarely used as a standalone treatment. It is most effective when it is used to address a specific, identifiable component of a larger movement or pain problem, including:
- Cervicogenic and tension type headaches driven by trigger points in the upper trapezius, suboccipital, and sternocleidomastoid muscles
- Neck and shoulder tension from prolonged desk work, driving, or tech neck postural strain
- Chronic low back tightness involving the quadratus lumborum and gluteal muscles
- Rotator cuff and shoulder blade tension in overhead athletes and tradespeople
- TMJ related jaw tension and associated facial or ear discomfort
- Post accident muscle guarding following whiplash or other motor vehicle related soft tissue injury
Trigger Point Therapy Compared to Dry Needling and Massage
These three techniques are often confused with one another because they all target the same underlying structure, the myofascial trigger point, but they use different tools to get there.
TPT Versus IMS Dry Needling
Intramuscular Stimulation (IMS) dry needling uses a fine acupuncture style needle to reach the trigger point directly, producing a local twitch response that can release a deep muscle band more quickly than manual pressure alone. TPT uses hands only. Many physiotherapy plans use both, starting with manual TPT and progressing to dry needling for points that are too deep or too stubborn to release manually.
TPT in Physiotherapy Versus Massage
Registered massage therapists also perform trigger point therapy as part of a massage treatment, and the manual technique itself is very similar. The difference is context. A physiotherapy session places trigger point release inside a broader diagnostic and exercise based plan aimed at correcting the underlying movement pattern, while a massage session is generally more focused on the soft tissue work itself. Many patients at Revive Rehab benefit from both, coordinated across the same care team.
What to Expect From a Trigger Point Therapy Session
Your physiotherapist will begin with a short assessment of your posture, movement, and the specific muscles that reproduce your symptoms. Pressure is then applied gradually, and most patients describe the sensation as a deep, localized ache rather than sharp pain. It is common to feel some tenderness in the area for a day or so afterward, similar to how a muscle can feel after an unfamiliar workout. Drinking water and light movement after your session generally helps this settle faster.
A Note from Your Physiotherapist
Trigger points are one of the most common things I find during an assessment, and also one of the most misunderstood by patients. People are often surprised that pain in one area, a headache behind the eye or an ache down the arm, can be traced back to a tight band of muscle somewhere else entirely. My approach is to explain that connection clearly, release the trigger point by hand, and then give you the specific exercises that keep it from coming back, rather than treating the same spot every few weeks indefinitely.
Jasleen Sandhu, Registered Physiotherapist, Revive Rehab Abbotsford Clearbrook
Reference Sources: Clinical background referenced in this article draws on the original myofascial trigger point mapping work of Janet Travell and David Simons, foundational reference material still used in physiotherapy education today, alongside guidance from the Canadian Physiotherapy Association (CPA) and the Physiotherapy Association of British Columbia (PABC). General pain science context is referenced from the International Association for the Study of Pain (IASP).
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