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[[File:GraysSoleusTrigger.jpg|right|thumb|250px|The Soleus trigger point that can cause pain in the Achilles tendon<ref name="TPManual"/>. Note that the calf has two main muscles, the Gastrocnemius and the Soleus. The Soleus is under the Gastrocnemius which has been removed from this diagram.]]
It is common for muscles to develop 'trigger points', also called '[[Muscle|muscle ]] knots'. These trigger points can be felt as small, hard lumps in the muscle that can be painful when pressed<ref name="TPManual"/>. Trigger points may give rise to characteristic patterns of referred pain, including tendon pain, and often result in a restricted Range Of Motion<ref name="TPManual"/>.
=Treating Trigger Points=
Trigger points can be treated in a variety of ways:
* '''[[Massage]].''' A number of studies have shown that massage [[Massage]] is an effective treatment for trigger points<ref name="TPMassHou"/><ref name="TPMassHanten"/><ref name="TPMassCesar"/>. [[Massage]] seems to be the most common and the easiest to perform at home.
* '''Laser.''' The use of a low power laser on trigger points has been shown to produce pain reduction for 3 months<ref name="TPGaLaser"/><ref name="TPFDiodeLaser"/>. Another study showed improvements from laser treatment, but the effect had disappeared by 6 months<ref name="TPFLaser6m"/>.
* '''TENS.''' Transcutaneous Electrical Nerve Stimulation, or TENS, uses a mild electric current to reduce pain. TENS has been shown to reduce the pain associated with trigger points, but it does not improve the Range Of Motion, suggesting it reduces the pain but not the underlying problem<ref name="TPTensEms"/>.
* '''EMS.''' [[Electrical Muscle Stimulation]] does not reduce the pain as much as TENS, but it does improve the Range Of Motion, suggesting it is improving the underlying muscle functioning<ref name="TPTensEms"/>.
* '''Needles. '''The use of directly inserting a needle into a trigger point appears to be effective, but there was no difference found between dry needling (no injection) and the injecting of drugs or saline and there is a concern that the needling may be no more effective than a placebo<ref name="TPNeedle"/>.
* '''Ultrasound.''' A study comparing Ultrasound plus massage [[Massage]] and exercise, just massage [[Massage]] and exercise, or a control group indicated that the Ultrasound did not improve the gains from massage [[Massage]] and exercise<ref name="TPUltra"/>.
* '''Magnets. '''The preliminary research suggests that magnet therapy may be effective, but more studies are required<ref name="TPReview"/>.
My personal experience is that trigger points can cause the muscle to be under continuous contraction, putting stress on the associated tendon. It is counterintuitive to work on a muscle that does not hurt to fix a tendon that is causing pain, but this approach has worked for me and others I know, but I have found no research to support or refute this belief.