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Myofascial Trigger Points: From Metabolic Failure to Recovery

Research Article | Vol 6 | Issue 1 |  January-June 2026 | page: 22-26 | Blanca Piñeyro Garza

DOI: https://doi.org/10.13107/jrs.2026.v06.i01.195

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted Date: 19 Apr 2026, Review Date: 28 May 2026, Accepted Date: April 2026 & Published: 30 June 2026


Author: Blanca Piñeyro Garza [1]

[1] Sportphysis Clinic, Monterrey, Mexico.
.

Address of Correspondence
Dr. Blanca Piñeyro Garza,
Sportphysis Clinic, Monterrey, Mexico.
E-mail: drabpineyro@gmail.com


Abstract


Background: Conventional treatment of myofascial pain has historically focused on symptom mitigation (pain relief), which may explain the high recurrence rates observed in clinical practice. Myofascial trigger points (MTrPs) represent a structural metabolic dysfunction characterized by a state of tissue hypoxia, localized “rigor mortis”, and fascial restriction.
Methods: This article aims to integrate the energy crisis model with molecular findings of tissue acidosis and ischemia, proposing a sequential non-invasive treatment triad consisting of radial pressure waves/focused shockwaves/radial pressure waves application (preparation/intervention/drainage).
Discussion: The chronological evolution of the MTrP concept is reviewed, from the integrated energy crisis hypothesis proposed by Travell and Simons to the molecular confirmation of Jay Shah’s “biochemical soup” and cytoskeletal blockade model. Shockwave therapy is introduced as a cellular “mechanical defibrillator” capable of restoring ATP synthesis and sarcomere homeostasis within a tensegrity-based framework. Treatment outcomes are further assessed using pressure algometry as an objective measure of functional recovery.
Conclusion: The BIOLOGICAL RESET protocol redefines the therapeutic approach, shifting from passive analgesic management toward active biological engineering, achieving clinical success through pure mechanotransduction.
Keywords: Myofascial pain syndrome, Trigger points, Shock waves, Radial pressure waves


References


1. Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Baltimore, MD: Williams and Wilkins; 1999.
2. Shah JP, Phillips TM, Danoff JV, Gerber LH. An in vivo microdialysis method separates active and latent myofascial trigger points from normal muscle tissue. Arch Phys Med Rehabil 2005;86:1321-31.
3. Simons DG. New views of myofascial trigger points: Etiology and diagnosis. J Musculoskelet Pain 2008;16:17-23.
4. Gerwin RD, Shannon S, Hong CZ, Hubbard D, Gevirtz R. Interrater reliability in myofascial trigger point examination. Pain 1997;69:65-73.
5. Gerwin RD. A review of myofascial pain and tissue issues. J Musculoskelet Pain 2014;22:330-6.
6. Shah JP, Danoff JV, Desai MJ, Parikh S, Nakamura LY, Phillips TM, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil 2008;89:16-23.
7. Zhuang HY, Long MJ, Zhang ZY, et al. Ultrastructural alterations of sarcomeres and sarcoplasmic reticulum in myofascial trigger points: The molecular mechanism of localized rigor mortis. J Ultrastruct Pathol 2019;43:145-54.
8. Ingber DE. Tensegrity I. Cell structure and hierarchical systems biology. J Cell Sci 2003;116:1157-73.
9. Ingber DE. Cellular tensegrity: Defining new rules of biological design that govern the cytoskeleton. J Cell Sci 1993;104:613-27.
10. Gleitz M, Hornig K. Trigger shock wave therapy in myofascial pain syndrome. Orthop Prax 2012;48:214-22.
11. Ramon S, Gleitz M, Cervallo L, et al. Focused vs. Radial shockwave therapy in myofascial trigger points: A randomized, controlled, biophysical comparative trial. Ultrasound Med Biol 2021;47:2540-51.
12. International Society for Musculoskeletal Shockwave Therapy (ISMST). Recommendations for the Clinical use of Focused and Radial Shockwave Therapy in Myofascial Pain Syndrome. Italy: ISMST Consensus Statement; 2023.
13. Fischer AA. Application of pressure algometry in quantification of myofascial pain and diagnosis of tender spots. Arch Phys Med Rehabil 1986;67:836-8.
14. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain 1987;30:115-26.
15. Moya D, Ramón S, Schaden W, Wang CJ, Gleitz M. The combination of focused shockwaves and radial pressure waves in musculoskeletal disorders: A 2024 evidence- based consensus update on sequential clinical protocols. J Orthop Surg Res 2024;19:112-24.
16. Moya D. Myths, truths, doubts and confusions about shockwave therapy and its role in musculoskeletal pathology. Rev Asoc Argent Ortop Traumatol 2024;89:199-209.


 


How to Cite this article: Piñeyro B | Myofascial trigger points: From metabolic failure to recovery | Journal of Regenerative Science | Jan-Jun 2026; 6(1): 22-26.

 


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