WEBVTT

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I am Dr.

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Cyril Fischhoff,

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a chiropractor and a specialist in musculoskeletal ultrasound practicing in Mauritius.

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I invite you to listen to a new episode of the Vertebra & Co.

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podcast every first and third Monday of the month.

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This podcast is dedicated to the world of musculoskeletal medicine and is for everyone.

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We discuss the mechanisms involved,

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diagnoses,

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treatments,

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and the prevention of various musculoskeletal pathologies through short clinical stories,

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the latest scientific research,

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and interviews with specialists.

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Hello everyone,

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so today we're going to tackle a topic that affects almost everyone yet remains surrounded by mysteries and misconceptions,

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the trigger point,

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or point gachette in French.

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We've long reduced this painful spot to a simple tired muscle or a knot that just needed massaging.

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But in 2026,

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science tells us a completely different story.

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It's an interface pathology,

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a true conflict between your nervous electricity,

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your internal chemistry,

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and the mechanics of your tissues.

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So today,

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we're going to decode this short circuit.

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We're going to start by looking at the genesis of the trigger point.

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What exactly causes this mechanism to appear?

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Well,

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a muscle never locks up completely by chance.

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It's often a defense mechanism that remains stuck in a constant alert mode.

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We can identify three major causes for this.

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The first one is acute overload.

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It's a sudden,

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brutal impact,

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a wrong move during sports or that overly heavy box we lift without thinking.

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Well,

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to prevent a tear,

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the muscle violently contracts by reflex and remains,

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as it were,

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stuck in this defensive posture.

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The second cause is due to postural stress.

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For example,

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when we refer to the technic syndrome,

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it's like slow suffocation.

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For example,

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by spending hours with your head bent over a screen,

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your muscles are constantly working to keep your head from dropping.

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They're not designed for this kind of static effort.

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The result is that microcirculation in the muscle stops,

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waste products accumulate,

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and the muscle eventually freezes to conserve what little energy it has left.

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Finally,

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there's the joint protection signal.

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At that point,

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it's the brain that takes command.

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If a vertebra or a joint becomes irritated or lacks its normal healthy mobility,

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then your nervous system instructs the surrounding muscles to contract,

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creating a protective safety belt.

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The trigger point is then nothing more than a clasp,

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a lock on this very belt.

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So now,

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to truly understand what's happening at the trigger point itself,

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we must delve down to the microscopic scale where the nerve meets the muscle,

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that is the motor end plate.

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Imagine your nerve sends its commands to the muscles via special registered letters.

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This particular messenger is called acetylcholine.

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Normally,

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once the message is received,

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the signal is destroyed so the muscle can relax.

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Well,

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in a trigger point,

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the force it leaks.

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The nerve sends contraction messages in a loop.

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The muscle stays in on mode,

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consuming...

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all its fuel,

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ATP.

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This is called the energy crisis.

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And then an amplifier comes into play,

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CGRP,

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which is a neurotransmitter.

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Imagine it like a loudspeaker screaming at your nervous system to amplify the pain while simultaneously preventing the muscle from cleansing itself.

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The affected area then turns into a veritable chemical cesspool.

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Then,

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as the muscle is permanently contracted,

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blood no longer flows,

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oxygen is lacking,

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and the area becomes acidic.

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The pH level locally drops below the threshold of 5.

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This is precisely where what we refer to as ASICs,

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the acid-sensing ion channels,

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come into play.

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They are ultra-sensitive acid sensors positioned directly on your pain nerves.

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As soon as the environment becomes too corrosive,

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these sentinels open electrical gates to the brain.

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This is why the slightest pressure on a trigger point causes a sharp burning pain.

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You're not just pressing on a tight muscle,

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you're physically activating a chemical alarm that screams,

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Ouch.

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to your brain.

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So for decades,

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it was said that all of this was subjective.

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Today,

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we have irrefutable evidence that the trigger point truly exists physically.

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With B-mode ultrasound,

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the classic ultrasound,

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we locate the nodule.

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It appears as a darker,

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denser region which distorts the perfect architecture of your muscle fibers.

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When we use Doppler,

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which allows us to measure blood flow,

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well then we have clear proof of asphyxia.

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We can see on the screen that the blood bounces back as if against the trigger point.

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Internal pressure is so strong it crushes microvessels.

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Infrared thermography is quote-unquote the proof of metabolic anger.

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The active point is a hotspot.

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Its temperature is half a degree to one degree warmer than the surrounding skin.

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Finally,

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another technique still linked to ultrasound called elastography allows us to measure its stiffness.

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We quantify the rigidity in kilopascals.

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The trigger point is often twice as hard as healthy muscle.

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It's like a real steel cord beneath the skin.

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So how can we repair this?

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short circuit?

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Well,

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in 2026,

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we'll be combining our forces,

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for example,

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procedures like hydro release or hydro dissection.

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Under ultrasound guidance,

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the practitioner injects a volume of physiological saline solution or isotonic glucose precisely between the muscle and its surrounding sheath,

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the fascia.

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There is a Karcher effect,

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that is,

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we're going to detach the tissues that were stuck together,

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thus restoring their natural gliding.

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And then there's also a chemical cleaning mechanism.

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We literally rinse the acid in CGRP.

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By normalizing the pH,

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we force the ASIC sensors to close.

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The pain often subsides instantly.

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Another older technique is dry needling.

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A fine acupuncture needle is used to cause a micro-shock.

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This is the electrical reset.

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We finally force the acetylcholine valve to close.

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And then,

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of course,

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all of the manual medicine techniques,

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what we might refer to as an articular reset.

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If we address the muscle but leave the joint,

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the painful and restricted,

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the brain will resend its protective signal tomorrow.

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It's essential to restore movement so that the nervous system agrees to relax its muscles.

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In summary,

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a trigger point isn't a foregone conclusion.

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It's a distress signal from a body that has become trapped in a vicious cycle.

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Between the science of acid sensors and the new hydro-release techniques,

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for example,

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we now have all the keys to restore your ability to move with pleasure.

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Thank you for listening to this new podcast from Vertibolisco.

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Take care of your muscles and,

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most importantly,

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straighten up.

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Join me again very soon for a new episode of the Vertebras and Coblet Podcast.

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Meanwhile,

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take care,

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stay active,

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and if you ever have any questions for me,

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please feel free to contact us on the podcast page vertebranco.com.