Trigger Point Formation and Posture

Alexander Technique and Trigger Points

Introduction

We all know that posture is important. Whether we're sitting at a desk, standing in line, or working out at the gym, the way we hold ourselves impacts our comfort, our energy levels, and even our long-term health. Yet, posture isn't just about standing up straight—it’s a complex interplay of muscles, fascia, and neurological patterns that shape how we move and function. And at the heart of many postural imbalances? Trigger points.

As an experienced manual therapist, I've worked with countless clients struggling with poor posture, chronic pain, and muscle dysfunction. Time and time again, I’ve found that trigger points in key postural muscles are a major culprit. These tight, hyperirritable spots in the muscle tissue don’t just cause local pain; they create referred pain patterns, restrict movement, and contribute to faulty posture that can be incredibly difficult to correct without proper intervention.

So, let’s dive deep into the relationship between trigger points and posture, exploring how they affect the body, what common postural imbalances they contribute to, and what we can do to fix them.

Ideal sitting posture for those who work with computers - failure to take posture seriously can lead to long term injuries.

The Role of Trigger Points in Posture

Trigger points—also known as "knots"—are small, hypercontracted areas within a muscle. They often develop due to overuse, poor movement patterns, injury, or prolonged static positions. These points of tension create dysfunction in the muscle by restricting blood flow, reducing flexibility, and altering how the muscle functions within movement patterns. When trigger points develop in postural muscles, they can have profound effects on alignment, leading to chronic pain and movement dysfunction.

Postural muscles are designed for endurance; they keep us upright and stabilize us throughout the day. When they become dysfunctional due to trigger points, the effects can ripple through the entire body. For example, a trigger point in the upper trapezius might not just cause a sore shoulder—it could lead to neck pain, headaches, and even a forward head posture that affects breathing and spinal health. Likewise, tight hip flexors laden with trigger points can lead to lower back pain, an anterior pelvic tilt, and compensatory muscle imbalances that throw off the entire kinetic chain.

Common Postural Imbalances Linked to Trigger Points

Two of the most prevalent postural imbalances we see in today’s modern world are Upper Crossed Syndrome (UCS) and Lower Crossed Syndrome (LCS). These patterns, first described by Dr. Vladimir Janda, explain how muscle imbalances develop due to prolonged poor posture, especially in our increasingly sedentary lifestyles.

Upper Crossed Syndrome (UCS)

Upper Crossed Syndrome is characterized by a forward head posture, rounded shoulders, and an exaggerated curve in the upper back. It’s commonly seen in people who spend a lot of time at a desk, looking at screens, or driving for long hours. This pattern creates a muscle imbalance between overactive and weak muscles, with trigger points playing a major role in keeping this dysfunction in place.

• Tight, overactive muscles with trigger points: Upper trapezius, levator scapulae, sternocleidomastoid (SCM), pectoralis major and minor

• Weak, inhibited muscles: Deep neck flexors, lower trapezius, serratus anterior

Trigger points in the upper trapezius and levator scapulae contribute to stiffness, pain, and limited range of motion in the neck and shoulders. Many people with UCS suffer from chronic headaches, as trigger points in the SCM and suboccipital muscles refer pain to the temples and base of the skull.

Upper Crossed Pattern

Lower Crossed Syndrome (LCS)

Lower Crossed Syndrome affects the pelvis and lumbar spine, creating an anterior pelvic tilt, excessive lumbar lordosis, and tightness in the lower back and hip flexors. This imbalance is common in people who sit for prolonged periods, such as office workers, truck drivers, and even athletes who don’t balance their training properly.

• Tight, overactive muscles with trigger points: Hip flexors (psoas, rectus femoris), lumbar erectors

• Weak, inhibited muscles: Gluteus maximus, abdominal muscles

Trigger points in the hip flexors and lower back muscles pull the pelvis into an excessive forward tilt, creating strain on the lumbar spine and making the core muscles ineffective. This often leads to chronic low back pain, tight hamstrings, and poor movement mechanics during exercise.