The protective model of myofascial trigger points: a testable systems-level framework based on strain-repair mismatch

Area of Science:

• Biomedical science
• Physiology
• Tissue repair biology

Background:

• Myofascial trigger points (MTPs) present complex physiology across biochemical, mechanical, and neurophysiological domains.
• Common MTP features like stiffness and sensitization lack a unified explanatory framework within tissue stress and repair.
• Existing interpretations do not consistently link MTP characteristics to established biological processes.

Purpose of the Study:

• To propose a systems-level integrative framework for understanding MTPs.
• To conceptualize MTPs as localized responses to mechanical strain exceeding repair capacity.
• To interpret MTP features within a unified model of tissue stress and repair.

Main Methods:

• Development of the Protective Model of Myofascial Trigger Points.
• Conceptual integration of MTP features (stiffness, electrical activity, sensitization) within a strain-repair imbalance framework.
• Formulation of eight falsifiable predictions for empirical testing.

Main Results:

• The Protective Model conceptualizes MTPs as adaptive responses to cumulative mechanical strain.
• Increased stiffness, motor endplate activity, and sensitization are interpreted as coordinated responses to strain-repair imbalance.
• Clinical variability in MTP presentation reflects differences in mechanical overload magnitude and duration.

Conclusions:

• The Protective Model offers a coherent framework for MTP research by integrating diverse phenomena.
• MTPs are viewed as indicators of unresolved load-recovery mismatch, not independent pathologies.
• The model provides testable predictions to guide systematic investigation into MTP formation, persistence, and resolution.