In the fall of 2015, after completing her first Ironman triathlon and a 50K road race, Dawn Cobak, 45, of Topsfield, began to experience debilitating pain in her right calf muscle. Fearing that these endurance events had done permanent damage to her leg muscles, Cobak turned to North Shore Medical Center’s sports medicine and non-surgical orthopedic specialist Navid Mahooti, M.D., for help.
A busy mother of two and part-time financial advisor, Cobak started running six years ago as a way to reduce stress and carve out some personal time.
“Once I started running, I never stopped,” laughs Cobak. “I used to challenge myself to run from telephone pole to telephone pole, then I upped it to a mile, then two. Before I knew it I was building up my mileage and signing up for marathons.”
Running, although strenuous at times, invigorated Cobak. “I was lucky to have avoided serious injury thus far, so I found the calf pain very upsetting,” says Cobak. “I went from running marathons to barely being able to walk. I was convinced that my active days were over.”
After a thorough exam, Dr. Mahooti discovered that several trigger points had formed in Cobak’s right calf muscle. “Trigger points, or ‘knots’ as they are commonly called, are painful, tender areas of muscle that can form from overuse, repetitive motion or a variety of other reasons,” he explains. Given Cobak’s intense training schedule, the formation of trigger points came as no surprise. Dr. Mahooti was able to treat Cobak’s pain with one round of trigger point injections.
“Trigger point injections are an outpatient procedure designed to reduce or alleviate pain,” explains Dr. Mahooti. “During the procedure, a small needle is inserted directly into the trigger point, which stimulates the muscle to relax from its tightened, contracted state. The procedure is safe, causes minimal pain to the patient and is highly effective.” An anesthetic can also be injected into the trigger point to help ease pain. In Cobak’s case, the pressure from the syringe alone was enough to stop her pain almost immediately.
“I woke up that morning and could barely get out of bed and about 20 minutes after the injections I walked to my car pain free. Within three days I was back to running,” recalls Cobak.
Athletes aren’t the only ones who suffer from trigger points. Sitting at a desk, sleeping awkwardly, driving a car for many hours a day and other overuse activities can result in trigger points in the neck, shoulders, upper back and buttocks, among other areas.
Dr. Mahooti also recommends physical therapy and deep tissue massage for some patients suffering with trigger points, but finds that many prefer the injections because they are often less painful, performed in an office setting and are typically covered by health insurance. Trigger point injections are generally not recommended for acute or severe muscle injuries.
“Running keeps me focused and is a big part of my life,” says Cobak. “Thanks to the trigger point injections, I am pain free and training for my next big challenge.”