State, Not Scar · source record · paper

Endplate Potentials Are Common to Midfiber Myofacial Trigger Points

David G. Simons; Chang-Zern Hong; Lois Statham Simons · 2002

AI-verified citationSRC-SIMONS-2002

identifier / locator: doi:10.1097/00002060-200203000-00010
url: https://doi.org/10.1097/00002060-200203000-00010
verification note: text retrieved and shown to the drafter on 2026-09-09 (run 2026-09-09-draft-vasocomputation-040754); passages checked by the verify verb
reliability notes: Peer-reviewed primary study, Am J Phys Med Rehabil 81(3):212–222; only the abstract was shown (Ovid landing page), so group-level statistics beyond the abstract are unrecorded.
The abstract itself describes the design as 'nonrandomized, unblinded'; 10 subjects, 11 muscles.
Authors are leading proponents of the trigger-point construct (Simons is co-author of the Trigger Point Manual); the finding nonetheless cuts against exclusivity of the electrical signature.

Evidence drawn from this source

Qualifies· moderateVASO-E031

what the source states: The source reports a needle examination at one test site and two control sites in 11 muscles of 10 subjects, with the endplate zone determined electrically: "Endplate noise without spikes occurred in all 11 muscles at trigger-point sites", "in four muscles at endplate zone sites outside of trigger points" (P = 0.024), and "did not occur in taut band sites outside of an endplate zone" (P = 0.000034). It concludes that endplate noise seems to be "characteristic of, but is not restricted to, the region" of a trigger point.
what we infer: This qualifies VASO-C002's 'confined to a nidus, absent in adjacent non-tender muscle': spontaneous activity was found at 4 of 11 non-tender endplate-zone sites. Hubbard–Berkoff's silent control sites may have lain off the endplate zone rather than demonstrating exclusivity. The correct comparator for the nidus is a matched endplate-zone site, which neither Hubbard–Berkoff 1993 nor McNulty 1994 used, as far as the ledger records. The prevalence gradient (11/11 vs 4/11 vs 0/11) still supports 'more common at trigger points'.
limitations: Abstract only; per-site amplitudes and subject details not shown.
Design described by the source as nonrandomized and unblinded; 10 subjects.
Authors are proponents of the trigger-point construct.

Supports· moderateVASO-E032

what the source states: The source states that endplate noise occurred at all 11 trigger-point sites, "in four muscles at endplate zone sites outside of trigger points", and "did not occur in taut band sites outside of an endplate zone"; it describes the study as "This nonrandomized, unblinded needle examination of myofascial trigger points".
what we infer: Direct anchor for the two observation claims: endplate noise occurs outside trigger points when the site is in the endplate zone, and not in taut bands off the zone. Together they imply the electrical signature tracks the endplate zone first and the trigger point second, which is the conventional skeletal-endplate reading.
limitations: Abstract only; unblinded; small sample.