SELF-MASSAGE TECHNIQUES
Introduction
I am going to discuss a way that you can help relieve some of the symptoms of trigger points and muscular pain. This method is not intended to be a substitute for professional help but can help you maintain the work your therapist has done between treatments. You may find you get considerable relief if this method is carried out correctly and the amount of treatments required with your therapist could also be reduced.
It is important to be aware that a therapist professionally trained in the diagnosis and treatment of trigger points should be consulted before performing any of these self-massage techniques.
Identifying the trigger point
First we have to identify whether the pain you are experiencing is coming from a trigger point or not. This is, usually, easily accomplished by applying firm but moderate pressure to the localised area where you feel pain. If the pain gets worse this is a good indicator that the problem is probably not related to a trigger point. If on applying pressure the pain does not increase then this could indicate the involvement of a trigger point. Trigger points have very well documented and consistent pain referral areas and a professional trigger point therapist will be able to identify the muscles most likely to be harboring the problematic trigger point, you can also reference a chart of trigger points and referral areas that will suggest locations to seek the trigger point.
One of the main rules of trigger point de-activation is that after treatment the muscle concerned needs to be stretched to allow it to reach its normal resting length. Trigger points always lie in muscle fibers that are shortened, if the muscle is not stretched the trigger point could remain active or quickly return to its previous active state.
Finding the trigger point can be a slow process, once you are aware of the muscles in which to search for the trigger point, you should slowly move along the length of the muscle either using moderate finger or thumb pressure or a squeezing action feeling for tender areas that increase sensations in the referral area. Trigger points are usually the size of a lentil but can often be as small as a pin head or as large as a bean. They are often tender and sore when direct pressure is applied to them and almost always refer sensations to the referral area.
Treating the trigger point
Once you have located the trigger point you need to treat it. Treatment is best applied again with the pressure of your finger or thumb or with a squeezing action. The pressure should never be so great that the pain is unbearable. If 0 was no pain at all and 10 was unbearable you should never reach a stage where the pressure you are applying goes above a 6 or 7.
- Apply pressure to the point until a sensation is felt in the referral area
- Sustain the pressure for around 5 to 10 seconds
- Then ease the pressure off by about 50% for 2 or 3 seconds
- Repeat these steps for between 30 seconds and several minutes
Repeat this process until the sensations in the referral area and the trigger point itself eases off considerable compared to when you started. This may take from between 30 seconds and several minutes.
If your trigger point is relatively new you may get considerable relief from this process within just several days, if however your trigger point is chronic and has been around for months or even years then it is likely that the muscle fibers surrounding the trigger point are hardened and fibrous, in this case it may take much longer to de-activate the trigger point.
Remember
Be aware that trigger points can often produce secondary and/or satellite trigger points in the same and sometimes different muscle structures. These trigger points will also need treating.
Remember you always need to stretch the treated muscle after any trigger point treatment to allow the muscle to return to its normal resting length. (Video on how to stretch your neck muscles)
This self-massage treatment should be carried out daily under the supervision of your therapist, consult your therapist for actual instructions on what to treat and how often. It is important that you visit your therapist at least weekly for the first 3 or 4 sessions to enable your therapist to identify the structures involved and successfully locate and start to treat all the trigger points. At this stage the time between treatments can usually be increased to fortnightly until all the symptoms have gone, it is then recommended that you have a monthly or 6 weekly massage to keep everything at bay. You will need to continue doing stretching and some self-massage to help keep things ticking over nicely and will often need to address the causes of the trigger point, such as working conditions, stress, posture and overuse.
Check out this great video on treating your trigger points
The tennis ball trick
The humble tennis ball is probably one of the best self-massage tools you can have in your armoury. Forget about the expensive, colourful and strange shaped massage tools on the market and get yourself a couple of tennis balls.
The basic idea of tennis ball massage is to trap the ball between your body and something else, this could either be the floor, a wall or even another body part. Be inventive and see what works for you.
The goal of tennis ball massage is to achieve a 'release' by applying just the right amount of pressure, enough to get the muscle knot or trigger point to release but not so much as you irritate it. The sensation you feel should be strong but satisfying, what it often referred to as 'good pain'. If you have to grit your teeth it is probably too much pressure, ease off a bit, you need to be able to relax whilst doing this.
Once you have found the right spot and the right pressure to use, relax as much as possible and wait for the sensation to subside to about 75% of its original intensity. This is the 'release' of the knot or trigger point. This may take anywhere between 10 seconds and several minutes.
Tennis ball massage is usually most effective in massaging the large hard to reach muscles of the back and hips. Many other places can be massaged with this technique but tend to be quite awkward to position and apply suitable pressure.
Tennis ball massage usually only provides temporary relief from your symptoms, you will need to continue seeing your therapist to really get the trigger points and knots de-activated.
Here are a few tips that will help to make the effect last longer.
- Only deal with a few knots at a time, starting with the worse
- Use heat as well, have a hot shower or bath before hand or use a hot water bottle to heat the area first
- Avoid physical exertion for 24 hours after treating the knots
- Move and stretch the muscle after gaining the 'release' of each knot
Self-massage techniques, such as the tennis ball trick, should not be seen as a substitute to treatment by a professionally trained trigger point therapist but rather as additional things you can do yourself to help relieve painful symptoms and maintain the work done by your therapist.