Trigger point massage

Definition

Trigger points are adhesions of muscle fibers with its surrounding connective tissue (called fascia). They can cause pain in other areas of the body (referred pain). They often dissolve after some time or they are too small to cause lasting discomfort. However, after working in a non-ergonomic posture for years, those trigger points can get very painful. Trigger points can occur in any muscle and cause pain in almost any area of the body. Head, neck and back pain is a common result.

Treatment

The actual muscle trigger points are not painful in a normal state. But they can be felt as a "knot" or stiff point by yourself or by a third party (e.g. physical therapist). Less pronounced trigger points cannot always be clearly identified.

You can massage all trigger points shown on this page with your fingertips or palm of your hand in circular movements applying gentle pressure. You should feel an uncomfortable pressure pain. Since under pressure the knot often wobbles to one side, you have to constantly reposition your finger. To cope with trigger points on the back, you can lie down on a hard surface with your back on two tennis balls.
You might also have trigger points which are difficult to identify. I recommend professional help in the form of a physical therapist (especially at the start and if both your arms are affected).

You can massage the trigger points every two days and after that you should perform a round of stretching exercises. After two to three weeks the referred pain should slowly subside.

Tools

Recent research findings state that elastic fascia is an extremely important part in the prevention of injuries. Even if you don't have any trigger points yet, you should train your fascia. For one thing this is done by regular stretching and for another thing by massages. Professional massages are most effective, but are also very expensive in the long term. I want to introduce you to two relatively cheap tools that I use regularly:

Tapping massager
Most office workers have painful spots on the upper back, so you should massage this area regularly, even if you can't identify trigger points. The best solution I found is a "tapping massager". It sounds like a ridiculous product promoted by a home shopping channel, but it does work for me! I use it at least once a week and my neck and upper back pain is completely gone. (Price: )

Some other reviewers criticize the following aspects, which I want to respond to:

• "It is too strong." - The massager has 10 different intensity levels. If level 1 is too strong for you, you should wear a sweater or put a towel between the device and your back. After a couple of uses, your muscles will become softer and level 1 won't feel too strong any more. I use it on level 10 and it just feels great!
• "After 15 minutes it switches itself off." - Yes it does, but 15 minutes should be long enough for one person. Another reason is, that it gets quite warm (which is very pleasant while using) and has to cool down a bit. Wait 5 minutes and it's good to go another round of 15 minutes.
• "The massage is only performed on two spots." - You can adjust the height of those spots by lowering the device. You can reach all muscles left and right of your spine from the neck down to your lower back.

Foam roller
With a foam roller you can release adhesions and muscle stiffness. In contrast to the tapping massager, which you can use passively, the use of a foam roller is much more strenuous. I recommend it from phase 3 in combination with the tapping massager. There are several brands available, I recommend the Grid Foam Roller (price: ). It is of good quality and you receive a couple of exercises in the package. You should avoid those exercises which involve straining your hands (instead, support your body weight with your forearms). The exercises shown can be easily combined with my strengthening program.
The two most important exercises for your forearms can be seen in this video. With the help of your body, you can apply exactly the amount of pressure which is pleasant for you.