Trigger Point Massage: What Is It And How Does It Work?

There are so many different types of massages available today, each with its own unique features and benefits. One that may be lesser known among the general public is the trigger point massage.

So, what exactly is a trigger point massage?

The Trigger point massage is one of the many techniques that can be used to alleviate pain in joints and muscles.

This technique focuses, unsurprisingly, on specific areas known as “trigger points”. These can form in several places, and are highly specific to the individual patient.

Massaging these points can remove pain in seemingly unrelated areas of the body. For example, a trigger point in the bicep could be targeted to relieve elbow pain.

Let's get into the details!

What Is A Trigger Point?

A trigger point is essentially a knot in a muscle. They are divided into two categories: Active and passive.

An active trigger point is a trigger point which causes pain when compressed (for example, when a muscle is engaged, or something pushes down on the trigger point artificially) and which can also cause pain when not compressed.

These are typically the most noticeable trigger points, as you feel the pain from them even when you are not actively engaging the area where they are located.

An active trigger point can also mean a trigger point that is not only painful at the location of the muscle knot, but also causes pain in other areas when pressed.

A passive trigger point is a trigger point that only causes pain when compressed. It can also mean a trigger point that does not cause pain in a non-local area when compressed.

Trigger points are taut bands that can often be felt as knots or bumps beneath the skin. They often cause a surprisingly large amount of pain and discomfort when engaged! This can seem unusual, as the points are typically quite small.

They can also commonly lead to a feeling of stiffness in the affected area, or a decreased range of movement in part of the body.

We’ll need to think about some anatomy and biology to really understand how a trigger point works.

However, before we get into that, let’s think about an analogy that will make sense even if you don’t have an in-depth knowledge of the human body:

Think about your muscle as a piece of string, with a certain length. A trigger point is a knot in that piece of string. (If you’ve got a piece of string near you, or something you can tie into a knot, give it a go!)

You’ll notice that the piece of string shrinks in overall length when tied into a knot. Some of the string has been used for making the knot, and so the overall string contracts.

Now, imagine that the string is stuck between two fixed points that can’t move; tied between two walls, for example. As you keep tying knots in the string, the string will keep getting tighter – pulling harder on those fixed points.

Those fixed points are where the muscle attaches to joints and bone. So, not only can a trigger point affect the location where it actually is, but it can also affect neighboring joints.

The leading biological hypothesis states that trigger points are formed due to something called acetylcholine. Acetylcholine is a natural substance that your body uses to contract muscles.

In the formation of a trigger point, too much acetylcholine is directed to a particular muscle point, overly contracting muscle tissue fibers and forming the “knot”.

This in turn constricts blood flow to the region, producing chemicals that interact with the nerves in the area and cause pain.

Trigger points are still a topic of research and debate in the scientific community, and there’s no clear consensus on exactly how they work yet!

What Causes Trigger Points?

Trigger points have multiple causes, and there’s no easy way to group them all together under one definite heading.

Lack of exercise, poor diet, overworking or overstressing a particular muscle group, poor posture, and existing joint problems are all examples of things that can cause trigger points.

How Trigger Point Massage Works

Trigger point massage aims to remove the knot by applying pressure to the area where the point is present. Up to 90 seconds is spent at a time, applying the pressure.

The pressure aims to increase the blood flow to the area and hence relieve pain, as well as removing the “knot” in the first place.

After applying pressure successfully, there will be a noticeable change in how the area of skin feels. There will no longer be a knot– or at least a much smaller one!

How To Massage A Trigger Point

There are various ways to massage a trigger point, with the most common method using your fingers and thumbs to apply firm pressure to your pain areas. 

Follow these steps to massage your trigger points: 

• First, locate the point of pain. This shouldn’t be too difficult, as the point will typically feel quite stiff and knot-like underneath the skin.
• If you can’t locate the trigger point, you can attempt a massage of the larger area to find any muscle tension or sore spots.
• Once you’ve located the trigger point, the next step is to apply direct pressure.
• Using your fingers and thumbs is best for this process, and you want to initially push and massage softly to warm up the area. After you have warmed up the area, start applying more intense pressure.
• If you know the direction in which your muscle fibers are pointed, apply your pressure and massage strokes in the same direction. This may help to ease out a knot and other tight spots. 
• Some discomfort is expected from trigger point massage. You’re pushing on something that is causing pain when compressed, after all!
• Push for up to 90 seconds, or until you feel a noticeable change in the area you are applying pressure to.

Here are some key things to keep in mind as you self-massage:

• If you’re experiencing a large amount of pain from your attempts, you should stop and seek professional help. It may also be a good idea to go to a doctor as it’s possible you have a more serious injury.
• If you start feeling changes in the area you’re massaging, ease the pressure to a gentler massage. This will help to relieve any pain that may be caused from the initial technique.
• Avoid massaging a specific areas for too long, even if you don’t feel any change. You can cause further damage if too much force is applied, for too long.

You can also massage a trigger point using various myofascial release and massage tools designed for relieving muscle and connective tissue pain. We’ve described tools in more detail in the section below.

Sometimes self-massage isn't always the most effective treatment in getting rid of knots and sore muscles though and why you may want to get a professional physical or massage therapist instead.

An experienced therapist will better know exactly what kind of techniques work best for each individual.

How To Prevent Trigger Points

Trigger points can be prevented by ensuring that you avoid the common risk factors.

Make sure that you are taking regular breaks when performing tasks that involve a particular muscle group being used frequently (such as repeated heavy lifting, typing, and so on). Overuse of muscle is one of the biggest ways that trigger points and chronic pain can form.

Stretching, eating and sleeping well, and ensuring that you are taking overall good care of your body (and especially your muscles) are all ways to prevent the formation of trigger points.

If you have already developed a trigger point, it’s still useful to apply these things. This will help to prevent further discomfort or worsening of the pain. 

Benefits of Trigger Point Massage

Trigger point massage is one of the best ways to deal with the pain and muscle spasms caused by trigger points.

There are other techniques that can be used, such as trigger point injection. However, these are typically much more invasive and difficult to perform.

Trigger point massage is relatively non-invasive, and can be performed by yourself if you feel confident doing so.

As well as this, you can often find professional physical therapists and licensed massage therapists that offer trigger point therapy. This means that you have the option of seeking professional care, or doing it yourself.

What Tools Can You Use For Trigger Point Massage?

If you don’t feel like using (or can’t use) your hands for a massage, there are various trigger point massage tools that can be used to help you achieve the same results:

Trigger Point Massage Ball

These are tennis-ball-like tools that you can use to apply to the affected area. Rolling over them or pushing them into your skin with your hand will both work to apply additional pressure.

If you can’t find an actual trigger point massage ball, a regular tennis ball will work fine in a pinch.

You can use a massage ball a few times per day to help with the pain.

Trigger Point Massage Gun

A trigger point massage gun will apply pressure similar to that which you would apply with your hands, but without the extra energy requirements.

You’ll need to be careful with massage guns, as when used too close to bone or joints they can cause pain and even damage.

However, they are an effective way to massage a trigger point when used correctly. If you happen to feel any intense pain, you should always stop immediately. 

Trigger Point Massage Stick

A trigger point massage stick is a long, typically curved stick, with knobs on it to help you reach the muscles that are hard to reach and apply pressure to. 

You use the massage stick by applying the knobs to the relevant area of muscle, and applying pressure by pulling or pushing on the rest of the stick.

Make sure not to apply the knobs to bone or joints, as this will not relieve the trigger point pain and will likely cause further discomfort.

Trigger Point Massage Roller

Trigger point massage rollers and foam rollers can be effective in relieving muscle tension and pain, and they are a popular choice among athletes and people who are regularly active. They are also a convenient and affordable option for self-massage at home. 

To use a massage roller, you lay it on the ground and roll on top of it, using your body weight with the part of the body that has trigger points. Roll up and down to reach the entire muscle area. 

FAQs Frequently Asked Questions

Is It Normal To Experience Pain After Trigger Point Massage?

Some discomfort during or immediately after trigger point massage is normal to be expected, as you are attempting to release the knots under the skin. You are stretching out the tight bands of muscle fibers. 

If you’re still experiencing pain after your massage like before, it’s likely you haven’t released the trigger point properly. As such, you might need to keep massaging the area.

If you experience new pain around the massage area, it was probably massaged too forcefully. Allow it to recover before trying to continue massage therapy.

Is Bruising After Trigger Massage Common?

You shouldn’t develop bruising after trigger point massages– or after any other kind of massage, for that matter! If you do, it is likely a sign of bad massage technique. Sometimes people can develop bruises after a good massage as well, but this is not very uncommon.

What Is The Difference Between Trigger Point Massage And Deep Tissue?

Deep tissue massages are typically focused more generally around the body, while trigger point massages are focused specifically on the affected area.

Deep tissue massages are also typically done in longer stretches at a time. Meanwhile, trigger point massages typically have a shorter duration, or are done in short intervals.

Both methods use firm pressure, however, which is one of the reasons they are often confused.

Deep tissue massages can help with a trigger point, but are generally not as useful as an explicit trigger point massage.

 

 

Sources: 

• https://www.aafp.org/pubs/afp/issues/2002/0215/p653.html
• https://www.livescience.com/how-to-perform-a-trigger-point-massage
• https://www.massageenvy.com/massage/personalized-experience/trigger-point-therapy
• https://health.clevelandclinic.org/knots-in-your-neck-how-to-try-a-trigger-point-massage-to-release-them/
• https://www.verywellhealth.com/trigger-point-2696165
• https://www.painscience.com/articles/self-massage.php