Knots also known as trigger points are common in the muscles of the shoulder, upper back, and trapezius. The Trigger Point Therapy Workbook by Claire and Amber Davies defines a trigger point as “a grumpy little spot in a taut band of muscle tissue that hurts when you press on it. With pressure it can reproduce and confirm your symptoms” (pain).
There is a lot of speculation as to what causes knots. We are of the belief that poor posture plays a large role. Specifically, forward head posture, shoulders rolled inward and increased bending forward at the base of the neck and upper back.
Therefore, our recommendation is to perform trigger point massage AND mobilize and correct posture. Trigger point massage can be performed with:
1. A massage cane.
2. A tennis ball or Lacrosse ball.
3. Massage gun or handheld massager.
The goal of the trigger point massage is to apply continued pointed pressure to the knot which can hurt (but it should be a pleasant kind of hurt). If it hurts too much you should stop. Generally, you should aim for the pain not to exceed a 5 on a scale of 1-10.
The Trigger Point Therapy Workbook by Claire and Amber Davies provides these rules of self-massage:
1. Never massage a pulse - avoid areas with arteries near the surface.
2. Use a tool if possible and save your hands.
3. Use deep stroking massage.
4. Massage with short, repeated strokes from one side of the painful spot to the other.
5. Do the massage stroke slowly.
6. Do the massage in one direction for the best ergonomics.
7. Aim at not going any higher than a pain level of 5 on a scale of 1-10.
8. Limit massage to 10 to 12 strokes per trigger point.
9. Work a trigger point three to six times per day.
10. If you get no relief, you may be working in the wrong spot.
Mobilization of the Upper to Mid Back
Start with the tennis ball, lacrosse ball on the wall, or with a towel over the top on the floor. The goal is the mobilization of the upper back. We want you to mobilize 6 spots- all adjacent to the mid-spine (thoracic) and between the shoulder blade and spine. 30-60 seconds on each spot.
(Ball in a sock) (Laying on the floor)
Specific Trigger Point Therapy
Then you are going to work on individual knots following the rules of the 12 rules of massage above. Work to bring the pain level of each knot down a few levels.
It may take a few days or longer. You can use the massage cane, tennis ball or lacrosse ball, or handheld massager. You could also have someone else use a massage gun on you. Continue the trigger point therapy until the pain is under control. At that point, you can stop the trigger point and just continue the mobilization of the back.
This video is part of a series of videos on how to treat your pain with self-massage. Check the full series of videos along with the downloadable guide sheets for each video on our website here: https://www.bobandbrad.com/massage/
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