This video goes along with the article: “Trigger Point Therapy – A Powerful Tool to Treat & Prevent Injuries”
Video Transcript
Hey this is Dr. Gangemi and in this quick little Sock Doc video I wanted to just address a couple little points and show you how I work a trigger point on a person and how you can work them on yourself. So sort of go along with the recent trigger point therapy post that I wrote for the Sock Doc site.
So, a trigger point if you’re finding a point I’m not going to go into what they are because that’s already been described, but once you find it let’s say we’re on our calf here like the Achilles tendinitis video. You’re looking for that sore spot and you’re going to hold the point sort of like that little nodule or knot that you feel in there if we’re talking about your Achilles and you’re working out your calf whether you’ve got shin splints, calf tenderness or an Achilles tendinitis issue. You’re going to apply pressure to that area and basically squeeze to your tolerance for at least 10 if not 15 seconds.
Now you do this a little longer. If you’re feeling the pain in there and it’s diminishing and especially if it’s radiating toward where you have your pain. In this case if I’m pushing on my calf here and I’m feeling it down more towards my Achilles and that’s, that’s resolving some of my Achilles pain, then you can continue to do that until it plateaus off or obviously you no longer feel pain in that area. And then once you do you’re pretty much good to go.
The other thing you can use is little tools like the stick or if you have a Thera Cane or something like that and you would just basically rolled back and forth up and down the calf like that. Again, you’re not trying to destroy your muscle, but it still should be relatively sore and to some discomfort. It’s not like you’re just doing the soft little massage in that area.
Now remember you need to have some understanding of anatomy which is part of the reason for this video and you also need to have some smarts about this. You don’t typically want to be on the area of injury, I say that a lot in my video, so for Achilles tendinitis. Very rarely my actually be working the Achilles tendon. You don’t want to be on ligaments too often. You’ve got to be careful of bursa and obviously if you keep on working a trigger point and it’s not getting any better then you should have that looked into if you haven’t already.
Usually people who are going to benefit from these the best they’re not getting help anywhere else and nobody has properly addressed the area. So, make sure there’s no fracture there and obviously if you’re working out close to your tibia here like for plantar fasciitis and you’re going down the inside of the tibia on that tibialis posterior muscle, you got a really sore spot actually on tibia bone, you can have a stress fracture there is it’s killing you that bad. But a lot of times its just tenderness from the fascial connections there.
And don’t forget if you’re working on trigger points two or three times a day, which isn’t necessarily bad but you shouldn’t have to keep on doing them all the time every day, week after week. If it’s just like stretching, you need to stretch to make yourself feel better which of course I’m very against, the same thing with the trigger points if you’re always having to work at trigger point but you’re not resolving the problem, well you’re not providing any benefit, any healing lasting benefit to yourself. So you’ve got to understand where those trigger points are coming from.
An Achilles problem for example that could be because you’re wearing the wrong type of footwear. Either you’ve been in thick shoes for too long and you adjust to minimalist or barefoot shoes too quickly that could hurt your Achilles. Or even vice versa if you’re wearing over supportive shoes orthotics too long that could be the result of an Achilles problem.
Another common thing people get trigger points in their traps all the time maybe from how you’re sitting at a computer or if you have a poor ergonomic position. But also these muscles and I talked about this a lot with the Sock Doc site and especially in the new trigger point post, these muscles are highly dependent on stress, lifestyle stress, dietary stress, emotional stress. Especially the dietary, what you eat and people who eat a lot of sugar will actually cause latissimus problems in their long back muscles and that will actually cause your upper traps to be tight.
This is exaggerating but basically you end up with tight shoulders, trap muscles because your lat muscles are unbalanced with your traps because they’re related to your pancreas and sugar imbalances and you’re always going to feel like you have trigger points in your trap. You can have those worked out all day, always want somebody to rub your shoulders, but if the trigger points are there because of the dietary imbalance.
So it’s still good to treat the trigger points. It helps a lot with local symptoms and will even help with muscle imbalances and resolve your problems, but you still need to resolve the actual calls of the problem to keep the trigger point gone. So, there you have it. Thanks for watching.
Susan says
thank you for additional information on TPT. i have two questions.
do you think it beneficial to hold the trigger point, (press on it) and extend the leg thru the range of motion while the TP is being pressed? It is a process of press, extend the leg, and release…repeat.
i have had insertional AT (complete with ‘pump bump’) for too many months now and have diligently worked my calf muscles. just now beginning to work the hamstring and high hamstring using the method above and seem to notice some relief. would a chronically tight hamstring on a leg with a supposed .25″ length shortage add to the destructive tension on the insertion point of AT?
running for 13 years and have always seemed to feel tightness in that hamstring, stretching it never did anything…probably made it worse. strengthening programs were seemingly wasted on it.
Sock Doc says
Sometimes that can be beneficial. Actually another way to do it (kinda more detail than what the article talks about) is finding the point and then moving the limb into a range of motion until the point is greatly diminished or disappears – and hold there for a bit.
A 1/4″ LL discrepancy could aggravate the AT – depends on other factors too – pelvis, foot, footwear, etc…
Stretch and strengthen, stretch and strengthen, repeat = Yes, they don’t accomplish much unless you have time to kill.
Nadia says
Hello Doc.
Would you recommend the use of a lacrosse ball to “loosen up” the ITB? Here’s an example of what I mean, but instead of the roller I was told to use a lacrosse ball:
http://www.lululemon.com/community/blog/wp-content/uploads/2010/08/IMG_8126.jpg
A former trainer told me I was too tight when doing overhead squats and he recommended the ball. I’m not doing much “gym” work (CrossFit) anymore, but maybe I should. (I’m training for my 1st marathon late February).
Sock Doc says
Definitely – or any ball for that matter.
Christine says
Hey Doc,
Just randomly found your website and this video on trigger points. I found the end of this video to be interesting about the interaction of the trapezius and latissimus dorsi. For two years now I’ve been battling upper left back pain near the top of and just next to my shoulder blade. It feels like my ribs are tweaked. I’ve been to my chiro and he adjusts my back to where it sounds like rice krispies. This usually helps a lot. I also get deep tissue massage to try and keep my muscles loose. I eat paleo and avoid all drugs/medications. I work a high stress job and for the longest had terrible ergonomics but lapse back into bad posture under stress. I’ve found that I unknowingly shrug my shoulders and my upper traps show this. I was wondering if you could elaborate a little further on the trap-lat connection that you mentioned in the video since it made me curious considering I have upper back issues.
Sock Doc says
Weakness (neurological) in the lats is common because these muscles are closely related to dysglycemia – blood sugar imbalances. When they fatigue, then the upper traps work harder as they are no longer opposed by the lats. The lats keep help keep the shoulder girdle supported from below, the traps above.
Scott Emhoff says
So for below the big toe which you talk about in foot pain how do you press the trigger point? I do over supinate a lot and am built like a linebacker.
Sock Doc says
I don’t know any other way to explain it other than how it’s discussed in the Trigger Point Therapy article here.
RVR says
Thanks for all the information and especially the focus on root/cause rather than source of pain. I ended up at your site looking for information on plantar fasciitis but then migrated over to the IT band and trigger point videos, as the IT band on the opposite leg of my PF has started to give me knee pain. On that side, I’ve also had chronic bursitis/piriformis/SI joint problems, so my question is: when using the foam roller or tennis ball on the glute max, how do I know if I’m hitting a trigger point or a bursa? There are some intensely painful spots, but I’m concerned I’m doing more harm than good. Would it make sense to seek out a PT who can teach me an individualized trigger point plan before trying to focus more on self-treating? I wouldn’t normally ask such a specific question when I know you’re providing a public service here, but I’m hoping your answer might help others as well.
Sock Doc says
Please read this; thanks!
https://sock-doc.com/sock-doc-questions-comments/
Doug says
Hi.
I’m on day 10 of foot pain. Inflammation persists round 3/4 toes top and bottom of foot. Started in mid foot tarsal area top, then to inside then to well area near toes. Less red and less fat. Been on ice and NSAIDs (600) to reduce pain and sleep. Injury came from over use- tennis/ running in golf shoes up/down hills. I’m 49- history of gout?metatasal breaks from ultimate frisbee and want to stop the foot trauma. Loved your teaching – I watch my diet and swim but guess I’ll check my shoes, balance diet, work on muscle areas. But also have hamstring injury – same leg as foot injury. Could this be related – hammy – foot pain?
Sock Doc says
Sure – it’s all typically related some way or another. Make sure you read my NSAID article!