An hour of professional massage therapy is always a treat, but it’s not always practical or affordable to get massage therapy, and it’s amazing how much relief you can get from muscle pain by massaging your own trigger points.

Who wouldn’t like an hour of this? But it’s not always practical or affordable to get massage therapy, and it’s amazing how much relief you can get from muscle pain by massaging your own trigger points.

Basic Self-Massage Tips for Myofascial Trigger Points

Learn how to massage your own trigger points (muscle knots)

by Paul Ingraham, Vancouver, Canada MORE
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Credentials and qualifications

I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.

For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.

EXCERPT This page is a simplified excerpt from a much more detailed tutorial, Save Yourself from Trigger Points & Myofascial Pain Syndrome!

Muscle knots or “trigger points” are small patches of super-contracted muscle fibres that affect performance of the whole muscle, spread pain to adjacent areas, and cause other trigger points. Once you know what a trigger point feels like and can find them yourself, the door is wide open to start self-massaging them.

You can often get even more relief from self-massage than you can get by paying a massage therapist to help you.

This article does not explain the phenomenon of trigger points — it introduces the basic principles of treating trigger points with self-massage. If you aren’t familiar with trigger points yet, you might want to look at the free introductory sections of the full trigger point tutorial before reading this.

What can you do about garden variety trigger points?

Most trigger point pain can be relieved with a surprisingly small amount of simple self-massage, or with a helping hand from the right therapist in those hard-to-reach spots! Although trigger points can certainly be weird and stubborn, most are simply painful spots in muscles that are usually easy to find and get rid of with a just little rubbing.

Dr. Janet Travell wrote that “almost any [physical] intervention” can relieve a trigger point. And self-massage is usually the simplest, cheapest, and most effective intervention. How can so little be so effective? How can such a minor treatment work?

Basic self-massage instructions

For an easy case, literally just a few moments of gentle rubbing can be enough. For slightly more difficult cases, a day or two of applying small but frequent doses of rubbing will usually do the trick. An “investment” of about a half dozen miniature treatments per day, each consisting of about 20–30 kneading strokes, can dramatically reduce the pain of the vast majority of trigger points.

Here are a bunch more specific tips …

Rub with what? Rub the trigger point with your fingertips, thumbs, fist, elbow … whatever feels easiest and most comfortable to you. Tools are often handy for spots that are harder to reach.

Rub in what way? For simplicity, either simply press on the trigger point directly, or apply small kneading strokes, either circular or back and forth, and don’t worry about the direction of the muscle fibres. But, if you happen to know the direction of the muscle fibres — sometimes it’s obvious — then stroke parallel to the fibres as though you are trying to elongate them. You are trying to elongate them, after all.

Rub how hard? The intensity of the treatment should be strong, but easy to live with. On a scale of 10 — where 1 is painless and 10 is intolerable — please aim for the 5–7 range, and err on the side of gentle at first.

What should it feel like? Pressure on a muscle knot should generally be clear and strong and satisfying; it should have a relieving, welcome quality. This is “good pain.” If you are wincing or gritting your teeth, you probably need to be more gentle. You need to be able to relax. See the next section for more information about how trigger point massage should feel.

What if it backfires? It probably won’t. But if you experience any negative reaction in the hours after treatment, simply ease up. In basic therapy, you can always count on trigger points adapting to stronger pressures over the course of a few days of regular treatment. If they don’t, either the problem isn’t really trigger points, or they are worse trigger points than you thought!

Rub where? For basic self-treatment, you can trust your instincts: rub where it hurts! Do explore for sensitive spots, but you can limit your exploration to a fairly small area of muscle tissue around the “epicentre” of your symptoms. So, for instance, if the top of you shoulder aches, search for trigger points mainly in the top of your shoulder. You will not necessarily be able to feel a bump or “knot” in your muscle, so don’t worry too much about that.

What if the trigger point is not where the pain is? As you learned earlier in the tutorial, trigger points may generate symptoms that aren’t where the trigger point is! What’s a beginner to do? Don’t worry about it too much. Remember, this is basic trigger point treatment. Bear in mind the possibility of confusing referred pain, but don’t start worrying about it unless basic therapy is failing.

Rub how much? Massage each suspected trigger point for about 30 seconds. This is actually enough for many trigger points — especially if you think that you have several that all need attention! Five minutes is roughly the maximum that any trigger point will need at one time, but there is not really any limit — if rubbing the trigger point continues to feel good, you should certainly feel free to keep going.

Rub how often? As long as you aren’t experiencing any negative reactions, you should massage a key trigger point at least once per day, and as often as a half dozen times per day.

How do you know it’s working? Getting a trigger point to “release”

The goal of self-massage for trigger points is to achieve a “release.” What is trigger point “release” and what does it feel like? How do you measure success?

Trigger point release, of course, is relaxation of the tightly contracted sarcomeres that the trigger point is made of, and the breaking of the vicious cycle that has been keeping them seized up.

Unfortunately, this happy change in state may not be obvious, even when it occurs! The problem is that the tissue remains generally polluted with waste metabolites even after a successful release. Release may actually involve or even require damage to the tissue of the muscle knots. This means that it will probably still be sensitive to pressure, even if you’ve succeeded.

For beginners, the way to cope with this problem is to just not worry about it! Simply trust that you probably achieved a release, or a partial release, and then wait for the tissue to recover. Over the next several hours, if you were successful, you will notice a distinct reduction in symptoms — mission accomplished.

If you released a trigger point, you will notice a distinct reduction in symptoms over the next several hours — mission accomplished.

Generally speaking, with easy trigger points, successful release is associated with “good pain” — that clear, strong and satisfying sensation that is somehow both painful and yet also relieving. It is positive in the same sense that throwing up is positive: it’s not exactly pleasant, and yet your body “knows” that it needs and wants the pressure. Usually, if you feel “good pain,” a trigger point release is likely.

On the other hand, if you are wincing or gritting your teeth, you probably need to be more gentle. Relaxation is an important component of successful treatment. If you can’t massage the trigger point without wincing, either you’re being too brutal on yourself, or the trigger point is simply too severe. Sometimes a trigger point will feel nasty and hot and burning and still release anyway. But often such a rotten trigger point will need more advanced treatment.

More information about taking care of your trigger points

Stretching is just one kind of self-treatment for myofascial trigger points, and arguably one of the least effective. What else can you do for muscle knots?

This has been an excerpt from a book-length tutorial, Save Yourself from Trigger Points & Myofascial Pain Syndrome! In the full version, you’ll learn more — way more! In the full tutorial, not only does the basic section continue with tips and tricks for longer lasting trigger point release, top mistakes that beginners make, and how to use tools, that’s still just the basics. The full tutorial has almost ten times as much information about advanced self-massage, 213 chapters (yes, you read that right) of practical methods, crucial concepts, case studies, and troubleshooting everything from “scar” tissue to insomnia to mysterious complicating factors. It’s pretty much a bottomless pit of options and ideas for self-treating myofascial pain syndrome! Buy it now ($19.95) or read the first few sections for free.