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Massages can be a relaxing, pleasurable way to deal with things like stress, postural problems, and even physical injuries. But professional massages can be expensive—not to mention difficult to enjoy safely during a pandemic—so it’s useful to know you can get a similar effect by using your own two hands.
But before we get into that—a bit of drama.
The controversy over trigger points
You may refer to them as knots, but those tender, stiff, and often painful areas you most likely have on your shoulders, neck, and back are technically known as trigger points. You’ve probably felt them when you rub your muscles to release tension, especially after spending a long time on your computer or repeating the same movement over and over again.
Considering you’ve likely felt them under your own skin, you may be surprised to learn that whether or not trigger points actually exist is a matter of fierce debate. Physiologists and physical therapists have been treating them for decades using pressure and acupuncture, but in a 2015 review, Australian researchers questioned the very existence of this phenomena, saying there’s just not enough evidence to prove trigger points even exist, and that larger, better studies are required. Neither biopsies nor MRIs show anything of note in muscles supposedly affected with knots.
But other experts, such as Peter Dorsher, a physiatrist at Mayo Clinic who specializes in chronic pain and myofascial pain syndrome, say the lack of conclusive data from scans and tissue samples is not a reason to dismiss trigger points.
“There are nice research studies that show the presence of inflammatory mediators that are consistent with local chemical inflammation, as opposed to cellular inflammation, which can be seen by biopsy,” he says.
Dorsher underscores the clinical importance of trigger points, and says that studies have shown trained examiners can reproducibly identify them in the body. But the Australians, and other specialists such as Karin Bø, physiotherapist and professor at the Norwegian School of Sports Sciences, don’t have the same opinion.
“The results [of current studies] differ and it does not seem that trained health care providers can reliably assess where the trigger point is,” she explains. “We need to have an open mind and ask basic research questions on the topic—what is it that makes pain in the muscles? Can we reliably assess it and treat it? And what is the effect size of different treatments compared to placebo?”
The controversy goes on to this day, but people keep finding these painful spots on their bodies, and most importantly, they keep reporting feeling relief after they are stimulated either with pressure and touch (massage), or with the insertion of thin needles (acupuncture). As massage is a non-invasive, safe technique, we don’t think you should have to wait for the debate to settle to go after your painful knots—as long as it feels good, there’s no problem in trying it.
How to self-massage
How you massage yourself will depend on the area of your body you want to address, how much pain you’re experiencing, and how much of it you can handle while kneading your muscles. However, the basic principles are always the same.
Using your four fingers, your thumbs, and the heel of your hand, press or pinch the area to stretch the tissue, and find the trigger point where pain stems from. Once you’re there, adjust the pressure by increasing it lightly and stay there for 30 seconds to 1 minute, then release. Inflicting intense pain on a knotted muscle won’t make it relax or stretch any faster, so keep the pressure at a level that doesn’t make you wince.
If your muscles feel so tight that the gentlest prod causes agony, a heated pad can be a great ally. Heat increases blood flow, which will help make the tissue more elastic, eliminate lactic acid and other toxins, and reduce pain.
If pain and discomfort persist after three months, consult with a physical or massage therapist to explore underlying injuries or issues that might be causing your muscles to tighten. But in the meantime, here are specific tips for targeting common problem areas:
Shoulder massage
If you work on a computer or spend hours looking at your phone each day, chances are you tend to hunch forward, which means your shoulders might feel stiff. Treating yourself with an easy shoulder self-massage to release some tension will help you continue to doomscroll with ease.
1. Get into position. Sit or stand up straight. Relax your arms and take several big breaths in and out.
2. Pinch your shoulder. Use your four fingers and the heel of your opposite hand as a clamp and lift your shoulder slightly toward your ear to better your grip.
3. Relax your shoulder and head. You can tilt or rotate your head toward the opposite direction, or drop it diagonally as if looking at your armpit. Each movement will give you access to new muscles, so keep trying until you hit a sweet spot.
4. Find your trigger point. Knead gently and test different areas. You’ll know you’ve found it if you feel a raised knot, pain, or even a muscle spasm when you apply pressure to that particular point.
5. Apply constant pressure on your trigger point for 30 seconds to a minute, and then release. Keep the pain level to where you feel comfortable and breathe slowly through it. Pinch your trigger point up to three times before repeating steps 1 through 5 on your other shoulder.
Specialists believe there’s also a psychological aspect to massage—touch, even from our own hands, makes us feel cared for, which releases feel-good hormones (endorphins, serotonin, and dopamine) and makes us feel more relaxed. If you think it helps, close your eyes and picture your knot melting away, and leaving your body as you breathe out.
6. Repeat the entire process daily. Being consistent is key, as this is a cumulative process—massaging yourself for hours one day and then stopping for a week will result in pain at the time you apply pressure, but not in significant tension release. If pain and discomfort persist after 3 months, consult with a physical or massage therapist.
Neck massage
If you tend to clench your teeth to release stress, it’s very likely the muscles around your spine and right under your jaw feel stiff. The good news is that a little goes a long way, and even just dedicating 10 minutes a day to your neck will help you feel a lot better.
1. Get into position. Sit or stand up straight. Relax your arms and take several big breaths in and out.
2. Find the beginning of the sternocleidomastoid. Don’t worry—it’s way easier to find this muscle than to pronounce its name. It goes from the back of your ear to the base of your sternum. Try looking over your shoulder while you’re feeling around that area, and it’ll pop right out. Follow it upwards with your fingers to find its starting point at the ear, and place your knuckles in a 45-degree angle right behind it.
3. Glide your knuckles down slowly, applying constant pressure. Here you can go one of three ways depending on where you feel pain or stiffness. As you glide down, turn your head away from your hand and follow the sternocleidomastoid toward your back. As a variant, keep your eyes looking forward and glide your knuckles down toward your shoulder in a straight line. And if you feel tension on the front part of your neck, turn your head toward your hand, and glide your knuckles down your neck and toward your chest. Make sure you go all the way down to your sternum. Repeat 3 times before switching to the other side of your body.
4. Repeat the entire process daily. If pain and discomfort persist after 3 months, you might want to consult with a physical or massage therapist.
Treat headaches with self-massage
The power of touch has also been associated with relieving tension headaches. There are a few studies where subjects have experienced a decrease in the duration, intensity and frequency of headaches after receiving massages focused on trigger points on the neck, head, and shoulders.
Though data is lacking in this regard, and there’s no evidence linking headache-relief directly to massage therapy, this is a non-invasive and safe practice, which means you might as well try it.
Since “headache” is an umbrella term—meaning the nasty phenomena express themselves differently from patient to patient, and can stem from different causes—you may want to try multiple massage techniques to see if one of them does the trick for you.
1. Get into position. Sit or stand up straight. Relax your arms and take big breaths.
2. Find your temporalis muscle. This curved muscle lies on both sides of your skull, right behind and on top of your ears. To find it, imagine you’re putting on headphones with both hands and place the tips of your fingers on your head, ¾ of an inch apart. Clench your jaw a couple of times—you’ll feel your temporalis contract around your ring and pinky fingers. Let your thumbs rest on either side of your spine, right where your trapezius ends. This is right underneath where your skull protrudes outward.
3. Apply light pressure in a circular, exploratory motion. This is where things get more willy nilly. Where, how much, and in what direction you apply pressure all depends entirely on what kind of headache you have, the intensity of the pain, and whether or not you feel any relief from the massage. This is more of an exploratory technique, so test yourself and try finding what feels good to you. If you feel no relief, there are other types of massage you can try, too.
4. Work on your trigger points. If you find any resistance—meaning, you find a trigger point or any kind of stiffness in your temporalis—stop the movement and apply whatever pressure you’re comfortable with for 30 seconds to a minute. Repeat as many times as necessary.