More Trigger Point Tools

Having the right tool can make all the difference. For example, it would not be very effective to use a screwdriver to hammer in a nail, and it would not make much sense to use a hammer on a screw. Sometimes, we can substitute another tool and it will be somewhat effective, like using a knife as a screwdriver, but it will be faster and more efficient to use the right tool. Sometimes, we have tools that are good enough, but a more specialized tool would make it so much easier.

I have introduced you to what I would consider the mainstays of a trigger point tool kit:  the lacrosse ball and the theracane (or backnobber). Today, I will introduce you to a few other tools that can be useful, especially for specific jobs.

Interestingly enough, bouncy balls are great tools for getting to some of the harder to reach muscles. They come in different sizes so you can usually find something that will fit your particular purpose. They are not as durable as lacrosse balls, but they are relatively inexpensive and they will last for quite a while.

Two sizes of bouncy balls and lacrosse ball.  

I have a favorite size that I have been using to massage the muscles in my arm while I am recovering from my elbow injury. There are many narrow muscles in several layers that I am working and this ball is perfect for this. The ball a size up is too big and the ball a size down is too small.  

Using bouncy ball on the outer elbow area.  

Using bouncy ball on inside area of elbow and down the arm.  

 Using the opposite hand, I press and roll the ball into my muscle. I use the heel of my palm to get particularly deep, but I also use the entire palm of my hand, and my four fingers held straight and close together to form one tool. Using this method, I roll the ball around my arm, and as I find trigger points, I work them for a few strokes before continuing on.

Getting in position to use the opposite hand on outer elbow.  The ball is placed between the palm and the opposite elbow. 

I have used a bigger size (the purple and orange ball in the photo above) for my triceps, and it is perfect for that. When I first got off the pain pills and I was starting to venture out into the world again, I went grocery shopping. I took that ball with me, and whenever my elbow started to really ache, I worked my triceps with the ball, and it relieved my pain.  

As part of my physical therapy, I have to wear a splint on my arm for 6 to 8 hours a day to help me stretch my muscles back to where they were before the accident. Often, my arm starts to ache when I wear this, but I can work some trigger points through the back side of it, which is open. I can also take the splint off temporarily, work some trigger points on the inside and put it back on. When I have worn it for several hours, my arm is usually pretty tender all over, and it hurts to move it. I use the ball to work all of the areas that are tender and stiff.  

The difference between the two arms.  I have gained quite a bit of range of motion, but I have some way to go still. My arm usually extends farther after I have had my arm in the hot whirlpool bath for 15 minutes at the physical therapist's office.   

My arm in the splint.  

Sometimes, I can just set the ball on the table, or another hard surface like a book, and roll the exposed part of my arm on the ball.  

Another tool that I have used recently is called the Palm Massager (made by a company called Pressure Positive, available online).  

Palm massager.

This handy tool is held in the palm of the hand. The fingers fit comfortably into grooves molded into the tops of the three "arms" of the tool. Each "arm" has a rounded end. Two of these ends are relatively small, while the remaining end is larger.  

The finger fits in the groove on top of the arm.

This design makes it easy to use quite a bit of pressure without totally trashing your fingers. I have used it for trigger points in the back of the neck, and, lately, I have used it to work my inner elbow. It is good for going deep.  

Using on the back of the neck.  It is even better if you can lean back into it, so that the muscles that you are working are relaxed.  

Late one night, I was using the palm massager on my inner elbow, and I was able to find some places that hurt that I had not been able to reach before. I worked them, and I could see that it was increasing my mobility. I was pretty excited. The next morning, I was dancing and singing: I've been dreaming of an arm that moves... to the tune of, "I've been dreaming of a true love's kiss," from the movie, Enchanted. It has become sort of a theme song for me.  

Another tool is the Knobble (also by Pressure Positive, available online).

The Knobble

This tool looks a lot like a round door knob. It has a rubber-like surface on its side, which helps in gripping the tool. I often like to hold the tool sideways and use the rubberized side for the trigger point therapy.

The Knobble, side view.

The Knobble is great for places that you want to get into deep with minimal effort. I have used it on my arms, my quads (but I decided later that I like the lacrosse ball against the wall better for the quads) and also on my pecs (using the side).

In position to use the Knobble on my arm.  My fingers are held up to show how the Knobble is placed.  They are wrapped around the Knobble when working the trigger points.  

Holding the Knobble sideways to work the pecs.  

I have even used it on the muscles of my head, staying on the gentler, rubber side.

Using the side of the Knobble on my temporalis muscle. 

Experimenting with different tools, you will probably find some that you prefer over others for particular tasks. The more comfortable you are using a tool, the more likely you will be to use it. You will also probably be more effective, giving the right amount of pressure, not too much, not too little.

Triceps

The triceps have become a special focus for me lately. A week ago, the doctor removed the splint and I have been working on regaining mobility in my left arm. At that time, I could not twist my wrist back and forth. My elbow was at at about a 90° angle, and I could not bend it closer to my body or extend it farther away from my body.

The surgeon told me that I might have my movement back in 3 to 4 weeks. [Update:  Nelson told me that the doctor said 8 to 12 weeks.  I was on meds and did not remember...] I needed to be prepared for the possibility that I won't get my full range of motion back. It has been about one week, and I am pleased with what I have gained so far. Today, I am able to twist my wrist to make my palm face down, and I can twist about halfway in the other direction (palm up). But I have gained only a little bit of movement in my elbow.

I have been occasionally working my trigger points in my arm and it has helped me, especially in gaining the twisting movement toward palm facing up. I found a particularly effective trigger point in the muscles on the outside of the lower half of my forearm that I worked to decrease my pain and increase my flexibility in that area. I have also been careful to not work too much or too hard. My elbow is still fairly swollen, and I need to give it time to heal a little bit before I can do extensive trigger point therapy. I am also still dealing with a fair amount of pain, and it does not take much to overdo it.  

I have wanted to do more research on arms for quite some time. So I guess this is the perfect opportunity for me. I decided to research the muscles that control extending the elbow. This led me to the triceps. 

Triceps

To me, the triceps are somewhat like a spare bedroom or spare closet in the house. They are useful but they don't seem to get much attention. Because they're located on the back of the upper arm, they are not that noticeable. But there are some very important trigger points in this muscle. 

The triceps is actually one muscle that is divided into three bands. The one on the bottom is wider and the two on the top are narrower. Together, they cover the back of the upper arm. 

There are five main trigger points in the triceps.  (For some good diagrams, see pp. 101-102 in The Trigger Point Therapy Workbook.)


Keep in mind that all of these trigger points are located on the back of the upper arm.  

(1) Triceps number one trigger point is a couple of inches down from the armpit on the inside edge of the arm. It refers pain to the back of the shoulder and the outer elbow. But it can also refer pain to the upper trapezius and the base of the neck, making this a potentially important trigger point when dealing with headaches.

(2) Triceps number two trigger point is located just above the elbow a little to the outside. The muscle is quite thin here, so it does not necessarily feel intuitive to search here for trigger points. Its pain pattern is on the back of the forearm and it sometimes reaches down the entire forearm. It is also a source of pain in the outer elbow, or "tennis elbow."

(3) Triceps number three trigger point is centered about halfway up the back of the upper arm. It causes pain in the back of the upper arm. But it can also cause numbness in the thumb side of the forearm and hand if it presses on the radial nerve. This one was so bad I could hardly touch it when I massaged it today.  So, I am massaging close to it until it settles down enough that I can massage directly on it.  

(4) Triceps number four trigger point is also just above the elbow, but it is located about in the middle.  It sends pain to the elbow, and makes your elbow "hypersensitive" to touch.  

(5) Triceps number five trigger point is an inch or two above the elbow on the inside of the upper arm.  It refers pain to the inner elbow.  It can also refer pain to the inner forearm.  This is sometimes called "golfer's elbow."  

All of the triceps trigger points have the potential to do the following:  

• cause pain in the fourth and fifth fingers 
• cause oppressive sense of achiness in back of forearm and in the triceps 
• weaken the elbow 
• limit bending and straightening of elbow 

Fortunately, the triceps trigger points are pretty easy to massage.  The hardest part is knowing where to find them.  Massage them with a lacrosse ball against the wall or on a table top.