Lacrosse Ball Trigger Point Exercises

At Therapydia Denver, every patient receives one-on-one hands-on treatments. Our PTs are certified in manual therapy and these techniques allow us to mobilize the joints and muscles as well as release trigger points. Trigger points are areas of adhesions within soft tissue resulting from trauma or overuse and can lead to ineffective movement and pain. In addition to hands-on manual therapy techniques, all our PTs are also certified in dry needling – a great way to release trigger points.

The goal of each physical therapy visit is to restore proper length tension relationships of soft tissue and enhance normal joint mechanics for proper function. Our patients can replicate some of these myofascial release techniques at home with the use of a lacrosse ball applied to trigger points in tissue. We like lacrosse balls because they can get into those hard to reach places foam rollers may miss. Below are a couple of lacrosse ball exercises we recommend for our patients:

pec-trigger-point-massage

PECTOLARIS MINOR

  • Great for posture correction and for patients that sit at a desk or computer all day
  • Picture on left demonstrates a less aggressive pec minor release
  • Picture on right is slightly more aggressive for those stubborn trigger points in the pec muscle
  • Trigger point is typically found an inch or two below the collarbone and just to the inside of the shoulder
  • Be careful not to place ball directly on the front of the shoulder.  This is where the biceps tendon is located and can get irritated from the pressure.  This will typically feel like a sharp pain if you are on the tendon vs an achy sensation on the trigger point.
  • 10-90 second hold, repeat 1-3 times, 1-2 times per day

hip exercise

TENSOR FASCIA LATAE

  • Find boney point in front of hip (ASIS) and move ball 2-3 inches down and to the side
  • Lay on side and apply sustained pressure with ball to the muscle
  • Duration of pressure depends on how long it takes for muscle or trigger point to “release”
  • Release of the trigger point can usually be felt when there is a significant decrease in the intensity of the pain from the pressure of the ball
  • We typically tell patients that the intensity of discomfort should drop several points on the 0-10 pain scale
  • For example, if discomfort is 8/10 on the pain scale, then hold the pressure on the trigger point until the pain drops to at least a 3-4/10
  • This can take anywhere from 10 – 90 seconds

calf tightness exercise

CALF

  • Place one calf on ball and cross opposite leg over the top
  • Locate tender trigger point and hold sustained pressure
  • Gently pump bottom ankle up and down for more aggressive trigger point release
  • Again hold pressure until there is significant change in intensity of symptoms
  • 10-90 second hold, repeat 1-3 times, 1-2 times per day

 

rotator cuff releas

ROTATOR CUFF

  • Locate tender trigger point(s) in back of shoulder, specifically on back of shoulder blade
  • Start with arm externally rotated (picture on left)
  • Maintain pressure on trigger point as you rotate shoulder into internal rotation (picture on right)
  • There are several trigger points in the back of the shoulder/shoulder blade so more than one point may need to be treated to address symptoms
  • These trigger points tend to cause radiating pain into front of shoulder and/or down the arm so don’t be surprised if ache is felt in areas other than where the ball is placed.
  • 10-90 second hold, repeat 1-3 times, 1-2 times per day

lacrosse-ball-plantar-fasciitis-therapy

PLANTAR FASCIITIS

  • Place the lacrosse ball under the arch of your bare foot and begin rolling.
  • Roll the ball in multiple directions
  • You should feel instant relief from tight arches. (Image source: Shape)

INTER-SCAPULAR

  • Place lacrosse ball in between scapula and spin
  • Add movement of the arm into flexion overhead and back down to the hip for several reps, encouraging more upper thoracic extension at end range shoulder flexion.
  • Move lacrosse ball to multiple locations left and right side of spine with short duration holds of pressure

Summer Knee Pain? Trigger Point Dry Needling May Be The Solution.

run assessment denver

Summer in Colorado brings warmer temperatures, longer days and inevitably more time spent outdoors. Many Coloradans choose to take advantage of summer by hiking or running on our vast network of urban and mountain trails. Oftentimes, this increase in miles traveled on our feet can lead to pain in and around the knee, specifically the kneecap. This pain is technically termed patellofemoral pain syndrome, but is commonly referred to as hiker’s or runner’s knee.

How Do I Know If I Have Hiker’s Or Runner’s Knee?

Another sign that you may be at risk for developing hiker’s or runner’s knee is a knock kneed (valgus) position during activities like squatting or walking up or down stairs. This position makes it more likely that your knee will become irritated or painful. The hallmark sign of hiker’s or runner’s knee is pain around or under the kneecap. This pain is usually worsened with squatting and walking up or down stairs or hills.

runner knee signs

 

Image credit: http://what-when-how.com/

What Is Patellofemoral Pain Syndrome?

Patellofemoral pain refers to pain arising from excessive or faulty contact between the kneecap (patella) and the bottom portion of the thigh bone (femur). The patella lies in a groove between two rounded portions of the bottom of the femur.  It is essentially like the patella is sitting in a valley between two hills.patella pain running

During weight bearing activity where the knee is bending and straightening (such as walking, hiking or running), the patella glides up and down in the valley between the hills. If the patella does not glide perfectly in the valley, it may grind awkwardly on one or both of the hills.  This grinding causes irritation, popping, pain and sometimes swelling.

What Causes Patellofemoral Pain Syndrome?

The patella is a sesamoid bone, meaning that it is suspended between two tendons rather than being attached to another bone by a ligament. The top portion of the patella is connected to the quadriceps tendon, which then attaches to the quadriceps muscle group. The bottom portion of the patella is connected to the patellar tendon, which then attaches to the shin bone (tibia).  This unique arrangement allows the patella to be pulled one way or another based on variability in muscle strength and flexibility.

patellofemoral dry needling

Image credit: http://physioworks.com.au/

The most common strength/flexibility issue leading to patellofemoral pain involves weakness in muscles on the inside of the thigh (vastus medialis obliquus) coupled with tightness in the muscles and tendons on the outside of the thigh (vastus lateralis, iliotibial band).  This weakness on the inside and tightness on the outside pulls the patella to the outside, causing it to grind up on the lateral hill rather than gliding perfectly in the valley.

Another common flexibility issue leading to patellofemoral pain involves tightness in the muscles on the back side of the thigh, also known as the hamstrings. Tightness in the hamstring group pulls the shin bone backwards, thus increasing the amount of force with which the patella is sitting in the valley. This increased force can lead to grinding and irritation between the patella and the femur, even if it is gliding in the correct portion of the valley.

How Can Trigger Point Dry Needling help?

Trigger Point Dry Needling (also known as functional dry needling or intramuscular manual therapy) involves inserting a tiny filiform needle into a taut band of muscle tissue, also known as a trigger point.  This causes the muscle to momentarily cramp and eventually release.  This treatment option is extremely effective in releasing muscle tension and restoring normal flexibility and function rapidly.

When addressing patellofemoral pain, releasing muscle tension and restoring normal muscle flexibility can decrease the likelihood that the patella will be pulled out of the valley and cause grinding, irritation and pain.  Releasing tension in the hamstring group can help decrease the amount of force with which the patella is pushing into the valley.  Coupled with specific strengthening and stretching exercise as prescribed by your Physical Therapist at Therapydia, Trigger Point Dry Needling is an effective tool in combating knee pain in hikers and runners.