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Treating Trigger Points

It’s been a long 24-hour shift and your neck and shoulders are really tense. On that last call, you noticed that your lower back was stiff and sore. In the back of your mind, you are hoping that old nagging injury is not going to rear its ugly head again.

Responders, we have all seen what the statistics show — our chosen career is hazardous to our bodies. Assuming that you have been following my articles for the past year, a basic understanding of postural distortions and their effects on your body should be in place; if not, you’ve got some reading to do! Over time, as we are exposed to poor postural positions, repetitive strain movements, faulty mechanics, stress, and improper exercise, our muscles begin to change. The negative stress placed upon us causes some protective but eventually deleterious changes. We have all felt these changes in the form of stiff and sore muscles, achy joints, and pain. Yet for many of us there is no memory of a specific injury that occurred; we just started to hurt.

Trigger points (TPs) are described as hyperirritable spots in skeletal muscle associated with palpable nodules in taut bands of muscle fibers. Compression of a trigger point may elicit local tenderness, referred pain, or a local twitch response. The problem with TPs is that you cannot stretch them (because they are too fibrotic) and if they cannot be stretched, they tend to cause pain and restrict movement, making it necessary to eliminate them.

One of the tenets of the ‘Fit Responder’ program and book is the notion that without an understanding of your body and how it moves, you will not be able to feel or understand when it is not working properly. Self-massage is a simple and excellent way to both treat and prevent the development of new TPs, and all you need is a tennis ball and a wall. A tennis ball is a great tool and serves a variety of purposes. First, it can be self-diagnostic, allowing you to find your own trigger points to assess where the dysfunction lies. Second, it plays a valuable role in self-treatment by enabling you to massage and release the TPs to restore your range of motion and decrease pain. Lastly, a tennis ball makes a good exercise tool to play wall ball or engage in some reaction drills.

With the use of a self-massage ball, you can break up these adhesions as well as stimulate the muscles to relax, allowing increased elongation of soft tissue. This is a very effective form of flexibility training that, when performed consistently and correctly, can have lasting effects. All responders are familiar with the aches, pain, and stiffness that occur with prolonged sitting, making the massage ball the perfect answer. The ball takes up almost no space in your bag and can be employed to relieve stress and strain of all kinds.

Self-massage techniques can be painful over some areas of the body, especially the outer thighs and lats. Always use caution to not apply too much pressure, and avoid direct pressure over joints and bony prominences. This technique should allow you to identify and address areas of the body that cause discomfort and limit performance. Focus on controlled breathing and allow the trigger points to slowly release before moving on to the next point. This process takes time, so be patient. Performing a self-massage routine prior to a workout is a great way to loosen up the muscles and get them prepared to work.

Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.), has dedicated over a decade to changing the culture of EMS from one of pain, injury, and disease to one of ergonomic excellence and provider wellness. He has leveraged his 15-year career in sports medicine, athletic training, spine rehabilitation, strength and conditioning and as a paramedic to become an expert on prehospital patient handling/equipment handling and fire-EMS fitness. His company, Fit Responder, works nationally with departments to reduce injuries and improve fitness for first responders. Contact Bryan at bfass@fitresponder.com.

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