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Self-treatment - (Massage Ball, Trigger Point Therapy)

As with foam rollers, when used correctly (see foam roller article), the use of massage balls for self trigger-point therapy can produce some good results. In fact, massage balls and foam rollers can prove an extremely beneficial addition to ones self-massage and self-maintenance routine. However, massage balls and foam rollers work on different massage principles. Unfortunately, not all of those people using or instructing in the use of foam rollers, massage balls or trigger point therapy techniques have any form of massage training and in some cases little to no training in anatomy or physiology.  Hence, it is common to see the incorrect use of foam rollers and massage balls, based on the massage techniques these tools attempt to replicate.  Although, self-massage methods can be quite useful they will never be as good as or replace the effectiveness of a good massage therapist. Furthermore, it is not possible to effectively self-treat all areas of the body, due to the limitations of the application of techniques in a self-context. Hence, even the author has to seek regular treatment between 4-6 weeks, and top-level athletes seek treatments far more frequently.

Foam Roller vs Massage Balls and Trigger Point Tools

The use and action of Foam Rollers is based on techniques from Sports Massage, such as stripping and petrissage. Massage balls and trigger point therapy tools have their origins in soft tissue techniques such as acupressure, trigger point therapy (TPT) and NeuroMuscular Technique (NMT). These three methods have many similarities in the way they are applied. To save confusion, the remainder of this article will use the term trigger point to cover acupressure, TPT and NMT. Many TPT tools were designed to reduce loads on the therapists hands, with some adaptions of self-treatment usage.


Examples of Trigger Point Therapy Tools
Example of typical Trigger Point Therapy type tools

Not only are Foam Rollers and Massage Ball’s shaped very differently but the techniques that they designed to replicate work in very different ways too. As with Massage Therapy, a Massage Therapist has training in multiple techniques or tools. Good Massage Therapists also know when to apply each method and under what circumstances. If a Massage Therapist were to pick the wrong treatment modality, then they could cause damage or make symptoms considerably worse for an extended period. The same rules around techniques and the application of them apply to home users of Foam Rollers and Massage Balls. Therefore, please do be careful before using a Foam Roller or Massage Ball, as you can make things worse. There are also contradictions to any form of Massage Therapy, even self-massage and one should check that it is safe to perform self-massage, before embarking on self-treatment. If in any doubt, please do consult a suitably qualified professional before any self-treatment. There are almost as many variations of massage balls and TPT tools, as there are of foam rollers.


Examples of self-treatment Massage Balls
Examples of typical Massage Balls


Muscles Spasms / Cramps Considerations

In essence, it is not usually a good idea to attempt to stretch a muscle that is in spasm/cramping. Tissues can go into spasm as protective (bracing or splinting) measure, due to a perceived risk of tissue damage control. Muscles can also “spasm or cramp” for other reasons including lack of fluids, vitamin and mineral deficiencies, over-shortening or extending tissue structures and other medical conditions. When the muscles are in “spasm or cramping” the fibres within the muscle tissues become highly contracted, which can prove very painful. Hence, apply force to lengthen these structures tends to result in further muscle contraction (a protective measure), more pain and even tearing of muscle fibres. Foam Rollers effectively stretch muscles and other underlying tissues and so tend NOT to work well with muscle spasms or cramps. One can use Massage balls in two ways; similar to a Foam Roller or as a means of applying self-trigger point therapy. Trigger point therapy techniques in effect shorten a section of muscle fibres, which in turn can create a relaxation of the muscle fibres. The exact mechanisms regarding how all of this works are far from being completely understood, yet the author can see common links with Positional Release Technique (PRT) and Dry Needling.

Massage Ball Versatility as a Roller and for TPT

Massage Ball’s have the versatility of being able to apply many techniques, though generally over small areas or smaller muscles. As with a Foam Roller, it can often be quite tricky using a Massage Ball correctly. As with massage, techniques work best when muscles are not under load. When one is lying on a massage bench, the muscles are not under load. Tissues will react to pressure too, which is why so many people view Sports Massage as painful, though it does not have to be. A therapist can either work with the patient’s body or fight it. Fighting the patient's body tends to thoroughly unpleasant and painful for you the patient. Too much pressure can hurt, due to the muscles tensing and this cycle continues as the therapist beats the muscles into submission, all completely unnecessary. Pain is also one of many “stressors” which can then initiate the body’s “fight, flight or freeze” response (see article on "stress").

Self Trigger Point Therapy basics

Trigger Point Therapy can be applied quite easily to many areas of the body such as the legs and arms. As with self Foam Roller massage, the application of the TPT technique ideally requires the tissues to be an unloaded position. One may have to get creative with towels or pillows to hold the body in a position that enables muscles to be as relaxed as possible during treatment. One would then apply the Massage Ball or TPT tool to the affected area and then just try and relax. There is no need to roll the TPT ball or device around or move the tissues during treatment. In theory, pain in the area being treated should either maintain or start to drop off within the first 12-20 seconds of applying the technique. If pain, just keeps increasing then there is a good chance that there may be some acute tissue damage present and one should stop self-treatment and seek professional advice. Provided that the tissues have somewhat released, one can then reapply the technique to other areas. It is possible to overwork tissues too, as in Massage and so it is worth spending a few minutes or less per treatment area. Massage Balls can also be used similarly to a Foam Roller. Unlike a Foam Roller, Massage Balls are great for treating smaller areas of tissue and are a better shaped for treating such muscles than a Foam Roller. The principles for safely using a Foam Roller, equally apply to using a Massage Ball like a Foam Roller.

In Summary
  • It is always worth seeking advice from a suitably qualified professional before embarking on self-treatment.
  • Avoid self-treatment if you meet any of the standard contraindications for Massage Therapy of any kind.
  • Do not treat tissues which are inflamed, bruised or cut.
  • Avoid applying to much pressure to tissues when self-treating (a rough guide discomfort is ok, though pain is not).
  • Avoid treating muscles that are under load additional load.
  • Avoid overworking tissues, which can result in additional pain, bruising and inflammation.

Article written by Dr Terry Davis MChiro, DC, B.Sc (Hons), Adv. Dip. Rem. Massag.,  Cert. WHS.
TotalMSK  
The Corporate Wellness, Musculoskeletal and Chiropractic Specialists
www.totalmsk.co.uk


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