Self treatment for a trigger point using a ball.

Patrick writes: After looking at some of the Sock-Doc’s videos on the Natural Running Center site and trying to find out how to deal with some pains on both the inside and the outside of my right knee, it appears to me that there is similarity between Dr Gangemi’s methods and Trigger-Point Therapy.  Is this accurate?  Would it be worthwhile having somebody mention the pros and/or cons of trigger-point therapy on your website?  I am using the foam roller and the stick and it seems after one week to be helping my knee.  However, at the moment there are too many variables to consider for me to confidently attribute my improvement to the massaging I’m doing of different areas on my quads and buttocks.  Of course, I hope that does explain my improvements as these are chronic problems for me.

Sock Doc replies: The trigger-point therapy (which is the term I use often in my articles and videos) is the same type of trigger-point therapy that many other therapists use. Some also call this origin-insertion technique. The benefits are primarily that it helps re-align muscle fibers so they may begin to heal, and it is also suspected that it may help with inflammation, perhaps much like compressing an injury can be of benefit. I also believe that when using trigger point therapy on an old or chronic injury that it’s also making your body aware that there is an injury present, and needs to be dealt with; it’s much like your body has compensated as to forget that there is still an injury present affecting you though there is no acute pain.  I see many patients with patterns of injuries that are not healing because their body essentially doesn’t recognize that there is a problem anymore. It’s difficult to explain, but when you’re injured certain aspects of your nervous system respond a certain way. When they don’t respond correctly, you don’t heal properly – or at all. For example, you may have injured your shoulder in the past and no longer have pain there. Now, months or years later say you have a pain in your hip due to a gait imbalance from that old shoulder injury on the opposite side of your body. This is actually very common, and the hip problem will not be resolved until you deal with the shoulder issue, perhaps via a trigger point in a muscle in that region.

The cons of trigger-point therapy? I’d say zero unless you have a therapist who doesn’t know what they’re doing and is just beating the hell out of your muscles and actually creating new injuries.

The other important factor to understand is that the trigger point is there because of some muscle imbalance. If you correct the trigger point, you may or may not correct the muscle imbalance. If you don’t, you won’t see much, or any, positive response. The muscle imbalance rarely occurs from the trigger point – it comes from some other problem related to stress. Too much physical stress (injuries, poor footwear), chemical stress (poor diet, nutrition) and emotional stress (poor sleep, work, commitments) create muscle imbalances, which in turn creates pain, injuries, and the trigger points. So working on the trigger points is part of the overall therapy in resolving the injury, but it is often not the only part of it. If you don’t correct the underlying problem, your trigger point work will provide no benefit or you’ll always feel the need to constantly be working the points out.