Tennis Balls for Trigger Points

Photo by biscione.

A friend of mine came to visit at the weekend who has been suffering with pain in the piriformis muscle and referral pain down the sciatic nerve in the leg. She asked me if I could give her any suggestions to help relieve the pain. As well as Epsom Salts baths, and several different stretches, I suggested she use a tennis ball to help relieve any trigger points in the muscle.

I found a great article about tennis ball massage for myofascial pain syndrome a little while ago. The author of the this article, Paul Ingraham, a registered Therapist in Vancouver, Canada says the aim of the tennis ball massage is

"to achieve a “release” by applying just the right amount of pressure: enough to do some good, but not enough to irritate the knot. The sensation should be clear and strong and satisfying, what we call “good pain.” If you are wincing or gritting your teeth, you need to be more gentle. You need to be able to relax."

To release any trigger points in the piriformis muscle, sit on the floor with your legs out in front of you bent at the knees, place your hands on the floor either side of you to support your body. Place your left foot on the knee of your right leg. If you are not very flexible, just lay down flat on the floor with your legs outstretched.

Place the tennis ball underneath the left buttock in approximately the right place.

"You do not have to be precise. “Explore” by moving slowly and gently, until you’ve got just the right spot."

"Once you have adjusted yourself to achieve the right pressure, relax as much as possible and wait for the sensation to fade to about eighty percent of the original intensity. This is the “release” — a change in the physiological state of the tissues, or a “melting” of the knot. This can take anywhere from ten seconds to several minutes."

Do this a couple of times before repeating on the other side or another trigger point if required.

It is a good idea to stretch out the muscle after doing the trigger point work with the tennis ball, so perhaps try out the exercises mentioned in the the Piriformis Syndrome post afterwards.

The tennis ball massage is most effective on triggers points of the upper and lower back but it can be used on any part of the body. It is excellent for myofascial pain syndrome, piriformis syndrome, sciatica, and fibromyalgia as well as general muscle tension and spasms.

Read the full article on Tennis ball massage for myofascial pain syndrome.

Plai – a natural anti-inflammatory

I first heard of Plai essential oil from a fellow Aromatherapist. I totally forgot all about it until I went on an essential oil course with Julie Duffy, lecturer in Aromatherapy at UWIC, where I was reminded of this oil. I learnt a little about it on the course and got to try it out in a massage. I really liked it so I decided to do some research on what the oil is used for and some of this research can be found in this post.

Plai (Zingiber cassumunar Roxb.) belongs to the same plant family as Ginger but instead of it having a warming affect on joints and muscles like Ginger, it actually has a cooling affect on them helping to reduce inflammation.

There has been a lot of research in to the efficacy of Plai as an analgesic and anti-inflammatory when applied directly to the affected area. The majority of this research has been carried out in Thailand as this is where the plant originates from and it is used extensively in Thai massage and herbal medicine.

In one research study, the anti-inflammatory activity of a compound found in Plai extracts was assessed and compared with aspirin, and two other lesser known anti-inflammatory drugs. The results obtained showed that the anti-inflammatory effect of the compound (compound D) mainly occurred in the acute phase of inflammation. (Panthong, A et al., 1997). Another study compared another compound found in Plai extract with the anti-inflammatory drug Diclofenac and found that when applied directly to the affected area, it was twice as potent as Diclofenac (also known as Voltarol). (Pongprayoon, U, et al., 1997). A gel containing Plai was tested on 21 subjects with wounded ankle joints and was compared with a placebo gel. The Plai gel was shown to reduce swelling and pain significantly in the first 2-3 days of the treatment. (Laopatarakasem et al., 1993). Since 1997 when the first two of these studies were published, there have been numerous more studies highlighting Plai’s anti-inflammatory and analgesic properties.

As an anti-inflammatory and analgesic, Plai can be used to help joint problems, inflammation, sprains, strains, sciatica, arthritis, rheumatism, muscular aches and pains, piriformis syndrome, bursitis, tendonitis, gout, bunions, muscle spasms, and torn muscles and ligaments.

Just add 20 drops of Plai essential oil to 10ml of carrier oil and massage in to the affected area. It can also be applied directly to inflamed joints undiluted but take caution with this especially if you have sensitive skin as it could cause irritation. If you have a reaction to the undiluted oil, wash off immediately and use diluted in future applications. When applied undiluted, Plai has been found to ease pain for upwards of 18 hours which makes it a lot more affective as an analgesic than any over-the-counter drug, with less side affects, and a lot cheaper too!

Besides its anti-inflammatory and analgesic properties, Plai is also anti-histamine, anti-neuralgic, anti-viral, anti-fungal, anti-bacterial, antiseptic, antispasmodic, carminative, digestive, diuretic, febrifugal, laxative, and rubefacient. I will discuss some of these other properties and uses in future posts.

Plai essential oil is an invaluable addition to my aromatherapy kit and it takes its place along side Lavender and Tea Tree in my home first aid kit!

The citations for the studies mentioned above are listed below:

Anti-inflammatory activity of compound D {(E)-4-(3',4'-dimethoxyphenyl)but-3-en-2-ol} isolated from Zingiber cassumunar Roxb., Panthong, A; Kanjanapothi, D; Niwatananant, W; Tuntiwachwuttikul, P; Reutrakul, V. Phytomedicine (1997) 207- 212.

Topical antiinflammatory activity of the major lipophilic constituents of the rhizome of Zingiber cassumunar .2. Hexane extractives, Pongprayoon, U; Tuchinda, P; Claeson, P; Sematong, T; Reutrakul, V; Soontornsaratune, P. Phytomedicine (1997) 323- 326.

Efficiency of “Plai Gel” (PlaiGesal) in treatment of wounded ankle in asthlics. Srinakarin Medical Bulletin, 8(3) Mokkhasmit, M., Ngarmwathana, W., Sawasdimongkol, K. and Permphiphat, U., 1971, Pharmacological evaluation of Thai medicinal plants. J. Med. Assoc. Thailand, 54: 490-504

Piriformis Syndrome

The piriformis muscle runs from the back of the femur (thigh bone) to the sacrum (base of the spine). It lies deep below the gluteal muscles of the buttocks. It assists in abducting and laterally rotating the thigh.

Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve, causing pain in the buttocks and referring pain along the course of the sciatic nerve which runs down the back of the leg right down to the foot.

The sciatic nerve usually passes underneath the piriformis muscle, but in approximately 15% of the population, it travels through the muscle. This anatomical variation, as well as overuse, injuries, and tension, can result in piriformis syndrome causing inflammation of the muscle which in turn irritates the sciatic nerve.

To help relieve the pain associated with piriformis syndrome, stretching of the piriformis muscles should be performed several times a day. This can be combined with physical therapy such as Deep Tissue Massage to help reduce inflammation, release any trigger points in the muscle, and speed up healing. Using hot and cold compresses on the area can also help to reduce pain.

To stretch the piriformis muscle, lie on your back and cross the involved leg over the other. With both knees bent, place both hands together under the knee of the other leg (the lower leg), and gently pull the bottom leg toward your chest and hold both thighs closely until a stretch is felt in the buttock area. Hold for 30 seconds and repeat on both sides.

The stretch outlined above and the picture were sourced from spine-health.com.