Common Trigger Points

Trigger points are contracted knots in muscle tissue. They can make a muscle feel both tight and weak. The tightness in the muscle can often be felt as pain in adjacent joints. The constant tension in these trigger points cause reduced circulation to the affected muscle. Metabolic waste products accumulate and are not removed efficiently. Likewise, oxygen and nutrients do not get to the area as well. This can perpetuate a vicious and painful inflammatory cycle which can go on for months (sometimes years) if nothing is done about it. The most distinguishing characteristic of trigger points is that they usually refer pain to another part of the body, which often throws many people off (including most doctors). Referred pain is a physiologic phenomena which occurs in predictable patterns for almost everybody.  A simple way to put it is that pain information converges at the spine and is displaced in consistent patterns around the body.

In the Wellness Center we use self massage methods and stretching to work with the properties of the muscle tissue in alleviating the trigger points. They don't go away on they're own--you have to physically intervene with them.  Below are some of the more common problems we see and ways to work them out.

Often times a little massage and stretching can take care of the trouble. Sometimes a trip to the doctor or orthopedic specialist is needed. It never hurts to check for trigger points first.

One of the best methods of treatment we have found is to do 3-4 alternating rounds of massage for 45-60 seconds and then stretch for 45-60 seconds. A little trigger point massage goes a long way. It is best to massage for only a few minutes and then leave alone for awhile. "Over massage" can make things worse. Find the most sensitive spot and put as much pressure on it as you can stand. Massage in a small rolling pattern over the spot. Remember, you're trying to mush the tight fibers apart and pump more blood into the area. Simple tools are used--tennis balls, foam rolls, roller stick and your fingers. If you want to know where to get some of the stuff, go to the links section of this site. Have fun!

Illustrations below are from Clair Davies excellent Trigger Point Therapy Workbook--everyone should own a copy.


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Achilles Tendon

What it feels like:

Sore and tight achilles tendon.


tibialis posterior trigger point and referred pain pattern

Tibialis Posterior


Put as much pressure on the tight spot as possible and roll.



Drop heel and feel the stretch. Experiment with knee locked and unlocked.

Calf Cramps

Feels like: Similar to above but pain sometimes is down around the bottom of the heal and foot.




Same as above


Same as above

Patellar Pain

Feels like: Pain in, around or under the kneecap. Sometimes sensitve around the edges of the kneecap, above and below.


Rectus Femoris


Fish around at the top of the thigh.


Keep torso upright, extend the affected leg back. Dip hip down toward the floor. Feel the stretch in the front of the thigh, below the hip.

IT Band and tensor fascia latae:

Feels like: Pain on the outside of the knee below the kneecap (to the outside). Can also feel like a deep ache behind your hip.


IT band


Roll the side of the thigh.


Press down on the knee of  affected leg.

Inside of Knee

Feels like: Pain in and around the inside of the knee.









Roll the inside of that leg.


Not a lot of effective stretches for this area. You may want to try the above stretch for kneecap pain.

Low Back

Feels like: Pain in lower most part of the back and across the tops of one or both hips

 buttocks trigger points and referred lower back pain







External Rotator


Cross the foot of the side being massaged over the opposite (support) leg. Roll that butt.


Keep opposite shoulder on the floor. Experiment with knee angle of the leg being stretched. Find the position (closer to the chest or further away) that gives the  most stretch.

Rotator Cuff

Feels like: Pain in the front or side of the shoulder.

 trigger points in the infraspinatus muscle of the shouder

referred pain pattern from trigger points in the infraspinatus muscle

Rotator Cuff


Fish the shoulder blade for the hot spot.


The lower hand is the shoulder being stretched. Pull the lower hand up higher with the upper hand.

Bicep Tendon

Feels like: pain in the front of the shoulder.


Bicep Tendon


Massage the tender spot.


Reach back behind you, make a fist with your palm facing the floor. Step away from the wall and let your wrist bend sideways. Arm is straight.

Levatator Scapulae

Feels like: Stiff neck, can't turn your head to one side.

Levitator Scapula

Press the ball against the wall and move in small circles.


Keep shoulder low on the side you are stretching. Tuck your chin in at an angle and gently pull your head to the side and down.

Tension Headache:

Feels like: Headache behind the head, behind the eye. Sometimes accompanied with blurred vision, flashing lights, dizzines, etc.

 trapezius trigger point and pain pattern

trapezius trigger point and pain pattern



Squeeze that lump in your trapezius.



Keep your shoulder low on the side you are stretching. Gently pull head to the side.





Getting rid of the pain and working out the trigger point is one thing. Figuring out why it occurred or keeps occurring can be a little trickier. That's where a conversation with a Wellness Center staff person may be helpful.