You know when you’re gliding over a foam roller and all of a sudden, you hit that sweet spot—and by sweet, we mean teeth-grinding, stomach-clenching sore spot?

That’s not just a sore spot, that’s a trigger point—and runners are especially susceptible to them due to the repetitive nature of the sport. Think about the math: A 10-minute mile, for example, consists of 1,700 steps, each one producing ground reaction forces about two and a half times your body weight. That’s a lot to ask of your muscles, and sometimes, they’re going to get themselves all tied up in knots over it—literally.

Here’s how to help them find relief.

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What is trigger point therapy?

Trigger points are knots in your muscles that often form as the result of repetitive overuse (ahem, like the thousands of steps you take over the course of a run). The muscle fibers in these knots, which feel like a nodule or a taut rope, can’t fully relax on their own, and trigger point therapy helps release these knots.

“Think of regular muscle fibers like fresh, hand-made spaghetti noodles lying neatly in parallel,” says Kayla Borchers, a doctor of physical therapy at the Jameson Crane Sports Medicine Institute at The Ohio State University Wexner Medical Center. “A trigger point, on the other hand, is like cooked spaghetti plopped on your plate, all intertwined and knotted together.”

That not only causes discomfort, but it also makes the tightly wound fibers unable to receive proper oxygen and nutrients. As a result, the surrounding nerve endings become more sensitized to the area, which makes you perceive pain or soreness in the area.

“By providing sustained pressure to these knotted muscle fibers, we can help get the fibers to align back into a parallel format, which is ideal for muscle contraction and relaxation, oxygenation, and nutrient absorption,” says Borchers.

There are a couple ways to deliver that sustained pressure.

  • Massage using a foam roller or a lacrosse ball, holding pressure on a trigger point until the nodule starts to break apart
  • Receive a sports massage, which is a more manual kind of manipulation
  • Dry needling, which is a way to get to deeper trigger points that are not as easily released with manual pressure

“Dry needling is nice, because instead of pushing on the top layer of skin trying to affect the underlying muscle and fascia, you can use a needle to slice right through that tissue to break up the nodules,” explains Steve Brown, a certified chiropractic sports practitioner at the Boulder Sports Clinic. “And when you take the needle out, you’ve kicked off this immune response that tells your brain to send healing nutrients to that area to rebuild that tissue in a healthier way.”

Before you freak out about the needles, know this: They’re nothing like what’s used to draw blood or deliver a shot. The “dry” part of the name comes from the fact that they don’t need to contain any fluid, which means they can be super skinny—just like needles used in acupuncture. (But don’t worry! When you’re receiving a dry needling treatment, the needles aren’t left in the body as long as they are when you receive acupuncture.)

FWIW, it hurts about as much as a mosquito bite, he adds (and you’re barely going to feel it in an asymptomatic area, the same way rolling over the looser part of a muscle doesn’t hurt.)

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Why and when should runners try trigger point therapy?

There are no hard and fast rules here: Runners of all levels can benefit from trigger point therapy. But one of the best times to do it is when you’re ramping up demand on your body.

“The more repetitive motion on your muscles, the more maintenance you’re going to need—just like if you drive your car more often, you need to change the oil more frequently,” says Brown. “It’s a great way to maintain muscle and tissue integrity.”

Outside of general maintenance, you should consider trigger point therapy any time you’re experiencing increased areas of muscle tension that result in pain or discomfort, says Borchers. It’s not a magical cure, though: It’s crucial to identify what may have caused the trigger points in the first place.

“[Trigger points often form because of] faulty body mechanics and/or muscle weakness and tissue overloading, and these improper loading strategies need to be addressed in order to prevent subsequent re-injury of the area,” says Borchers. “If you don’t address what caused the trigger points in the first place, you’ll be caught in a constant cycle of feeling the need for trigger point release on a continual basis.”

If you properly address the trigger point, you shouldn’t need ongoing treatment—and your practitioner should be able to do trigger point release at home using a foam roller, tennis ball, or lacrosse ball in order to help address trigger points in the future, she adds.

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Can trigger point therapy help injuries?

“Waiting until the train comes off the rails to try and put it back on is obviously not optimal,” says Brown—which is why your coach is always harping on you to foam roll and do that prehab maintenance work. But trigger point therapy can absolutely help you with injuries—in fact, that’s the primary use of it.

“Let’s say you sprain your ankle,” says Brown. “The muscles around that joint are going to spasm and swell, because they’re protecting it. We can needle the muscles and swelling around that injury to stimulate that healing response.”

This can reduce discomfort caused by increased areas of muscle tension in chronic pain conditions, acute or sub-acute injuries, and post-surgery, says Borchers.

There hasn’t been a huge amount of research done specifically on dry needling, but one small study published in the Journal of Orthopaedic and Sports Physical Therapy in 2011 found that trigger point therapy—in addition to regular stretching—may help relieve plantar heel pain (one of the most common running injuries). Several studies have demonstrated immediate or short-term improvements in pain and/or disability by targeting trigger points, according to a 2014 scientific review published in Physical Therapy Reviews, but the authors noted that more research is needed.

However, there is a placebo effect: Dry needling was associated with decrease in pain compared to sham needling (in which a blunt needle was not inserted fully into the skin) after a half marathon in a study published in 2021 in The International Journal of Sports Physical Therapy. Just believing you’re doing something good for your muscles can be a powerful thing.

Where can I get trigger point therapy?

Good news: You can do things like foam rolling right at home, and many physical therapists and recovery studios and clinics offer manual massage. If you’re specifically looking for dry needling, keep in mind that a specialty certification is required for it, so not all physical therapy practitioners offer this version of trigger point release, says Borchers.

In your search, keep an eye out for physical therapists, osteopathic physicians, chiropractors, and massage therapists. But most importantly, says Borchers, “if you’re seeking trigger point release due to a painful condition, you should seek out evaluation by a physical therapist to better understand the faulty movement patterns or overloading principles that caused the trigger points in the first place.”

If you don’t get to the bottom of what’s causing those knots, you’ll likely be back in the same place within a few weeks.

This content is imported from poll. You may be able to find the same content in another format, or you may be able to find more information, at their web site.