Pain in the body is a result of some kind of imbalance.
This imbalance can be due to disease, injury, structural limitation, or muscular and fascial tension. When you experience pain in your body, your body is trying to tell you something is wrong, out of balance or at risk of injury.
As therapists, we see the result of tensional imbalance every day with our clients. They come to us to open up their locked tissues and help them to relax. While we are working with our clients, leaning over our tables day after day, we create tensional imbalance in our own bodies.
The torso, the front of the upper body—especially pectoralis major and minor—and the belly, become short and tight over time. The back and posterior shoulders, generally speaking, become long, tight and weak. In the arms, often the biceps become short and tight, while the triceps become long and weak.
The wrist flexors and extensors become dysfunctional as we hold our wrists in an extended position and then load our weight on it, using the heel of the hand for the pressure of the strokes. Even as we try to keep our backs straight, we still lean over a table, putting our erector bundles under constant strain.
Add this all together, and you’ve got a lot of therapists working with chronic tension and often wrist, shoulder and back pain. This is why self-care is so critically important in our profession.
Enter self-massage—with therapy balls and foam rollers—and effective stretching techniques to restore balance. Studies are indicating that the use of foam rollers and therapeutic rolling with balls increases flexibility and range of motion, and decreases pain faster than stretching alone.
Breath and brain
It is helpful to recognize that tension in our bodies is also a result of stress in our modern lives. Chronic pain is stressful. Our lives, our busy-ness, driving and traffic and work all add stress to our lives.
Unfortunately, if we are under chronic stress, as most of us are, it means we regularly engage the sympathetic nervous system—fight, flight or freeze—which feeds muscular tension. Using the breath as a bridge into the nervous system to shift into parasympathetic mode—rest, digest and heal—is invaluable in reducing muscular tension.
As you roll around on your foam roller and balls, you will want to use long deep breaths, breathe into your belly with diaphragmatic breathing, and sink your body on the exhale to foster a shift in the nervous system.
Begin with movement
I recommend starting with some movement of the parts of the body you will be rolling out. Begin with standing up and rolling your shoulders up and down while taking some deep, sighing breaths. Breathe in and lift your shoulders up to your ears, breathe out with a sigh and drop shoulders away from the ears.
Do this several times. Then swing your arms around in big circles and in both directions. Next spend a minute or so just shaking your arms and hands in the air.
Get on the ball
The first thing you will need is a ball, or a few balls. I like to have an assortment of balls available, as some areas respond better to a softer ball and some areas need a smaller and firmer ball to get into the deeper layers, especially in the forearms. A few good balls to have are a tennis ball; a toy play ball with air inside that is about 4 inches in diameter and has some give to it; and a ball about the size of a golf ball but softer. A handball works great for this size; a super bouncy ball can work as well.
You can do an Internet search for therapeutic and physical-therapy balls as well, rather than gathering sports balls.
Breathe into the belly
Stand and breathe, letting your belly get really big on the inhale and softening on the exhale. Do this four times. You will return to this breath as you roll out your tissues.
Roll around on the tissue for about a minute to loosen the fascia, then hold for a couple of breaths on tender spots to release the trigger points in the muscles. Step closer to the wall for less pressure, and farther away from the wall for more pressure. If you feel like you are bruising yourself, back off and use a softer ball. My motto is, “No pain … no pain!”
Don’t try to get every single tender point. When you begin, you will be surprised at how many tender points there are. Just do a few in any given area so you’re not sore the next day. Remember to breathe deeply and keep relaxing as much as possible. Be kind to your body. Err on the side of too little pressure.
Following is a short practice to release the chest, shoulders, upper back, and wrist flexors and extensors to help you care for yourself and keep you doing the work you love.
1. Roll the pectoralis major and minor
Releasing the pecs should come first and is critical to releasing the upper back and shoulders. Our pectorals tend to be very tight so use the softest ball you have at first. Using your larger air filled toy ball, step up to a wall and place the ball between your chest and the wall. Place the ball at the top of the pecs just under the collar bone. Rock your body side to side rolling the upper pecs. Roll around a while then find some tender spots, just one or two, and pause, sink your body and relax, take a couple of breaths, release and move on.
Now move the ball lower an inch or two and repeat the process. You will roll side to side for about a minute, then find a tender spot or two, sink into it, breathe deeply, then move on.
As you get to the central area of one side of the chest, you will find you are going over what feels like a speed bump. This is pectoralis minor. As you find this typically tender muscle, carefully sink into the tenderness there, breathe, then release.
Now turn your body so that the ball can work into the front of the armpit, the intersection of the chest and anterior shoulder. You can roll or pin and stretch; sink into a spot and then do some arm movement while pinning the spot under the ball.
2. Roll the upper arms
Using a smaller, firmer ball, perhaps a tennis ball, begin to roll down the biceps and triceps. Some spots will be very tender.
3. Roll the forearms. To roll the wrist extensors, place your hand along the outer thigh and trap a small ball between your forearm and the wall, halfway between elbow and wrist. Lean in and bend your knees up and down to roll the ball up and down. You will typically find very tender spots in the upper third of the forearm near the elbow.
To roll the wrist flexors, you can place your hand behind your back and trap the ball between your arm and the wall. Then rock side to side for your rolling. Again you will find most of the tender trigger points in the upper third of the forearm closer to the elbow. Find, pause, sink, breathe, release.
4. Roll between the shoulder blades
With a tennis or similar ball, turn your back to the wall, drop the ball between the shoulder and the spine near the bottom corner of the shoulder blade. Bend and straighten your knees to glide the ball up and down. You are treating the trapezius, rhomboids, and even some erector muscle tissue. The middle trapezius will have tender spots on the central line between the spine and the scapula. The rhomboids will hold their spots closer to the scapula. Be gentle in this area. It’s often stretched out long and tends to be very sensitive.
5. Roll the upper trapezius and levator scapula
Roll the ball up to the lower attachment area of levator scapula. You will have to arch your body forward to angle your body so that you can get into this area. Tilt your body slightly toward the side that you are rolling. Rock side to side, bend and straighten the knees and roll the ball all around this upper area of the shoulder, above the shoulder blade. Work across the top and out toward the outer upper corner of the scapula to get all along the top of the upper trapezius.
6. Stretch it out
Once you have done the rolling work, you will want to stretch. Place your hand on the wall behind you, turn away from the wall, pressing your hand into the wall and stretch the pecs. Do some shoulder shrugs and circle your arms as in the beginning of the practice.
Cross your right arm over the front of your body and pull across to stretch the rhomboids and middle trapezius.
Face the wall and bring your palm to the wall at shoulder height then slide your hand down the wall to increase the stretch in the wrist flexors. Flip your hand over and place the back of the hand to the wall, gliding the hand up the wall to increase the stretch in the wrist extensors.
Shake out your hands and arms for a full minute. Take some deep breaths.
Be your best
Sometimes stretching a tight area can make it worse—but just a little bit of targeted rolling and stretching each day will keep you feeling good so you can be the best massage therapist possible.
About the Author
Cat Matlock has been a Trigger Point Therapist specializing in chronic pain since 1993. She instructs in anatomy and kinesiology, and offers continuing education for massage therapists in trigger-point therapy and self-care with therapeutic rolling. She runs a yoga studio in Asheville, North Carolina, where she offers group rolling classes. Check out her new YouTube channel with rolling videos. Read “The Power of Therapeutic Rolling,” here.
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