Massage is a very commonly used technique for muscle aches and pains, and can be done yourself, or by a professional. Once again, regularity is important. Once a week for a month or two is likely not enough, I had 2-3 treatments a week for over 6 months, by a professional massage therapist.

I found that deep massage on very painful TPs did not help, and could make them worse. At this stage other techniques were more appropriate, although light, non-painful massage can be relaxing, and perhaps indirectly help relax the TP. Deep massage is good when the TPs are mild.

Light massage relieves pain by increasing blood flow and stimulating the touch receptors in the skin. This second effect is why we feel the compulsion to rub an banged elbow, or recent injury, the rubbing sensation felt replaces the pain. Although this sort of massage can be great for easing stress and providing temporary pain relief I found that it produced no long term benefits.

Instead, deep hard massage is the way to break up the scar tissue, loosen up the muscle and promote healing. Such massage is, particularly in the beginning, very painful. That said I found a certain satisfaction in, so to speak "beating the shit" out of one of my TPs. According to the Acupuncturist I was seeing such massage actually damages and breaks down muscle tissue, and should not be overdone. I would occasionally get bruising on my arms from his work. This breaking down of the muscle can also cause an increase in muscle weakness, so should ideally be combined with exercise to promote recovery and rebuilding of the muscle. Deep massage, particularly on the shoulders and hands, requires considerable strength. I tried out many physiotherapists and other treatment professionals, and found that many of them were unable to massage hard enough to properly reach some of the deeper muscles. In particular I did not find anyone able to get at the muscles in the hands properly, and ended up treating this area myself.

This last paragraph may sound a bit masochistic, and as if I am talking about inflicting even more damage on already damaged areas. However, I found that deep hard massage was the only way to make real progress with my condition, and a treatment professional with a bit of strength behind them helped greatly.

Applying massage yourself

It is very satisfying to work on your trigger points yourself. However, if your arms and hands are sore already the activity involved in massaging one area can make another area worse. I solved this problem by using some, probably rather strange sounding, methods.

Forearms

This can be done by using the knuckles of one hand applied to the other forearm. To apply pressure place hand and forearm between your knees. Use knees to push knuckles into arm, whilst using shoulder to pull / push forearm along against the knuckles.

Hands

Another approach is to find some inanimate object which you can lean the affected body part against, and using a suitable lubricant (oil or moisturiser) massage the area using your body weight to apply the pressure. I used this approach for my hands. I had an old ten speed pair of handlebars. I placed these in a vice and used the rubber brake hoods as a massage surface. They were of the type that have the brake cable running internally, and the rubber point at the top was particularly good for getting into the small places like the interossei. I would lean one palm on this, with the other hand on top to apply pressure. After a bit of practice it worked very well, and no treatment professional I visited was able to give as good a hand massage as I could myself. I found it still took quite a bit of effort to properly get into the nooks and crannies in my hands.

When performing massage on myself I found it important to take regular small breaks or micropauses. Every couple of mins I would rest, stretch and relax. Otherwise the exertion involved was likely to reactivate other TPs.

It is important not to overdo this. I would perform this massage on myself every one or two days, and now feel that this may have been too often. It may not have given the areas enough time to recover in between the massages. Especially for the very deep, hard massage.

Stretches are also very important. I had collected a large list of them from books and handouts from treatment professionals. I would go through this list several times a day, especially after exercise or treatment. I found it important to concentrate on doing the stretch correctly and smoothly, trying to extend yourself. It is easy to get into the habit of going through the motions.