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Who hasn’t spent countless hours on a foam roller or lacrosse ball trying to get rid of those pesky  “knots” in a muscle? Putting ourselves through pain before, during, or after our workouts, and for what? Why are we even doing it? Is it because we saw someone else do it? Is it because someone told us to do it? Is it because we saw it on Instagram or some other social media platform and thought this a good reference for my own pain management? 

To understand how to properly relieve pain, you must understand why you are feeling pain in the first place. For starters, those “knots” are defined as trigger points in the muscle. Trigger points are  hyper-irritable spots in taut bands of skeletal muscle that are painful on compression, stretch, or contraction of tissue. They are usually identified as a small, taught, “ball” within a specific muscle. When pressure is applied to a trigger point, it can cause a painful sensation at and away from the site.  

Trigger points found within muscle can compress local blood vessels leading to lack of oxygen to the  muscle. Lack of oxygen, also known as tissue hypoxia, is the enemy of all tissue and cells in the human  body. When this happens, things go wrong. This itself can cause pain and a perpetual cycle of formation  of trigger points. When we roll on trigger points, we feel pain because compression, stretch, or load to  a certain muscle activates pain pathways to the brain. But this method is not the end all, be all of ridding yourself of knots: there is a better way to remove them than crushing our tissue against the foam roller.  


Enter trigger point dry needling. A skilled practitioner can identify an active trigger point, or a trigger  point responsible for the pain you may be seeking out treatment for, not just a tender area. When pressed, this will usually send pain away from the knot, indicating a problem. This is known as referred pain, a true trademark finding with an active trigger point. A fine filament needle, similar to a needle  used in acupuncture, will then be placed and slid gently into the muscle tissue. If done properly, this will  create a twitch response in the muscle and lead to increased blood flow and a release of this muscle.  

Truly identifying a knot and not normal muscle anatomy is often tricky and likely why some people see great benefits from dry needling and others don’t. The referred pain can be key to identifying who may  benefit most from dry needling with even a single session. These trigger points are important  physiologically because if used incorrectly, they can cause pain and dysfunction of the muscle leading to  lack of strength/power development as well as impair flexibility.  


It is absolutely important to identify and not overlook muscles as the cause of your pain. Only recently I  had a client come in after having her knee injected for lateral knee pain. She was experiencing pain that  caused her to stop walking, hiking and working out. The doctor advised her that she may have a  meniscus tear and may need to limit her activity. But that’s not the end of the pain management  journey: ask a physical therapist, and they will tell you lateral knee pain is a very common complaint and  can often be caused by simple tightness and trigger points amongst other things. After a thorough evaluation, we treated her with trigger point dry needling to her lateral quad muscle and some  stretching and massage afterward. Within two weeks, she was hiking and walking as much as she  wanted, with no pain to speak of anymore.  

Muscle pain and dysfunction are associated with a large portion of reasons for seeking out treatment from a doctor or physical therapist. While trigger point dry needling may not be appropriate for everyone, it is important to consider all treatment options to help you stay healthy and active. Ask an expert and see if trigger point dry needling can benefit you on your journey to optimal health.


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