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Fibromyalgia and Myofascial Pain Syndrome self-treatment: Tennis ball pressure

This is an excerpt from Fibromyalgia and Myofascial Pain Syndrome by Devin Starlanyl.

The use of a tennis ball against the wall to treat TrPs takes practice. It takes time to develop a feel for the right pressure to keep it between you and the wall, and not to press too hard. I’ll help you start and tell you some techniques I developed along the way. Pick a blank wall with a hard surface. Begin by leaning on the ball against the wall, with the ball at least an inch or so away from your spine. Keep your dominant hand lightly under the ball as you press it against the wall with your back until you get the feel of this therapy. When you find a TrP, press on it for 15 to 30 seconds. Avoid compression on any TrP for more than 30 seconds, as it impairs circulation. Then roll the ball a little further out and press on the next TrP ouch spot. Keep your body pressure on the ball as you roll the ball toward the side of your body, stopping to press each ouch spot. Breathe properly as you work the TrPs, and don’t press on too many TrPs the first day.

If you find 10 TrPs by the time you reach the edge of your back on that level, that’s all you do the first day. If you can roll the ball all the way to your side, and if you can keep the ball steady on the wall, work on quadratus lumborum. As with any therapy, start slowly, and adjust your therapy according to how you feel the next day. Drink plenty of good water to help flush out any waste released by the therapy. If you feel fatigued and ache all over, take it easy for a few days before starting again. Listen to your body and let it decide how much therapy you can do every day.

A tennis ball in a knee sock can be useful to get mid-back TrPs. Two tennis balls knotted together in a knee sock can be used as rollers along the sides of your spine, to work those paraspinal muscles. Another good place to start is with the gluteus minimus muscles on the sides of your hips. They are easy to work, and you may be able to roll the ball around the area without dropping it. They often have a lot of very sore TrPs, and a few seconds of light pressure on a few of them may be all that you can handle. You will be able to treat your whole hip and do so more quickly once you have broken up some tight fascial layers. Stop before you have become fatigued.

To work the muscles between your ribs (intercostals), start between your lowest rib and the next highest one. Check the intercostals in the gallery. Your ribs will help keep the ball in place on an intercostal muscle. Work on both sides of the ribs as well as the front and back, but start slowly. Don’t try to cover all of this area in a day if you have a lot of TrPs. The front intercostals are better worked with finger pressure. The diaphragm is attached to several areas of the low ribs. Working those areas is one way to improve breathing.

You can work on the serratus anterior on the side of your body after you’ve worked the intercostal area on the same level, when your body is ready to handle that as well. Once you get comfortable with the technique, you can venture into the area of the rotator cuff. Then you’ll be sideways to the wall at these times and sometimes facing the wall. I’ve found that most of the rotator cuff muscle attachment areas can be worked with a tennis ball, as can some of the triceps brachii. You can look at your arm as you treat it, with part of the triceps leaning on the tennis ball. Any new area of treatment and any new therapy must be approached with caution until you know how you respond. There are too many variables. You aren’t going to be treating all your body every day, although you may be able to hit all the active TrPs.

Therapy on the shoulder blade can be started by placing the ball as high as you can comfortably reach in the back. Press and then start the ball moving again. Or you can place the ball behind your shoulder blade area through a side access. A lot of the trapezius and other muscles can be worked with the ball, although an S-shaped or hook TrP tool can be easier to enable access to some TrPs. Working on the floor against a tennis ball is beneficial for the legs and hips, but it’s harder to control the amount of pressure you have on the ball. Roll on an area once or twice lightly and see how you feel the next day. You don’t have to learn this on your own. You can have the same teacher I had. He wrote a book on TrP tennis ball therapy (Blatman and Ekvall, 2022).

Avoid tennis ball work on the sides of the neck. Your learning fingers may not work those muscles easily. Attachments tend to get tight and neck muscles require proper leverage, which is easier for someone else to have. Some edge muscles, like the SCM, need different tactics. Pincer palpation, using the thumb and first fingers (the tiger mouth) to grasp the edge of the muscle, can do the trick. Pull outward lightly if you can. Start with a light pressure and see how your body reacts. Directions where to start and how are in the gallery. Even if you are in bed on your side, you can access the edges of the top side trapezius, scalene, SCM, and some other muscles, including the muscles under the arm. Some of the muscles are also accessible on the side closer to the pillow. Once your body becomes accustomed to bodywork, it responds more and more swiftly.

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