Trigger point & pressure point therapy for your shoulder pain

Trigger points or “pressure points”: which do we use?

Trigger point and pressure points such as acupressure are largely the same points, but the way they are diagnosed and treated can be a lot different.

Pressure points (eg. acupuncture points)

Ancient civilisations found that certain points were associated with various conditions including shoulder pain, and that pressing on them or needling gave relief.

Trigger points

More recently scientists have “re-discovered” these points calling them trigger points, and subjected them them to modern scientific analysis.

The difference between using “pressure points” and trigger points

"Pressure points"

The ancient civilisations had no modern scientific knowledge to enable them to work out what the point were, so made up stories based upon their beliefs at the time (1–6). These stories provide no help in diagnosing which points are involved. For example, how does one measure “life force” running through a meridian to find out where it is blocked? All these systems can tell us is which points are commonly involved, not whether they actually are or not.

Trigger points

On the other hand “trigger point” scientists have identified the physical characteristics of the points so they can be identified, plus better ways of preventing and treating them. Because of this we will be using the “trigger point” system for identification and treatment.

How to find the right points for your shoulders

We will show you a complete list

Clearly, if you use the “common points” approach you will likely treat some that are not involved, but more importantly will not treat a lot that are. In this article we will give you a systematic way to examine and treat all 17 muscles possibly involved. To do this will show you:

• the basic examination techniques, and
• in the section on individual muscles we will show you where to look.

Your basic home trigger point therapies

Trigger point therapy vs release

For practical purposes trigger point therapy and release mean the same, so the terms are used interchangeably.

Specific points an therapy for each muscle

Infraspinatus, Teres Maj. & Min.

We’ll group three of the most important muscles together: infraspinatus, teres minor and teres major. As these diagrams shows they’re at the back of your shoulder blade. In these diagrams the “x”s are the trigger points and the red is where they usually shoot pain. The best way to massage these is lay on your side to put your arm up so the muscles are easy to access.

Trapezius, Supraspinatus

The upper trapezius muscle runs across the top of your shoulder and up the side of your neck. According to the scientists this was the second most common problem muscle for shoulder pain.

The supraspinatus sits underneath the upper trapezius muscle in a groove at the top of your shoulder blade. These are very easy to reach and examine for trigger points. The trapezius is at the top so you can easily start with the flats of your fingers, but supraspinatus is in a bit of a groove so you need to curl your fingers a bit to get to it.

Massage these sitting up, holding the massager with the opposite hand so the muscles I’m massaging are relaxed. If you sit up straight you’ll see the muscle is on slope so you need to grip the massager so it doesn’t slide off, but if you lean slightly across and forward it makes the part more horizontal so it’s a lot easier to hold. What you can do is move over the muscle systematically, giving anything you find a good soak. When you’re to the side over the top of supraspinatus just remember it’s deep and in a groove so give it a good soak.

The middle and lower trapezius ar best massaged sitting, leaning forward.

Deltoid muscles

As these diagrams show they they run from your shoulder to part way down your arm, with part at the front, side and back. These are easy to reach and examine. And the easiest way to massage these is laying on your side. You roll backwards a bit for the front part, on your side for the side part, then forward for the back part of the muscle. Again, work systematically and give anything you find a good soak.

Biceps and Triceps

Now your biceps and triceps muscles are very easy to massage. It sits at the front and back of your arm running from your shoulder to your elbow so it’s very easy to reach and examine. To massage the muscle I just have the massager in the palm of my hand and go over the muscle systematically.

Pectoralis Major and Minor

As these diagrams show the biggest muscle pectoralis major sits on top running from the centre of your chest to the top of your arm, while pectoralis minor sits underneath the outer part running roughly vertical.

Subscapularis

There’s a muscle sitting under your shoulder blade called subscapularis. It normally sits between your ribs and shoulder blade where you can’t get to it, but if you bring your arm up like this your shoulder blade sticks out and you can get to it a bit. With every other muscle I use the flat head on my massager to get the best vibration transfer, but because this one is so hard to get to I use the domed attachment.

What I do is sit the head in there getting the best access I can, and this is where you’ll be really glad you’re using a vibration massager. You’ll never be able to poke your fingers or thumb in far enough to effective massage this muscle, but the vibrations will soak in. That said it is difficult and there are a lot of sensitive structures near there so I definitely recommend getting a professional show you and make sure you are doing it correctly

Scalene Muscles

The last muscles are the scalenes that run deep along side of your neck. The scientists found that these were the least important of the 17 muscles, which is a good thing because I don’t want you self massaging them. They sit on top of sharp pointed parts of your spine right next to some major nerves and blood vessels. Leave these ones to the professionals.

Other things that can help shoulder pain

While treating these muscles can be highly effective (7,9–14)⁠ there can be other issues causing shoulder pain. Please check out the following articles for more information.

Shoulder pain reference articles

Why shoulder pain keeps coming back and what you can do about it
Do exercises help shoulder pain

References

1. Robinson N, Lorenc A, Liao X. The evidence for Shiatsu: A systematic review of Shiatsu and acupressure. BMC Complement Altern Med. 2011;11.
2. Cabo F, Baskwill A, Aguaristi I, Christophe-Tchakaloff S, Guichard JP. Shiatsu and acupressure: Two different and distinct techniques. Int J Ther Massage Bodyw Res Educ Pract. 2018;11(2):4–10.
3. Sun M, Yang M, Rong J, Ma X, Zheng H, Cai D, et al. Trigger points and sensitized acupoints: same book, different covers? Acupunct Herb Med. 2021;1(2):74–80.
4. Dorsher PT, Fleckenstein J. Trigger points and classical acupuncture points: Part 1: Qualitative and quantitative anatomic correspondences. Dtsch Zeitschrift fur Akupunkt. 2008;51(3):15–24.
5. Dorsher PT, Fleckenstein J. Trigger points and classical acupuncture points Part 2: clincal correspondences in treating pain and somatovisceral disorders. Rev Int Acupunt. 2009;62–8.
6. Dorsher PT, Fleckenstein J. Trigger Points and Classical Acupuncture Points Part 3: Relationships of Myofascial Referred Pain Patterns to Acupuncture Meridians. Dt Ztschr f Akup. 2009;52(1):9–14.
7. Bron C, De Gast A, Dommerholt J, Stegenga B, Wensing M, Oostendorp RAB. Treatment of myofascial trigger points in patients with chronic shoulder pain: A randomized, controlled trial. BMC Med. 2011;9.
8. Bron C. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain. BMC Musculoskelet Disord. 2011;12.
9. Gordon CM, Andrasik F, Schleip R, Birbaumer N, Rea M. Myofascial triggerpoint release (MTR) for treating chronic shoulder pain: A novel approach. J Bodyw Mov Ther 2016;20(3):614–22.
10. Sergienko S, Kalichman L. Myofascial origin of shoulder pain: A literature review. J Bodyw Mov Ther. 2015;19(1):91–101.
11. Shih YF, Liao PW, Lee CS. The immediate effect of muscle release intervention on muscle activity and shoulder kinematics in patients with frozen shoulder: A cross-sectional, exploratory study. BMC Musculoskelet Disord. 2017;18(1):1–10.
12. van den Dolder P, Ferreira PH, Refshauge KM. Effectiveness of Soft Tissue Massage for Nonspecific Shoulder Pain: Randomized Controlled Trial. Phys Ther. 2015;95(11):1467–77.
13. Hains G, Descarreaux M, Hains F. Chronic Shoulder Pain of Myofascial Origin: A Randomized Clinical Trial Using Ischemic Compression Therapy. J Manipulative Physiol Ther . 2010;33(5):362–9.
14. Esparza D, Aladro-gonzalvo AR, Rybarczyk Y. Effects of Local Ischemic Compression on Upper Limb Latent Myofascial Trigger Points : A Study of Subjective Pain and Linear Motor Performance. Rehabil Res Pract. 2019 Mar 4;2019