You know the spot.

That stubborn knot between your shoulder blades. The tight place at the top of your shoulder that never seems to completely let go. Or the tender spot in your low back or hip that you keep rubbing, stretching and trying to work out.

Sometimes, that persistent muscle pain may be coming from a trigger point.

What Is a Trigger Point?

Trigger points are highly sensitive, tender areas within tight muscle tissue. You may feel them as a knot or particularly sore spot when you press on the muscle.

What makes trigger points especially frustrating is that the discomfort isn't always limited to the spot you're pressing.

Trigger points can produce referred pain, meaning the discomfort may be felt somewhere else.

Depending on the muscles involved, a trigger point around the upper back, shoulder or neck may contribute to pain that travels toward the neck or head. Trigger points around the hip and low back can also produce pain beyond the immediate tender spot.

That can make it difficult to figure out where your pain is actually coming from.

Why Do Trigger Points Develop?

Trigger points can develop for a number of reasons, including repetitive movement, muscle overuse, injury and prolonged tension.

Think about how much time many of us spend sitting at a desk, looking down at a phone, driving, carrying children, working overhead or repeating the same movements day after day.

Over time, certain muscles can become persistently tight and tender.

And sometimes stretching alone doesn't seem to reach that stubborn spot.

Using a Lacrosse Ball for Trigger Point Relief

One simple tool I often recommend is a lacrosse ball.

Its size and firmness make it useful for applying controlled pressure to a tight muscle without requiring someone else to massage the area for you.

The key word is controlled.

This shouldn't be a contest to see how much pain you can tolerate.

Place the ball between your body and a wall and slowly position it over the tight muscle. When you find a tender spot, stop rather than aggressively rolling back and forth.

Apply tolerable pressure and breathe slowly while giving the muscle time to relax.

Then move the ball slightly and look for the next tender area.

Between the Shoulder Blades

For a knot between your shoulder blades, place the ball between your upper back and the wall.

Slowly move until you locate a tender area in the muscle.

Avoid putting the ball directly over your spine or other bony areas. Once you've found the muscle you're trying to target, hold gentle pressure there and breathe.

Back of the Shoulder

If the discomfort is around the back of the shoulder, you can use the same basic technique to work the muscles surrounding the shoulder.

Place the ball between the back of your shoulder and the wall, then gently shift your body until you find the tender area.

Again, you don't need enormous pressure. Adjust your distance from the wall to control how much body weight you're putting into the ball.

Low Back and Hip

A lacrosse ball can also be used against the wall to work some of the muscles around the low back and gluteal region.

Be especially careful here.

Stay on the soft muscle tissue rather than pressing directly against the spine, pelvis or sacroiliac joint. If you're unsure where you should be applying pressure, don't guess.

Top of the Shoulder

The top of the shoulder can be harder to reach because you can't easily lean backward onto the ball at the correct angle.

Instead, a doorway or open corner can give you a surface to lean toward.

Position the ball over the muscular area at the top of the shoulder and gently lean into it. Small changes in your position can help you find the tight areas without using excessive pressure.

More Pressure Isn't Necessarily Better

One of the easiest mistakes to make with self-massage is assuming that more pain means you're accomplishing more.

It doesn't.

If you're working against a wall, you can easily control the pressure by changing your stance. Move closer to the wall for less pressure and farther away for more.

You should be able to relax and breathe while you're working on the area. If you're bracing your entire body against the pressure, back off.

Know When a “Muscle Knot” Needs a Closer Look

Not every pain in your neck, back, shoulder or leg is a trigger point.

Persistent or worsening pain — particularly pain associated with an injury, significant weakness, numbness, tingling or other concerning symptoms — deserves a proper evaluation rather than increasingly aggressive work with a massage ball.

If the problem keeps returning despite stretching, massage and other things you've tried at home, it may also be worth looking at what is contributing to the recurring tension.

At Advocate Wellness, we look at how the muscles, joints and movement patterns are working together rather than simply chasing the place that hurts.

Sometimes a lacrosse ball is a useful tool.

Sometimes the stubborn knot is telling us it's time to take a closer look.