EPHYT

Periscapular Trigger Point Release (Holding)

Equipment Required

  • A wall
  • A tennis ball, hockey ball, or golf ball

Movement Execution

  1. Stand with your back to the wall and place the ball between the wall and the target area near your shoulder blade (periscapular region).
  2. Lean into the ball to apply gentle pressure on the trigger point.
  3. Hold the pressure steady on a tender spot for 20–30 seconds until you feel a release or reduction in tension.
  4. Adjust the ball’s position slightly to address different areas of tightness around the scapula.
  5. Use your legs and body weight to control the amount of pressure, ensuring it remains tolerable and non-painful.

Proprioceptive Cues

  • Keep your shoulders relaxed and avoid tensing the surrounding muscles.
  • Focus on deep, diaphragmatic breathing to enhance the release.
  • Visualize the muscle relaxing and softening under the pressure.
  • Avoid leaning too hard to prevent excessive discomfort or bruising.

Common Cheat Movements or Mistakes

  1. Overpressurizing: Applying too much force, leading to unnecessary pain or discomfort.
  2. Misplacing the Ball: Positioning the ball over bony areas instead of the soft tissue.
  3. Short Duration: Not holding the pressure long enough for an effective release.
  4. Tension in the Upper Body: Keeping the shoulder or neck tense instead of relaxed.

Sets, Reps, and RPE

  • Beginner: 2–3 sets of 20–30 seconds per trigger point at RPE 3–4.
  • Intermediate/Advanced: 3–4 sets of 1 minute per trigger point at RPE 4–5, ensuring steady, controlled pressure.

Progression or Variations

  • Increased Intensity: Use a harder ball (e.g., lacrosse ball) for deeper pressure.
  • Dynamic Release: Add small, controlled movements of the shoulder blade (scapular protraction/retraction) while holding the trigger point.
  • Seated Variation: Perform the exercise seated against a chair or wall for added stability.
  • Active Shoulder Movement: Combine the release with gentle arm stretches to further improve mobility.

Why Perform Periscapular Trigger Point Release as an Exercise?

  • Reduces muscle tension and pain in the periscapular region, improving function.
  • Increases scapular mobility, essential for healthy shoulder mechanics.
  • Enhances recovery by releasing myofascial adhesions.

Clinical Reasons to Perform Periscapular Trigger Point Release

  1. Shoulder Impingement Syndrome: Reduces tension in the muscles surrounding the scapula to improve shoulder alignment.
    • Suitable during the subacute phase to restore mobility.
  2. Scapular Dyskinesis: Relieves tightness that contributes to poor scapular movement patterns.
    • Effective during rehabilitation and corrective exercise phases.
  3. Thoracic Outlet Syndrome: Addresses tight periscapular muscles that may exacerbate symptoms.
    • Best performed during the early rehab phase to alleviate muscle tension.

Who Should Perform This Exercise?

  • Overhead Athletes: Swimmers, throwers, and volleyball players to reduce periscapular tightness.
  • Rehabilitation Patients: Individuals recovering from shoulder or upper back injuries.
  • Desk Workers: Those with poor posture and periscapular tightness from prolonged sitting.

Muscles Involved

Rhomboids

  • Origin: Spinous processes of C7-T5 vertebrae.
  • Insertion: Medial border of the scapula.
  • Function: Scapular retraction and stabilization.

Trapezius (Middle and Lower Fibers)

  • Origin: Spinous processes of C7-T12 vertebrae.
  • Insertion: Spine of the scapula.
  • Function: Scapular retraction, depression, and upward rotation.

Levator Scapulae

  • Origin: Transverse processes of C1-C4 vertebrae.
  • Insertion: Superior angle of the scapula.
  • Function: Scapular elevation and downward rotation.