Tennis Ball Massage (2) – Low Back, Hip and Buttocks

If you have low back pain, you may feel it where the pelvis (illium) and the base of the spine (sacrum) meet – the sacroiliac (SI) joints. 

However, it doesn’t always mean that the joint is the cause of pain.  It is most likely the joint is irritated because of the tilt/twist of your pelvic structure.  A lot of muscles are attached to the pelvis, so if one (or more) of them gets tight pulling the structure one way or another, you feel pain in the SI joint.  Quite often, low back pain is actually originated in your buttocks.

Common trigger points for the low back pain in the buttocks are below the top ridge of the pelvis (iliac crest) toward the hip in the gluteal muscles (gluteus maximus, gluteus medius). 

They don’t normally hurt themselves until you press on them, and they are surprisingly tender.  It’s effective to use a tennis ball to massage the sensitive spots than a pointy self-massage tool. 

If low back pain comes on after standing or walking, or you have sciatica, massage in the middle of the buttock (piriformis), especially at the edge of the sacrum and the top of the thighbone.  It could be very tender. 

Please read the guidelines for massage in the previous post.

I strongly recommend you receive a massage in the buttock area from a massage therapist.  If you are new to the idea, please read my posts FAQ: Does a massage therapist work on my buttocks? (with a video) and FAQ: Should I take off my underwear?.

Tennis Ball Massage (1) - Upper Back

I always recommend my clients massage themselves with a tennis ball as well as using a heat pack.  I would like everybody to get a massage as often as possible, but I know the limitation.  Massaging yourself every day would help you more than completely being dependent on massage sessions.  I would also like you to be in charge of taking care of yourself, so don’t be lazy and ask your family members to do it. 

I have introduced a few self-massage tools, but a tennis ball is actually versatile and inexpensive. It is good for massaging trigger points in your back, hip and buttocks. Although many instructions tell you to lie down on it, I would lean on a ball against a wall so that you have a complete control over the amount of pressure. If you lie on it, it’s difficult to roll the ball around, and it could be too painful for your condition. I also would put a ball in a sock so that you don’t have to pick it up every time the ball falls on the floor. It’s like scratching your back on the wall.  Here is how it looks like. 

If a tennis ball doesn’t give you enough pressure you want, you can try a smaller and firmer racquet ball.  It has a grip, so you could use it without a sock.  Or, if a tennis ball is too firm, you can try a softer squash ball. You might want to try with whatever ball you have at home first. 

GUIDELINES

• Pressure: The sensation should be what we call “good pain” and NOT exceed a pain level of 7 on a scale of 1-10.  If you can’t breath normally, you need to lighten up the pressure.  
• Relax the whole body as much as possible and wait for the sensation to fade. 
• Don’t overwork too long: Work on one spot only up to 12 strokes at a time. If you get sore or bruised next day, you work on it too much.
• Massage as often as possible (6-12 times a day)

The common trigger points in the back are located: 

• Between the spine and the inner shoulder blade: trapezius, rhomboids, thoracic erectors
• In the middle of your shoulder blades: infraspinatus
• The outer edge of the shoulder blades close to the armpit: teres minor/major, lattisimus dorsi

I will show you more common trigger points in the hips and buttocks for lower back pain in the next post.

Self-Massage Tools

The Stick

When I was training for marathons, I bought The Stick at the expo of one of the races.  It is a massage tool.  I was told that no matter how hard you roll it, it wouldn’t harm your muscles, and it is true for me.  But, don’t roll it on the bones; it does hurt.  There are many types, but I have a Sprinter Stick pictured below.

I use it on my quadriceps, hamstrings, calves, IT bands, hips, buttocks, and wherever it’s sore.  It’s a good tool to loosen up the muscle (tibialis anterior) right outside of the shinbone (tibia). 

I’ve had really good results.  When muscles feel tired especially after a long run, I use it, and it seems I get less sore later.  Of course, it doesn’t feel anything like getting a massage, but to relieve tightness and soreness, it is a quick fix.  I would recommend this to anybody including teenagers who are active in sports.

Thera Cane® / Body Back Buddy™

Thera Cane

These tools are for massaging trigger points.  The Thera Cane was mentioned in The Trigger Point Therapy Workbook by Clair Davies, but it’s probably because the Body Back Buddy wasn’t available back then.  After some research, I bought Body Back Buddy recently just because it has more knobs.  I never used a Thera Cane, so I can’t say which is better.  It works fine as I know where my trigger points are, but I’m still learning how to maneuver it as it is cumbersome and a little heavy.  A Thera Cane may be easier to use.  

I bought this especially to treat trigger points in my shoulder blades.  As a massage therapist, I use arms all the time, so I get trigger points in the middle of the shoulder blades (infraspinatus).  I know the benefits of massage, so I try to self-massage every day. 

Even if you can’t afford to get a massage as often as you would like, you can use these tools to take care of yourself.  Happy Massaging!

FAQ: Does a massage therapist work on my buttocks?

When my clients have a lower back problem, I always work on their buttocks; gluteal muscles.  The area is very important to be addressed because there are many trigger points to relieve pain in the low back, hip, and thigh, piriformis syndrome (the symptoms similar to sciatica), and numbness in the leg.  Good massage therapists know the benefits of gluteal work and aren’t hesitant to work in the area.  I strongly recommend your buttocks be worked on if you have problems mentioned above.  I work on the area over the sheets if a client wears underwear.  I can’t apply smooth gliding strokes, but I can use compressions and other techniques, which are as effective as ones directly on the body.  However, if I work on the tissue directly, I would be able to feel the trigger points and adhesions more accurately, and the strokes would feel smoother to you. 

Here is an example video of how a massage therapist works on the buttocks area.  It's long and technical, so you can fast-forward it.  I don't do exactly the same way, but this will give you a general idea of how a massage is done. 

The important thing for you is to be comfortable and make the most out of your massage session.  Don’t feel pressured to agree on what you don’t feel like.  If your therapist is good, they never insist on their own agendas. 

FAQ: Should I take off my underwear?

This is probably the first question you may have before you get a massage for the first time.  I always tell my clients to undress to their level of comfort.  This means, if you are not comfortable taking off your bras, you can leave them on.  Massage sessions are for your comfort, which is more important for your relaxation than my convenience.  I can work around any garments left on.  I have worked on a lady with a tank top or undershirt.    

It is true, however, without undershirt or bras on, I can apply smooth, continuous gliding strokes to the body, which would feel more relaxing, if you are comfortable.  I get permission from clients to unhook the bras only when I work on the back, and put them back.  However, if you are not comfortable with this request, you should say no.  

Regarding underpants, I don’t mind if they are on or not.  Male clients tend to keep them on maybe because they don't want to embarrass me, but I am professional, so I won't be uncomfortable.  If clients wear boxers or briefs, I ask them to pull them up toward the hip bone when I work on their upper legs.  Without underpants on, I can apply continuous strokes up to the top of the thighbone and the buttocks to be able to address low back pain, sciatica, knee pain, and tight quadriceps, hamstrings, and IT bands (a thick band on the side of your thighs).  

When clients, whom I have seen some time, have sciatica or low back pain, and I think it will be more beneficial for them to receive work on their buttocks without underwear, I explain it to them and make sure if it will be totally comfortable for them.  I recommend you try without underpants on next time if you are completely comfortable with the idea.  

You might also want to read the related post "FAQ: Does a massage therapist work on my buttocks?" and watch the video. 

FYI - Draping is required in the state of Florida, so even if you are without underwear, the gluteal (buttock) cleft must be covered all the time, and only one side of the buttocks is undraped at a time.