Pain •Sensible advice for aches, pains & injuries

Ah, the humble tennis ball

Best buddy to the common muscle knot!

Tennis Ball Massage for Myofascial Pain Syndrome

Some creative tips on using an ordinary tennis ball and other massage tools to self-treat muscle knots and myofascial trigger points

1,100 words, updated 2010archivedThis page will probably not be updated (or only rarely, for significant corrections). Most PainScience articles are regularly updated with fresh science and ideas. The “archived” stamp identifies a few articles that are not actively maintained.
by Paul Ingraham, Vancouver, Canadabio
I am a science writer, the Assistant Editor of, and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I’ve written hundreds of articles and several books, and I’m known for sassy, skeptical, referenced analysis and a huge bibliography. I am a runner and ultimate player, and live in beautiful Vancouver, Canada. • full bioabout

EXCERPT This article is an excerpt from’s ridiculously detailed tutorial about trigger point (muscle knot) self-treatment, which contains more detail about the bath trick, as well as hundreds of other basic and advanced tips and tricks.

One of my clients was recently describing an experience she’d had with an orthopedic specialist:

“He didn’t know about using tennis balls for massage! He asked what helped my back pain, and I told him I always lie on a tennis ball. He looked at me like he was going to refer me to a psychiatrist! How can an orthopedic surgeon not know about the tennis ball thing? Doesn’t everyone know about the tennis ball thing?”

Unfortunately, no: not everyone knows about the tennis ball thing. But it is one of the most time-honoured simple solutions for chronic muscle aches and pains, running a close second to “the hot tub thing.”

Indeed, a tennis ball is simply a handy tool that you can use in the self-treatment of knots in your muscles, technically known as trigger points. Too many trigger points is known as myofascial pain syndrome.1 In this basic article, I serve up some fun tips on how to use a tennis ball and similar tools to relieve knots in your muscles.

The basic idea of tennis ball massage

The basic idea of tennis ball massage, or any massage with any kind of ball, is simply to trap the ball between your body and something else: usually the floor, sometimes a wall, another body part, and a few other creative options.

Everything else is a variation on this theme!

The therapeutic goals of tennis ball massage

The goal of tennis ball massage is to achieve a “release” by applying just the right amount of pressure: enough to do some good, but not enough to irritate the knot. The sensation should be clear and strong and satisfying, what we call “good pain.” If you are wincing or gritting your teeth, you need to be more gentle. You need to be able to relax.

Once you have adjusted yourself to achieve the right pressure, relax as much as possible and wait for the sensation to fade to about eighty percent of the original intensity. This is the “release” — a change in the physiological state of the tissues, or a “melting” of the knot. This can take anywhere from ten seconds to several minutes.

Does it have to be a tennis ball? Not hardly! Other massage tools for trigger point release …

Remember, if you use the Symptom Checker at, don’t assume that all pain is completely muscular. Pain has many different causes; always have a qualified practitioner rule out other disorders.

There are, of course, countless self-massage tools on the market: balls of every description, sticks and widgets, rollers and thumpers, wooden thumbs, and on and on.

Even rocks can make good self-massage tools!

Even rocks can make good self-massage tools!

I even know a therapist who collects smooth river rocks — seriously —and gives them away to patients as self-massage tools. It’s a great idea! Although hard as rock, too hard for many patients, they’re perfect for certain self-massage challenges. For instance, they might be ideal for firm “scraping” of the muscles of the forearm — a muscle group which can really take a beating in some people.

Squash balls are softer and smaller than tennis balls, which makes them ideal for massaging some hard-to-reach spots, like the back of the shoulder.

Squash balls are softer and smaller than tennis balls, which makes them ideal for massaging some hard-to-reach spots, like the back of the shoulder.

Many of these tools are handy and fun, but one of the most important idea’s in this article is that you really don’t need to go out of your way to buy anything special: most people already have a tennis ball around, and it really is one of the most versatile self-massage tools in the world.

And other simple, cheap balls work, too! For instance, another great massage tool that a lot of people have handy is a Kong dog toy, of all things! With it’s pyramidal shape, a hardness that varies depending on how you use it, it’s even better than a tennis ball!

The Kong dog toy is an amazingly good self-massage tool!

The Kong dog toy is an amazingly good self-massage tool!

The Kong dog toy is an amazingly good self-massage tool!

The Kong dog toy is an amazingly good self-massage tool!

The guidelines in this article for self-treatment apply more or less regardless of what tool you use.

Where to massage with your tennis ball

Tennis ball massage is usually the most effective in the muscles of the back and the hips. Many other locations are awkward (especially for beginners), and you may find it difficult or impossible to apply consistent pressure.

Lie down on a tennis ball, placing it in approximately the right location. You do not have to be precise. “Explore” by moving slowly and gently, until you’ve got just the right spot.

The sensation should be clear and strong and satisfying; it should have a relieving, welcome quality — this is what we call “good pain.”

See the “Perfect Spots” series of articles for several highly recommended places for massage.

Tips and tricks for longer lasting trigger point release

Trigger point massage often provides only temporary relief. Here are some basic tips and tricks to help make it last as long as possible:

Why tennis balls work for trigger points

A knot or trigger point is a clenched patch of muscle tissues. The nerve that controls the muscle is firing too quickly, and the tissue is full of waste molecules produced by the “revving” tissue.

Pressure probably has two main therapeutic effects on muscle knots: it creates a small, local stretch that tends to inhibit the motor nerve and/or separates sarcomeres to the point of breaking the vicious cycle of spasm, and it deforms the tissue and literally squashes stagnant tissue fluids out of the area.

More information about trigger point self-treatment … a lot more!

This article is a small excerpt from’s large, advanced trigger point tutorial, which goes into waaaay more detail: not just more about tennis ball and other tools for self-massage, but every other kind of self-treatment for trigger points you can imagine, how to troubleshoot every kind of treatment challenge — mistakes that beginners tend to make, how to deal with unusually stubborn trigger points, what to do for trigger points that are ‘stuck’ with adhesions and contractures, and explanations for why stretching sometimes works really well for trigger points and sometimes not at all, and much, much more.

About Paul Ingraham

I am a science writer, former massage therapist, and assistant editor of Science-Based Medicine. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook and Google, but mostly Twitter.