The importance of strength training, stretching and relaxation for pain relief

Have you ever wondered if and when you should start strengthening your muscles, a stretching routine, or maybe begin practicing relaxation exercises to alleviate your pain?

In terms of time, trigger points come before strength training, stretching and relaxation – or at least simultaneously.

First free your muscles from trigger points and only then start strengthening or stretching your muscles.

Trigger points are the first steps, and one of the most important ones. Strength and flexibility are also important, but usually not the first step.

Why that is so, I would like to explain now.

Strength training / strengthening exercises

This includes all methods that can be used to strengthen your muscles.

So, things like training with free weights, on machines, body weight training, Pilates, yoga, Calisthenics etc.

Appropriate strength training is important because strong muscles are less prone to injury, and less prone to develop/activate trigger points.

However, trigger points disturb the interaction between the nervous system and muscles, and potentially increase muscle tension.

Of course, muscles are repeatedly or permanently contracted during any kind of strength training. If pain is present, it often becomes stronger under tension and contraction, respectively.

Strength training then, is not yet effective.

Strength training is important. It makes your muscles and the whole body more resilient, but it is usually not the first step. The first step is to remove and deactivate trigger points.

In my experience, it only takes a few days or weeks until you can start training again.


Stretching gets discussed controversially and its effectiveness in terms of alleviating pain is lacking scientific evidence.

This may be due to the difficulty designing good studies, running them long enough, choosing adapted exercises, and performing them correctly and long enough under guidance, etc.

I personally have had very good experiences with stretching, especially with yoga. However, the effects do not come overnight, and a certain regularity is important, at least in the beginning.

But: Even with stretching, no matter if classical stretching or yoga, you should wait until you have your trigger points under control and until your pain went down quite a bit.

At the very least, you should perform trigger point self-massages simultaneously, if you do not want to wait.

Stretching can cause structural changes and have a positive effect on your posture and pain – this is my long term experience and opinion.

However, if the nervous system is currently “unable to relax” your muscles due to active trigger points, stretching will not (yet) help.

Instead, it can temporarily worsen pain. Therefore, stretching is not the first step, although I would like to recommend it to you for the future.

The same applies here as for strength training. Take care of your trigger points first.

You can probably start (again) with your stretching program or yoga practice in a few days to weeks – of course at a level that is appropriate for you.

Relaxation and awareness exercises

This includes things like Autogenic Training, Feldenkrais, Thomas Hanna, etc. I have worked intensively with these methods and they have often helped me a lot.

You can use them to control your muscle tension, lower your resting tone, feel more supple, and release tension in general.

Pain and tension in my experience however, which are caused by trigger points, cannot be controlled by these approaches.

Trigger points are not classic tensions and are beyond the control of the nervous system.

However, the methods mentioned above all work through the nervous system. They can increase the influence of the parasympathetic nervous system and thus promote relaxation, and they train your concentration.

In my opinion and experience you cannot “relax” a trigger point away. It simply does not work.

Again, I just want to show how important I feel trigger point work is. In no way do I want to devalue any of the methods mentioned above, quite the contrary is the case.

They are wonderful pillars in any pain treatment and can be combined well with a trigger point self-treatment.

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