Myofascial Trigger Point Therapy: What the Research Shows

Indy Myopain Relief Center is in Carmel, Indiana. We have been helping people with pain using myofascial trigger point therapy, extracorporeal shock wave, and frequency specific microcurrent since 2012.

This article is for patients who want to understand what trigger points are, what the research shows, and how the main treatments compare. It covers what is well supported and what is still debated. We have tried to say clearly which is which.

The short version

• The pain is real. A tender spot in muscle that reproduces your familiar pain when pressed is something clinicians observe every day. What causes it is still debated. [1][8]

• Finding trigger points by touch is a skill with limits. Two examiners agree only moderately on where a trigger point is. Your own recognition of "yes, that's my pain" is one of the more dependable signs. [2]

• Several treatments give short-term relief. Manual pressure, dry needling and shockwave all show pain reduction in reviews, mostly over days to weeks, with low to moderate certainty. [10][14][17]

• No single technique clearly wins. Head to head, dry needling and hands-on trigger point therapy perform about the same. [12] The best-supported plans combine hands-on care with movement and self-management. [14]

• Serious side effects are rare. Soreness and bruising are common after needling. In large surveys, serious events occur in fewer than 1 in 1,000 sessions. [28][29]

Key numbers

• 0.45: the average agreement (kappa) between two examiners locating the same trigger point. On the standard scale, that is "moderate." [2]

• 32 percentage points: the difference in people reaching a meaningful improvement with trigger point manual therapy for jaw pain, compared with placebo. [14]

• 5 of 24: the dry needling trials that one review judged well blinded. Those five found no difference from sham. [11]

• Less than 0.1%: the share of sessions with a major adverse event in a 20,464-session dry needling survey. [29]

What is a trigger point?

The idea comes from physician Janet Travell and her collaborator David Simons, whose two-volume Trigger Point Manual mapped where pain from individual muscles tends to spread. The third edition, published in 2019, was edited by Joseph Donnelly with César Fernández-de-las-Peñas, Michelle Finnegan and Jennifer Freeman. [35]

In plain terms, a trigger point is described as a small, very tender spot inside a tight band of muscle. Pressing it often sends pain, aching or tingling somewhere else. A sore spot in the upper shoulder, for example, can be felt as a headache at the temple. When this pattern drives someone's symptoms, the condition is called myofascial pain syndrome.

There is no blood test or scan that confirms a trigger point, so experts tried to agree on a definition. In a 2018 international Delphi study led by Fernández-de-las-Peñas and Jan Dommerholt, 60 experts from 12 countries settled on three core findings: a taut band, a hypersensitive spot within it, and referred pain. [1] The same panel agreed that the main difference between an "active" trigger point, one causing your symptoms, and a "latent" one, which is tender but silent, is whether pressing it reproduces the pain you recognize. [1]

How common is it? Nobody knows for the general population. One often-quoted 1989 study found that 30% of internal-medicine patients whose main complaint was pain met the criteria. That describes one clinic, not everyone. [36]

What might be happening in the tissue

The best-known explanation, the integrated hypothesis, proposes that a nerve to muscle junction releases too much of its chemical signal. A small patch of muscle fibers stays contracted, local blood flow drops, and the area becomes irritable and short of oxygen. Neurologist Robert Gerwin, Jan Dommerholt and Jay Shah later expanded the model to include sensitized nerves. It is coherent and widely taught, but it remains a hypothesis. [7]

Two small studies anchor much of the biology. At the U.S. National Institutes of Health, Jay Shah's team used microdialysis, a hair-thin probe that samples fluid inside muscle, in nine volunteers. Active trigger points sat in a more acidic fluid with higher levels of inflammatory and pain-signaling chemicals than normal muscle. [5] Some of those changes also appeared in a distant, unaffected calf muscle in the same people. That hints the whole nervous system, not just one spot, is involved. A companion ultrasound study of nine subjects could see trigger points as small, stiffer areas. It could not tell active points from latent ones by size. [6]

The emerging view is that trigger point pain is probably a mix of local tissue changes and a nervous system that has become more sensitive. That helps explain why calming, movement-based approaches matter alongside hands-on treatment. [7][9]

The fascia perspective

Fascia is the web of connective tissue that wraps and runs through every muscle. For decades it was treated as passive packing. Since the first International Fascia Research Congress at Harvard Medical School in 2007, founded by physiatrist Thomas Findley with Robert Schleip and colleagues, it has become an active research field. [33]

Gliding layers. Anatomist Carla Stecco's group in Padova found layers of hyaluronan, a slippery lubricant, between fascia and muscle and within fascia itself. They propose that when hyaluronan thickens, a process they call densification, the layers stop sliding smoothly. That could contribute to stiffness and myofascial pain. [31]

Tissue that can tighten. Robert Schleip's work on fascial contractility suggests that cells called myofibroblasts may let fascia slowly change its own stiffness, independent of muscle. [32]

Whole-body connections. Thomas Myers' Anatomy Trains and David Lesondak's Fascia: What It Is and Why It Matters popularized the view that tension in one region can be linked to distant areas through continuous fascial lines. It is a useful clinical map, though the specific lines are still being tested.

What this means for you: fascia research is promising and supports gentle, sustained hands-on work and regular movement. Most of it is laboratory and anatomical science, so it explains possibilities, not proven treatment results.

Can clinicians reliably find trigger points?

This is the most debated question in the field. A 2017 meta-analysis pooled six studies with 363 patients. It found an average agreement between examiners of kappa 0.45. On the standard scale, where 1.0 is perfect agreement and 0 is chance, that is "moderate." [2] The detail matters more than the average. The simplest findings held up best. The signs that try to describe the tissue itself varied widely. [2][3]

Examiner agreement, sign by sign (Cohen's kappa)

• Local tenderness: 0.68

• "That's my pain": 0.58

• All signs, pooled: 0.45

• Taut band: from -0.08 to 0.75 across studies

• Local twitch response: from -0.05 to 0.57 across studies

The first three numbers are pooled estimates from the 2017 meta-analysis. [2] The ranges show individual studies, where a value below zero means worse than chance. [3]

Training helps. In a 1997 study, Gerwin and colleagues first failed to reach good agreement, then succeeded after the examiners trained together. The twitch response stayed the hardest to agree on. [4] A 2025 viewpoint co-signed by researchers on both sides of the debate called for tighter diagnostic criteria for exactly these reasons. [9]

What this means for you: your feedback is part of the exam. When your therapist asks "is that the pain you know?", your answer is among the most useful information in the room.

The scientific debate, fairly stated

The critics. In a 2015 review in Rheumatology, John Quintner, Geoffrey Bove and Milton Cohen argued that the contracted-knot theory lacks scientific support and should be considered refuted. Importantly, they did not deny the pain itself. They wrote that the clinical phenomena exist and can be explained by known nerve mechanisms. [8]

The defenders. Shah and colleagues acknowledge that terminology and criteria have been inconsistent. They point to imaging, tissue chemistry and brain studies as evidence that something measurable is going on, involving both local tissue and nerve sensitization. [7]

Both camps agree on the part that matters most to a patient. The pain is real, and pressing on the right spot can reproduce it.

Our reading of the debate

For you, the practical takeaway is about language. Phrases like "breaking up knots" overstate what we know. A more accurate description: we are working on a sensitive area that reproduces your pain, to reduce that sensitivity and help you move more comfortably.

Treatments and what the evidence shows

A note before the details. Almost all of this research measures results over days to weeks, in small trials. The reviewers themselves usually rate the certainty as low to moderate. That is the honest state of the field for most musculoskeletal pain care, not a weakness unique to trigger point therapy.

Manual pressure and massage

Hands-on trigger point therapy, meaning sustained pressure often combined with stretching and massage, has some of the stronger evidence. A 2023 BMJ network meta-analysis of 153 trials with 8,713 people studied chronic jaw pain. Trigger point manual therapy raised the chance of a meaningful improvement by 32 percentage points versus placebo, with moderate to high certainty. The same study found the best overall results came from approaches that encourage movement and coping. [14]

For pressure alone, called ischemic compression, reviews disagree. One found it raised pressure tolerance but not reported pain. [15] Another, focused on neck pain, found short-term pain relief. [16]

Much of this hands-on work is taught as neuromuscular therapy, a structured approach developed by Leon Chaitow and Judith DeLany. It pairs a systematic assessment of muscles and posture with graded pressure. Chaitow's integrated neuromuscular inhibition technique combines sustained pressure on the trigger point with gentle contract-and-relax muscle work, then stretching. [41][42] These methods are widely taught and used. They come from clinical experience and textbooks, and they have not been tested head to head in controlled trials.

Dry needling

A thin, solid needle is inserted into the trigger point. A 2021 meta-analysis found large short-term reductions in pain compared with no treatment, sham or other therapies. The evidence for that was low quality. A moderate effect at 1 to 3 weeks came with moderate-quality evidence. [10] Neck-pain reviews report similar short and mid-term benefits. [39]

Two cautions. In a review of 24 sham-controlled trials, only the five that were well blinded showed no difference between real and sham needling. [11] Benefits beyond 6 months have not been shown. [13] When compared directly, dry needling and manual trigger point therapy produced similar results. [12]

Trigger point injections

A physician injects a local anesthetic, sometimes with a steroid, into the point. A 2023 American Family Physician review describes an emergency-department trial in which plain saline worked as well as a lidocaine and steroid mix. That suggests the needle itself may do much of the work. [21] Medicare's coverage policy notes very low certainty of evidence for several injection uses. [22] Botulinum toxin injections have moderate-certainty evidence of no clinically meaningful benefit for neck and shoulder myofascial pain. [23]

Shockwave therapy

Extracorporeal shockwave therapy (ESWT) sends acoustic pulses through the skin without needles. A 2024 meta-analysis of 27 randomized trials found it reduced pain and improved function in myofascial pain syndrome, with a tendency toward better results at lower energy doses. [18] An earlier meta-analysis reported pain about 1.3 points lower on a 0 to 10 scale than comparison treatments. [17] A review focused on the trapezius muscle found no clear advantage over dry needling, injections or laser. [20] A 2025 scoping review called for standardized treatment settings, because protocols vary widely. [19]

Frequency specific microcurrent (FSM)

Carolyn McMakin, a chiropractor, developed frequency specific microcurrent. It applies very low electrical current at chosen frequencies. Her case series in head, neck, face and low-back trigger point pain reported that many people found relief, though results varied. [24][25] A later controlled study found FSM added benefit to rehab for low back pain, but not for neck pain. [26] Case series without control groups can't establish effectiveness. So FSM should be considered promising but unproven.

Self-treatment

Foam rollers, massage balls and self-pressure are inexpensive and low risk. A 2019 meta-analysis of 21 studies, mostly in healthy and athletic people, found small, short-lived effects: slightly better flexibility and somewhat less muscle soreness after exercise. [27] Studies in people with myofascial pain syndrome specifically are limited. Self-care works best as part of a plan, to extend relief between visits and to keep you moving.

Practitioner-written guides can help. Trigger Point Therapy for Low Back Pain, by Sharon Sauer and Mary Biancalana, walks readers through locating and pressing their own trigger points. [43] One useful caution comes from neuromuscular therapist Stewart Wild: the IT band on the outer thigh is too tough to be stretched, so the relief people feel from rolling it more likely comes from easing trigger points in the muscles underneath. [44]

Evidence at a glance

Approach

Best available finding

Certainty

Manual trigger point therapy

32 percentage points better chance of meaningful improvement for jaw pain. Similar to dry needling head to head. [14][12]

Moderate to high for jaw pain. Low elsewhere.

Dry needling

Short-term pain relief. No difference from sham in well-blinded trials. No proven benefit at 6 to 12 months. [10][11][13]

Low to moderate

Shockwave (ESWT)

Pain and function improve across 27 trials. Not clearly better than other active treatments. [18][20]

Low to moderate. Protocols vary.

Trigger point injection

Saline performed as well as an active drug mix in one trial. [21]

Very low to low

Botulinum toxin

Statistically detectable, but below the threshold patients notice. [23]

Moderate (for no useful benefit)

Microcurrent (FSM)

Positive case series. One controlled study positive for low back, not neck. [24][26]

Very low. Not yet reviewed.

Foam rolling and self-release

Small, short-term reductions in soreness. Mostly studied in healthy people. [27]

Low for this condition

Certainty wording follows the source reviews where they graded it. "Not yet reviewed" means no systematic review was found.

Safety and side effects

Hands-on trigger point work commonly causes temporary tenderness for a day or two. For needling, two large surveys give the clearest picture. They disagree on how often minor reactions occur, likely because of how the data were collected. So we report both.

Survey

Sessions

Dry needling sessions followed by a minor reaction (bruising, bleeding, soreness)

Ireland

7,629 treatments [28]

19.2%

United States

20,464 sessions [29]

36.7%

In the larger U.S. survey, 20 serious events were reported across 20,464 sessions. That is fewer than 1 in 1,000. [29] In a randomized study of 120 patients, post-needling soreness occurred in most people. It increased with the number of needle insertions and muscle twitches provoked. [30] Shockwave reviews report minimal side effects, typically temporary redness or soreness. [17][19] Injection side effects in trials included temporary numbness, coldness and discomfort, usually resolving within days. [40]

When muscle pain needs a different look

Trigger point pain should never be a default label. Tell your clinician, or seek medical care, if you notice:

• A lump or mass, even if it is not painful

• Constant night pain that does not change with position, or fever, weight loss, or a history of cancer

• Numbness, weakness, or pain following a nerve path down an arm or leg

• New chest, jaw, or shoulder-blade pain with shortness of breath, or heart risk factors

• No improvement after four to six well-delivered treatments

In one published case, persistent neck pain treated as myofascial pain turned out to be a muscle tumor. It was found only when a mass was felt on re-examination. [37]

Guidelines, standards and insurance

There is no single national clinical guideline for myofascial pain syndrome. Practice draws on expert consensus, such as the 2018 Delphi criteria, [1] on professional position statements, such as the Israeli Society for Musculoskeletal Medicine's Delphi-based statement on intramuscular stimulation, [38] and on the systematic reviews summarized above.

Coverage is uneven. Dedicated billing codes for dry needling (CPT 20560 and 20561) took effect in January 2020. Even so, several major insurers have classified dry needling as investigational. [34] Medicare has a specific coverage policy for trigger point injections. [22] Check with your plan before starting any needle-based treatment.

For hands-on care, the main credential to look for is CMTPT, Certified Myofascial Trigger Point Therapist. A national certification board awards it after postgraduate training and an exam. It is separate from a basic massage license.

Where research goes next. Much of what experienced trigger point therapists do has been refined over decades of practice but not yet tested in well-designed trials. That gap is not proof the methods fail. It is unfinished work. Controlled studies run by trained trigger point therapists, with consistent methods and follow-up beyond six months, would do more than anything else to settle which approaches help, for whom, and for how long.

Making good decisions about your care

Taken together, the research supports a sensible, patient-centered approach:

• Expect relief, not a cure in one visit. Most benefits are measured over days to weeks. A short series of visits with home care is typical.

• Choose the method that suits you. Because manual therapy and needling perform similarly, comfort and preference are legitimate reasons to pick one. [12]

• Keep moving. Plans that include movement, exercise and self-management have the strongest support. [14]

• Reassess if you are not improving. No progress after four to six visits is a reason to rethink the diagnosis, not simply to do more of the same.

• Ask questions. What is the goal of today's treatment? What should I feel afterward? What can I do at home?

How we approach care

At Indy Myopain Relief Center, we use this evidence to guide care: careful assessment, honest expectations, and a plan that pairs hands-on work with what you can do at home. Our services include myofascial trigger point therapy, extracorporeal shock wave therapy (ESWT), frequency specific microcurrent (FSM), and self-care coaching. If another approach, such as needling or injections, may suit you better, we will talk it through with you.

Cost depends on your condition, so we talk through your situation before anything else. Call us at (317) 973-0888.

Indy Myopain Relief Center

10291 N Meridian St, Suite 170

Carmel, IN 46290

(317) 973-0888

Mon to Fri 9am to 9pm, Sat 11am to 6pm

Call us at (317) 973-0888 to talk through your situation.

The information on this website is for general education and is not medical advice. It does not replace the care of your physician or another licensed healthcare provider. Visiting this site or contacting us does not create a patient relationship. Results vary from person to person, and testimonials describe individual experiences. If you have a medical emergency, call 911.

Sources

Accessed November 2026. Where only a secondary summary was available, it is noted. Research and drafting support from an AI model, Claude by Anthropic. Reviewed and approved by Indy Myopain Relief Center.

1. Fernández-de-las-Peñas C, Dommerholt J. International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: a Delphi study. Pain Med. 2018;19(1):142-150. pubmed.ncbi.nlm.nih.gov

2. Rathbone ATL, Grosman-Rimon L, Kumbhare DA. Interrater agreement of manual palpation for identification of myofascial trigger points: a systematic review and meta-analysis. Clin J Pain. 2017;33(8):715-729. pubmed.ncbi.nlm.nih.gov

3. Lucas N, Macaskill P, Irwig L, et al. Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review. Clin J Pain. 2009;25(1):80-89. pubmed.ncbi.nlm.nih.gov

4. Gerwin RD, Shannon S, Hong CZ, et al. Interrater reliability in myofascial trigger point examination. Pain. 1997. pubmed.ncbi.nlm.nih.gov

5. Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil. 2008;89(1):16-23. pubmed.ncbi.nlm.nih.gov

6. Sikdar S, Shah JP, Gebreab T, et al. Novel applications of ultrasound technology to visualize and characterize myofascial trigger points. Arch Phys Med Rehabil. 2009;90(11):1829-1838. pubmed.ncbi.nlm.nih.gov

7. Shah JP, Thaker N, Heimur J, et al. Myofascial trigger points then and now: a historical and scientific perspective. PM&R. 2015. pubmed.ncbi.nlm.nih.gov

8. Quintner JL, Bove GM, Cohen ML. A critical evaluation of the trigger point phenomenon. Rheumatology. 2015;54(3):392-399. pubmed.ncbi.nlm.nih.gov

9. Cook C, Degenhardt B, Fernández-de-las-Peñas C, et al. Viewpoint on myofascial and trigger points. J Orthop Sports Phys Ther. 2025. pubmed.ncbi.nlm.nih.gov

10. Sánchez-Infante J, Navarro-Santana MJ, Bravo-Sánchez A, et al. Is dry needling applied by physical therapists effective for pain in musculoskeletal conditions? A systematic review and meta-analysis. Phys Ther. 2021;101(3). academic.oup.com

11. Braithwaite FA, Walters JL, Li LSK, et al. Effectiveness and adequacy of blinding in the moderation of pain outcomes: systematic review and meta-analyses of dry needling trials. PeerJ. 2018;6:e5318. pubmed.ncbi.nlm.nih.gov

12. Lew J, Kim J, Nair P. Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther. 2021. pubmed.ncbi.nlm.nih.gov

13. Gattie E, Cleland JA, Snodgrass S. The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2017. pubmed.ncbi.nlm.nih.gov

14. Yao L, Sadeghirad B, Li M, et al. Management of chronic pain secondary to temporomandibular disorders: a systematic review and network meta-analysis. BMJ. 2023;383:e076226. pubmed.ncbi.nlm.nih.gov

15. Lu W, et al. Ischemic compression for myofascial trigger points: systematic review and meta-analysis. 2022. pubmed.ncbi.nlm.nih.gov

16. Xu A, et al. Ischemic compression for myofascial trigger points in neck pain: systematic review and meta-analysis. 2023. pubmed.ncbi.nlm.nih.gov

17. Wu T, et al. Efficacy of extracorporeal shock waves in the treatment of myofascial pain syndrome: a systematic review and meta-analysis of controlled clinical studies. Ann Transl Med. 2021. atm.amegroups.org

18. Efficacy of extracorporeal shockwave therapy on pain and function in myofascial pain syndrome: a systematic review and meta-analysis of randomized clinical trials. Am J Phys Med Rehabil. 2024;103(2):89-98. journals.lww.com

19. The state of extracorporeal shockwave therapy for myofascial pain syndrome: a scoping review and a call for standardized protocols. 2025. ncbi.nlm.nih.gov

20. Zhang Q, Fu C, Huang L, et al. Efficacy of extracorporeal shockwave therapy on pain and function in myofascial pain syndrome of the trapezius: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2020. pubmed.ncbi.nlm.nih.gov

21. Trigger point management. Am Fam Physician. 2023. aafp.org

22. Centers for Medicare & Medicaid Services. Local Coverage Determination: Trigger Point Injections (L39656). cms.gov

23. Saltychev M, et al. Botulinum toxin A for neck and shoulder myofascial pain: systematic review and meta-analysis. 2025. pubmed.ncbi.nlm.nih.gov

24. McMakin C. Microcurrent treatment of myofascial pain in the head, neck, and face. Top Clin Chiropr. 1998;5. frequencyspecific.com

25. McMakin C. Microcurrent therapy: a novel treatment method for chronic low back myofascial pain. J Bodyw Mov Ther. 2004;8(2):143-153. researchgate.net

26. Effect of adjuvant frequency-specific microcurrents on pain and disability in patients treated with physical rehabilitation for neck and low back pain. J Bodyw Mov Ther. 2020. sciencedirect.com

27. Wiewelhove T, Döweling A, Schneider C, et al. A meta-analysis of the effects of foam rolling on performance and recovery. Front Physiol. 2019;10:376. ncbi.nlm.nih.gov

28. Brady S, McEvoy J, Dommerholt J, Doody C. Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. J Man Manip Ther. 2014. pubmed.ncbi.nlm.nih.gov

29. Boyce D, Wempe H, Campbell C, et al. Adverse events associated with therapeutic dry needling. Int J Sports Phys Ther. 2020. pubmed.ncbi.nlm.nih.gov

30. Martín-Pintado-Zugasti A, et al. Post-needling soreness after myofascial trigger point dry needling: a randomized trial. 2018. pubmed.ncbi.nlm.nih.gov

31. Stecco C, Stern R, Porzionato A, et al. Hyaluronan within fascia in the etiology of myofascial pain. Surg Radiol Anat. 2011. Secondary summary available.

32. Schleip R, Klingler W. Active contractile properties of fascia. Clin Anat. 2019. onlinelibrary.wiley.com

33. Schleip R, Findley TW, Chaitow L, Huijing P, eds. Fascia: The Tensional Network of the Human Body. Elsevier; 2012. books.google.com

34. Dommerholt J. Dry needling systematic reviews and meta-analyses. Myopain Seminars; 2021, updated 2026. Practitioner commentary. myopainseminars.com

35. Donnelly JM, Fernández-de-las-Peñas C, Finnegan M, Freeman JL. Travell, Simons & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual. 3rd ed. Wolters Kluwer; 2019. pt.lwwhealthlibrary.com

36. Skootsky SA, Jaeger B, Oye RK. Prevalence of myofascial pain in general internal medicine practice. West J Med. 1989. pubmed.ncbi.nlm.nih.gov

37. Chu E, Sabourdy J. Desmoid tumor mimicking myofascial pain syndrome. Cureus. 2023. pubmed.ncbi.nlm.nih.gov

38. Ratmansky M, Minerbi A, Kalichman L, et al. Position statement of the Israeli Society for Musculoskeletal Medicine on intramuscular stimulation for myofascial pain syndrome: a Delphi process. Pain Med. 2016. researchgate.net

39. Hernández-Secorún M, et al. Effectiveness of dry needling in improving pain and function in comparison with other techniques in patients with chronic neck pain. Pain Res Manag. 2023;1523834. onlinelibrary.wiley.com

40. Trigger point injection therapies for chronic myofascial neck and back pain: a systematic review. 2022. sciencedirect.com

41. Chaitow L. Modern Neuromuscular Techniques. 3rd ed. Churchill Livingstone; 2010. leonchaitow.com

42. Chaitow L, DeLany J. Clinical Application of Neuromuscular Techniques, Vols 1-2. 2nd ed. Churchill Livingstone/Elsevier; 2008-2011. nmtcenter.com

43. Sauer S, Biancalana M. Trigger Point Therapy for Low Back Pain: A Self-Treatment Workbook. New Harbinger; 2010. newharbinger.com

44. Wild S. Pole dancing on the ITB. 360NMT Blog; 2013. Summarized in a secondary article: Massage and WellBeing, "Foam rolling: IT band or vastus lateralis?" massageandwellbeing.wordpress.com