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Injury Prevention

5 Pain Management Techniques You May Have Never Heard Of

When it comes to any pain that results from swim, bike, or run training, the solution is not to suck it up. Instead, seek professional help and consider one of these unique techniques.

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At some point in your triathlon career, something is gonna hurt. While we can put the best injury-prevention and recovery techniques into place, odds are the continuous swim, bike, and run will take their toll at some point in some way. Fortunately, the fun of tri far outweighs the pain and there are pain management techniques you can use to get yourself back out there sooner rather than later. 

Whether it’s a sore shoulder from swimming, a twisted ankle from a run misstep, or low back pain from the bike, you don’t have to be left to fend for yourself when it comes to treating pain. Specialists like physical therapists, chiropractors, sports medicine doctors, and orthopedic surgeons are standing by to assess and treat any number of irritations and injuries. Along with a variety of medical professionals who home in on working with athletes, there are also numerous lesser-known pain-relieving methods that can provide a strong foundation for recovering well and catching injuries before they become a bigger problem.

RELATED: An Injury Guide for Triathletes

Dry Needling

Dry needling is one of the more popular forms of therapy a triathlete might receive if they are complaining of an ongoing moderate issue. It was born out of acupuncture and is the process of using thin needles to quickly prick a muscle and spur relaxation, blood flow, and even rewire the neurological pathway of the area. 

“Dry needling and acupuncture help to sort out areas of specific muscle tightness—what you might call a ‘knot,’” said Bryan Kent, DC, at Forward Spine and Sport in Boston, Mass. “The goal is to have the needle hit a trigger point where it interrupts the pain cycle, allowing the muscle to relax and the neurological pathway responsible for tightening that muscle to reset.”

If you struggle with soft tissue that won’t seem to calm down no matter how much you foam roll, consider asking your care team about incorporating dry needling into an upcoming visit or seeking out someone who specializes in the technique.


Swimming great Michael Phelps is largely responsible for making much of the world aware of cupping therapy as a pain management technique. Phelps walked out onto the Olympic pool deck in Rio with several perfectly circular purple spots on his back, thrusting the technique into the mainstream.

Cupping finds its roots primarily in Eastern medicine, where it was (and is) used for everything from solving aches and pains to supposedly boosting the immune system. In this technique, hollow glass cups (imagine votive candle holders) are secured onto your skin with a hand pump to create a vacuum. This causes blood to safely collect in the area, and the capillaries closest to the top of your skin may even burst, causing bruising—this is normal and is said to even help foster an immune response and bring white blood cells to the area. 

The primary benefit of cupping is that it relaxes the skin and layers just beneath it—the fascia. Fascia can become tight and stuck in one position unless consciously moved, like with cupping. 

“When you put a cup on your skin and tug at that fascia, you create a nervous system response,” said Dr. Kent. “You are helping to foster a potential neurological response that will positively impact how the brain is ‘sensing’ that area of the body, and you may find that cupping helps release tension held in very localized sections of the anatomy.”


Graston Technique is used by both physical therapists and chiropractors as a way to offer temporary pain management and a gateway to a functional movement treatment program. A Graston tool is a slightly curved piece of smooth metal about six inches long. When used correctly through a series of targeted rubbing motions on the skin, Graston can help improve blood flow and loosen fascia.

Casey Campbell, DC, owns G.R.I.T Chiropractic in Boulder, Colo., and frequently uses Graston methods on her patients. 

“Graston technique creates a window of opportunity to make a more lasting impact by adding in functional movement and a treatment regimen,” said Dr. Campbell. “The window created by using Graston allows us to reintroduce proper movement mechanics and load the tissue to foster more lasting change.” 

Active Release Technique

Active Release Technique, or ART, is an extra certification that physical therapists or chiropractors can opt to learn post-graduation from their graduate programs. 

ART is just what it sounds like—using conscious movements to improve range of motion, blood flow, and relieve muscle tightness. The provider will press down on a specific muscle or soft tissue and then ask you to rotate through a series of motions like leg extensions, arm raises, or back extensions. Dr. Campbell employs active release when working on athletes who need to relax and release certain muscles. 

“Active release technique is similar to Graston in that it is a temporary fix,” said Dr. Campbell. “The key is to use active release technique to promote stimulation and healing in tissues that can then be loaded and worked through a treatment program.” 

Muscle Flossing

Although not a new form of pain management and relief (it has been around since the 1960s), muscle flossing has recently seen an uptick in usage after being made popular by the CrossFit community. 

Muscle flossing involves wrapping a tight elastic band (like the kind you might use for banded lunges or squats) around a muscle or joint. The compression provided by the band safely and temporarily restricts blood flow to the area while the athlete completes functional movements such as squats, arm reaches, or calf raises to mobilize the surrounding soft tissues. 

“The fascial system of the human body is a complex network of connective tissue that is constantly responding to movement and pressure changes,” said Caitlin Alexander, PT, DPT, CAFS who practices at BUILD Sports Performance Lab in Broomfield, Colo. “Fascia can become sticky and matted down if not kept mobile, which can eventually cause pain.”

After the band is released, blood flow is restored to the soft tissue and the fascia is recalibrated in a sense, often resulting in pain relief for the localized area. Dr. Alexander suggested talking with your physical therapist or care provider about employing muscle flossing if you are managing an orthopedic injury such as a mild muscle strain, if you’re looking to improve range of motion in a joint, or if you’re exploring ways to decrease muscle soreness.

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