Response to "Knot in a muscle' post

Replies to This Discussion

Permalink Reply by Boris Prilutsky on July 7, 2011 at 11:49pm

Hi Gary.

Energy work is a different topic and in many cases significant and real results is unexplainable phenomena just clinical proving. I do believe that some people gifted and can do some miracles that most of us cannot. At this discussion we are talking on trigger point therapy that must be adequate.here we talking on scientifically developed and clinically  proven protocols of medical massage. This protocols most of us who have a passion to treat people can learn and to provide real therapy. It is crucial not to confuse this.I believe in simple approach to medical massage, but not to simplify trigger points therapy to some light touch that really providing therapy. I mean touch as a physical stimuli for trigger point therapy.

More than this I don't believe that any pathology  and histology texts referring as well as describing muscle knots as a pathological changes within muscles or mentioning it at all. I believe that"muscle knots" is a sensation description by people who is suffering from pinpoint pain localization .As a practitioners we shouldn't keep  "muscle knots" as a pathology in our minds because it can lead to some techniques that can harm. I mean if pathology  is not existing and you trying to apply some techniques to "open up muscle knots"it can be not only not productive but also traumatizing.On the other hand morphology of trigger points is very much known fact, as well proposed treatment designed to address this blood supply  insufficiency to this particular inflamed cells. Have a proposal let's stop in our discussion to use this term, and let's stop simplify massage therapy in general including to simplify  adequate trigger point therapy that's a little bit more demanding  then you have  described .

Best wishes.

Boris

 

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Gary W Addis, LMT on July 8, 2011 at 12:26am

In general I agree with you about everything you've said.  But I also believe everything Gordon has said.  Especially the part about it not being necessary to analyze everything (as I tend to do) but to follow the course the body is trying to set, if the therapist is listening. After all, every client we see isn't in a state of major duress.  Alright, I guess here I'm going to question the analysis of a scientist.  Doctor, if you can't produce scientific proof that more than 3 minutes of ischemic compression will result in myelosis sometime down the road, it's just supposition, an educated guess, which is essentially what Travell was doing in 1942, and Gordon's massage methodology--which has been helping his clients for more than two decades, and the clients of thousands of other massage therapists for, what, about a 100 years--is at least as medically sound as any other methodology mentioned here.

 

I mean, medicine is still in its infancy.  just about every day we read about some accepted treatment that is being debunked.  In the scale of things, just yesterday, respected doctors were draining blood from patients, to "let the bad stuff out."

 

I don't know anything about anything...yet.   I for one am striving to keep my mind open to all possibilities.  As a scientist, you shouldn't be speaking in absolutes, either, should you?

 

Boris Prilutsky said:

Hi Gary.

Energy work is a different topic and in many cases significant and real results is unexplainable phenomena just clinical proving. I do believe that some people gifted and can do some miracles that most of us cannot. At this discussion we are talking on trigger point therapy that must be adequate.here we talking on scientifically developed and clinically  proven protocols of medical massage. This protocols most of us who have a passion to treat people can learn and to provide real therapy. It is crucial not to confuse this.I believe in simple approach to medical massage, but not to simplify trigger points therapy to some light touch that really providing therapy. I mean touch as a physical stimuli for trigger point therapy.

More than this I don't believe that any pathology  and histology texts referring as well as describing muscle knots as a pathological changes within muscles or mentioning it at all. I believe that"muscle knots" is a sensation description by people who is suffering from pinpoint pain localization .As a practitioners we shouldn't keep  "muscle knots" as a pathology in our minds because it can lead to some techniques that can harm. I mean if pathology  is not existing and you trying to apply some techniques to "open up muscle knots"it can be not only not productive but also traumatizing.On the other hand morphology of trigger points is very much known fact, as well proposed treatment designed to address this blood supply  insufficiency to this particular inflamed cells. Have a proposal let's stop in our discussion to use this term, and let's stop simplify massage therapy in general including to simplify  adequate trigger point therapy that's a little bit more demanding  then you have  described .

Best wishes.

Boris

 

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Gordon J. Wallis on July 8, 2011 at 1:34am

Its not energy work...I just induce a clasp knife reflex onto the trigger pointed muscle.

• ▶ Reply

Permalink Reply by Dr. Ross Turchaninov on July 8, 2011 at 1:37am

 

 

Gary,

 You referring to the fact that light touch helps thousands of clients including those who successfully treated by Gordon. Great! But this is generalization or let say 'educated guess' you just criticized above. The same way one may turn table and now apply the same judgement on your views (with the same thousand of patients). It seems that one of the views is wrong. I learned long ago that correct approach to any medical issue is small personal ego and integrative approach to solving any case.

 

I think that there are two completely different subjects are discussed here and it confuses the readers of this blog. The position you and Gordon defend is correct while position I defend is also correct. Why is that? The answer is very simple. Light touch with fingertips which is discussed here is very helpful tool when the client has hypertonus without formation of active trigger point. In such case the basic preparation of the muscle with following application of the light pressure "dissolves" so called knot (or hypertonus to called it correctly) without any trace. However when active trigger point is already formed and it distorts the normal contraction of the myofibrils and as a result local ischemia forms the light pressure alone is simply is not enough to get to the bottom of the well and completely eliminate trigger point. This is where ischemic compression is used. However ischemic compression is also isn't enough because it must follow by Muscle Energy techniques. 

From post to post and from publication to publication I see very sad trait when massage practitioners and educators trying address medical conditions. When the practitioners learned something they faithfully follow it loosing bigger picture. This picture consists from one simple fact that there is no silver bullet in one approach or technique  and the ultimate solution in the ability of the practitioner to have correct tools( in the form of suitable techniques in each particular case) at the correct time. In such case when you restrict yourself to the light touch in all cases of muscle pathology your clients on the loosing side. 

Couple final thoughts. You are writing that:

"..it's just supposition, an educated guess, which is essentially what Travell was doing in 1942, and Gordon's massage methodology--which has been helping his clients for more than two decades, and the clients of thousands of other massage therapists for, what, about a 100 years--is at least as medically sound as any other methodology mentioned here."

You simply discharge Travell's work on the ground that it started in 1942 while Gordon's work freshly developed  20 years ago. If one will follow your train of thoughts than  the stomach resection called Billroth 1 should be abandon on the ground that it was developed by Teodore Billroth in 1881. There are newer methods proposed to address the same problems but every abdominal  surgeon knows and uses Billroth 1 approach when it is the best choice. The muscle pathology is the same medical condition as gastric abnormalities and it requires ability to make correct decision based on your client's needs instead of the personal preferences.

While you see Travell's work which based on enormous analysis of scientific data and clinical information as 'educated guess' you put your complete fate on Gordon's work. Let us agree at least at basic that Gordon's views, he has all rights to express, are based on his own personal clinical experience and they never underwent any scientific scrutiny. However Trvell's work did and I don't think that anyone may even closely compare contribution of both authors to the field of manual therapy and massage. Discharging Travell's  hard scientific data you immediately requsted to produce scientific data to justify aspects of trigger point therapy you feel uncomfortable. I think that if you don't believe and don't use scientific data  it doesn't make sense to request it.

I would like to finish this long post with final pleas to everyone: Don't restrict yourself in one or two techniques or approaches! This is a dead end! Learn new methods just to put them into the tool box and use when they needed. Don't believe anyone who claim that this particular method or technique is ultimate solution!

 

Dr. Ross Turchaninov

Gary W Addis said:

In general I agree with you about everything you've said.  But I also believe everything Gordon has said.  Especially the part about it not being necessary to analyze everything (as I tend to do) but to follow the course the body is trying to set, if the therapist is listening. After all, every client we see isn't in a state of major duress.  Alright, I guess here I'm going to question the analysis of a scientist.  Doctor, if you can't produce scientific proof that more than 3 minutes of ischemic compression will result in myelosis sometime down the road, it's just supposition, an educated guess, which is essentially what Travell was doing in 1942, and Gordon's massage methodology--which has been helping his clients for more than two decades, and the clients of thousands of other massage therapists for, what, about a 100 years--is at least as medically sound as any other methodology mentioned here.

 

I mean, medicine is still in its infancy.  just about every day we read about some accepted treatment that is being debunked.  In the scale of things, just yesterday, respected doctors were draining blood from patients, to "let the bad stuff out."

 

I don't know anything about anything...yet.   I for one am striving to keep my mind open to all possibilities.  As a scientist, you shouldn't be speaking in absolutes, either, should you?

 

Boris Prilutsky said:

Hi Gary.

Energy work is a different topic and in many cases significant and real results is unexplainable phenomena just clinical proving. I do believe that some people gifted and can do some miracles that most of us cannot. At this discussion we are talking on trigger point therapy that must be adequate.here we talking on scientifically developed and clinically  proven protocols of medical massage. This protocols most of us who have a passion to treat people can learn and to provide real therapy. It is crucial not to confuse this.I believe in simple approach to medical massage, but not to simplify trigger points therapy to some light touch that really providing therapy. I mean touch as a physical stimuli for trigger point therapy.

More than this I don't believe that any pathology  and histology texts referring as well as describing muscle knots as a pathological changes within muscles or mentioning it at all. I believe that"muscle knots" is a sensation description by people who is suffering from pinpoint pain localization .As a practitioners we shouldn't keep  "muscle knots" as a pathology in our minds because it can lead to some techniques that can harm. I mean if pathology  is not existing and you trying to apply some techniques to "open up muscle knots"it can be not only not productive but also traumatizing.On the other hand morphology of trigger points is very much known fact, as well proposed treatment designed to address this blood supply  insufficiency to this particular inflamed cells. Have a proposal let's stop in our discussion to use this term, and let's stop simplify massage therapy in general including to simplify  adequate trigger point therapy that's a little bit more demanding  then you have  described .

Best wishes.

Boris

 

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Stephen Jeffrey on July 8, 2011 at 2:04am

Great stuff Gary.....go with the flow, you are not alone.

http://www.massageprofessionals.com/group/massageandenergyworkunite...

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Stephen Jeffrey on July 8, 2011 at 3:04am

Hi Dr Turchaninov

Deep stroking does seem to have gained considerable favour with some practitioners

 http://www.learnmuscles.com/mtj%20TrP%20article%20-%201-08.pdf  I look forward to your forthcoming debate in science of massage.

 

I would also like to hear your opinion of the Borgini Stecco research (available on pub med) to which I refered earlier with regard to  compressions/holds of  2 min minimum up to 5+ mins for chronic fascial conditions as presented by antonio stecco at the recent world massage conference.
I love the research work of Luigi Stecco, but cannot understand why Stecco's release technique phase would take so long if the target tissue is correctly prepared ?

 

 

Dr. Ross Turchaninov said:

Stephen,

 

You are completely correct when saying that 3 min compression is harmful. It is unacceptable way apply ischemic compression. One minute and some cases even less is more than enough. Unfortunately this recent idea of slow stroking instead of ischemic compression doesn't have any scientific data and we will shortly discuss it in the next issue of Journal of Massage Science

 

Dr. Ross Turchaninov

 

Stephen Jeffrey said:

Hi Therese,

we all had a bit of a ding dong over ishemic compression duration, over in joe muscolinos group http://www.massageprofessionals.com/group/joemuscolinotheartandscie...

 and two camps seemed to evolve = those that favour long slow static, follow the melt, and those that argue the last thing a knott deprived of blood/oxygen needs is more depravation of blood/oxygen and insist the on off repeated deep stroking  is best.

Now that long static holds (average 3 mins) are being "recommended"  by scientific researchers in the new field of  fascia research I believe that those favouring longer holds are actually more involved with rectifying fascial constrictions than blood/ishemic ones. 

 

IMO it is always best to consider your massage (eg TP work) as having effects on fascial mechanisms  because every technique you use on any human body will be effecting fascia in some way. This is yet to be fully recognised and acknowleged by the many treatment manuals and protocols that will need to be re written:)  

 

   
Therese Schwartz said:

Lucianna, it's my understanding that ischemia refers to lack of blood supply.  In that sense a muscle knot could be ischemic because it certainly has lost appropriate blood flow.  With compression techniques we deliberately create temporary ischemia in order to encourage the body to rush blood into the area when the compression is complete.

 

I do think that long-term isometric contractions are very damaging!  Some of the worst cases involve people with their monitors too low, and people who talk by holding the phone between their ear and shoulder.  Muscles are meant to have a rest phase and if they don't get it, it's trouble.

 

Gordon, I need to pay attention to when you post about TP's - I want to know too!!

• ▶ Reply

Permalink Reply by Gordon J. Wallis on July 8, 2011 at 5:05am

Its not energy work...Its inducing a clasp knife reflex.  So the muscle collapses ,releasing the trigger point.

Stephen Jeffrey said:

Great stuff Gary.....go with the flow, you are not alone.

http://www.massageprofessionals.com/group/massageandenergyworkunite...

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Stephen Jeffrey on July 8, 2011 at 6:15am

The reply was to Gary's feelings of something else at work, possibly energy work.? discusion's do sometimes lead on to other subjects lol.

Gordon J. Wallis said:

Its not energy work...Its inducing a clasp knife reflex.  So the muscle collapses ,releasing the trigger point.

Stephen Jeffrey said:

Great stuff Gary.....go with the flow, you are not alone.

http://www.massageprofessionals.com/group/massageandenergyworkunite...

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Gary W Addis, LMT on July 8, 2011 at 7:48am

Ah, Dr turchaninov:  You said: "This picture consists from one simple fact that there is no silver bullet in one approach or technique  and the ultimate solution in the ability of the practitioner to have correct tools( in the form of suitable techniques in each particular case) at the correct time. In such case when you restrict yourself to the light touch in all cases of muscle pathology your clients on the loosing side"

Neither I nor Gordon nor anyone else has suggested that light touch be used exclusively.  To the contrary.  Gordon said, Use what works--sometimes a light touch but most of the time normal trigger point therapy, and in everything I have written, I have agreed with Gordon and Therese, et alial.  In the above quote, you said the same thing.  However, YOU made the definitive statement earlier that light touch was always harmful, in all cases, with all clients.  That is patently ridiculous--there is plenty of evidence out there--thousands of clients have benefited and still benefit to this day through the usage of a myriad of techniques.  How many modalities are there? More than 10, less than 10,000?  Your methods are not the only proven methods, Doctor.  That is all I am saying.  I certainly will not argue medicine with you.

 

Regarding Travell, I did not discount Travell's work.  I mentioned Travell to point out that the medical field (including massage therapy) is continuously evolving as more information is discovered.  Some of it is still supposition.  The things we have all been discussing have never been definitively defined--certainly not to the degree that practicing therapists should be disrespected as you have, when you discount as harmful to clients therapies that are practiced successfully by literally thousands of practitioners.  In the medical field researchers make pronouncements from on high that until proven in the field--on operating room tables, in MD offices-- that are just suppositions.

 

Your statement that I choose to ignore Travell's work as "supposition" and rely solely on Gordon's work is simply ludicrous, as Gordon himself has praised the work of Travell.  Please don't let your ego lead you astray.  I don't discount Travell--or your work for that matter.  I am merely saying that it is flat wrong for you or anyone else that doesn't work on clients to speak in absolutes...that you are wrong if you label the work of a therapist harmful in any way unless you have ever been treated by him or her--and not even then, for every body is different, that what works on john Doe Client today may not work on him tomorrow.  You should not condemn on the basis of a few words.  There are few absolutes in this life.  That is all I am saying.

 

I had essentially this same conversation a couple of months back, defending your colleague Boris against another scientist in a different but eerily similar conversation.

Dr. Ross Turchaninov said:

 

 

Gary,

 You referring to the fact that light touch helps thousands of clients including those who successfully treated by Gordon. Great! But this is generalization or let say 'educated guess' you just criticized above. The same way one may turn table and now apply the same judgement on your views (with the same thousand of patients). It seems that one of the views is wrong. I learned long ago that correct approach to any medical issue is small personal ego and integrative approach to solving any case.

 

I think that there are two completely different subjects are discussed here and it confuses the readers of this blog. The position you and Gordon defend is correct while position I defend is also correct. Why is that? The answer is very simple. Light touch with fingertips which is discussed here is very helpful tool when the client has hypertonus without formation of active trigger point. In such case the basic preparation of the muscle with following application of the light pressure "dissolves" so called knot (or hypertonus to called it correctly) without any trace. However when active trigger point is already formed and it distorts the normal contraction of the myofibrils and as a result local ischemia forms the light pressure alone is simply is not enough to get to the bottom of the well and completely eliminate trigger point. This is where ischemic compression is used. However ischemic compression is also isn't enough because it must follow by Muscle Energy techniques. 

From post to post and from publication to publication I see very sad trait when massage practitioners and educators trying address medical conditions. When the practitioners learned something they faithfully follow it loosing bigger picture. This picture consists from one simple fact that there is no silver bullet in one approach or technique  and the ultimate solution in the ability of the practitioner to have correct tools( in the form of suitable techniques in each particular case) at the correct time. In such case when you restrict yourself to the light touch in all cases of muscle pathology your clients on the loosing side. 

Couple final thoughts. You are writing that:

"..it's just supposition, an educated guess, which is essentially what Travell was doing in 1942, and Gordon's massage methodology--which has been helping his clients for more than two decades, and the clients of thousands of other massage therapists for, what, about a 100 years--is at least as medically sound as any other methodology mentioned here."

You simply discharge Travell's work on the ground that it started in 1942 while Gordon's work freshly developed  20 years ago. If one will follow your train of thoughts than  the stomach resection called Billroth 1 should be abandon on the ground that it was developed by Teodore Billroth in 1881. There are newer methods proposed to address the same problems but every abdominal  surgeon knows and uses Billroth 1 approach when it is the best choice. The muscle pathology is the same medical condition as gastric abnormalities and it requires ability to make correct decision based on your client's needs instead of the personal preferences.

While you see Travell's work which based on enormous analysis of scientific data and clinical information as 'educated guess' you put your complete fate on Gordon's work. Let us agree at least at basic that Gordon's views, he has all rights to express, are based on his own personal clinical experience and they never underwent any scientific scrutiny. However Trvell's work did and I don't think that anyone may even closely compare contribution of both authors to the field of manual therapy and massage. Discharging Travell's  hard scientific data you immediately requsted to produce scientific data to justify aspects of trigger point therapy you feel uncomfortable. I think that if you don't believe and don't use scientific data  it doesn't make sense to request it.

I would like to finish this long post with final pleas to everyone: Don't restrict yourself in one or two techniques or approaches! This is a dead end! Learn new methods just to put them into the tool box and use when they needed. Don't believe anyone who claim that this particular method or technique is ultimate solution!

 

Dr. Ross Turchaninov

Gary W Addis said:

In general I agree with you about everything you've said.  But I also believe everything Gordon has said.  Especially the part about it not being necessary to analyze everything (as I tend to do) but to follow the course the body is trying to set, if the therapist is listening. After all, every client we see isn't in a state of major duress.  Alright, I guess here I'm going to question the analysis of a scientist.  Doctor, if you can't produce scientific proof that more than 3 minutes of ischemic compression will result in myelosis sometime down the road, it's just supposition, an educated guess, which is essentially what Travell was doing in 1942, and Gordon's massage methodology--which has been helping his clients for more than two decades, and the clients of thousands of other massage therapists for, what, about a 100 years--is at least as medically sound as any other methodology mentioned here.

 

I mean, medicine is still in its infancy.  just about every day we read about some accepted treatment that is being debunked.  In the scale of things, just yesterday, respected doctors were draining blood from patients, to "let the bad stuff out."

 

I don't know anything about anything...yet.   I for one am striving to keep my mind open to all possibilities.  As a scientist, you shouldn't be speaking in absolutes, either, should you?

 

Boris Prilutsky said:

Hi Gary.

Energy work is a different topic and in many cases significant and real results is unexplainable phenomena just clinical proving. I do believe that some people gifted and can do some miracles that most of us cannot. At this discussion we are talking on trigger point therapy that must be adequate.here we talking on scientifically developed and clinically  proven protocols of medical massage. This protocols most of us who have a passion to treat people can learn and to provide real therapy. It is crucial not to confuse this.I believe in simple approach to medical massage, but not to simplify trigger points therapy to some light touch that really providing therapy. I mean touch as a physical stimuli for trigger point therapy.

More than this I don't believe that any pathology  and histology texts referring as well as describing muscle knots as a pathological changes within muscles or mentioning it at all. I believe that"muscle knots" is a sensation description by people who is suffering from pinpoint pain localization .As a practitioners we shouldn't keep  "muscle knots" as a pathology in our minds because it can lead to some techniques that can harm. I mean if pathology  is not existing and you trying to apply some techniques to "open up muscle knots"it can be not only not productive but also traumatizing.On the other hand morphology of trigger points is very much known fact, as well proposed treatment designed to address this blood supply  insufficiency to this particular inflamed cells. Have a proposal let's stop in our discussion to use this term, and let's stop simplify massage therapy in general including to simplify  adequate trigger point therapy that's a little bit more demanding  then you have  described .

Best wishes.

Boris

 

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Boris Prilutsky on July 8, 2011 at 8:11am

Gary.at one of your posts you did call me a friend.I did appreciate it and didn't took it for granted. To be friends is also means to trust.therefore I would like to ask you to trust my advice.A) try to focus on discussion. I mean yesterday you described some energy work, but replied to trigger point therapy discussion, and addressed it what you did as a  trigger point  therapy,that done by light pressure.B) don't rush to come to some conclusions because it will resist your development as a massage therapist.C) don't take personal my posts because as a friend at this point I'm looking for you.

I do know that you would trust Dennis. Great person, who achieved a lot in the world where you coming from.I had opportunity to listen to his presentation and can tell you that he knew anatomy and physiology including details in regards of muscles contractions but when I did explain to him the concept of comprehensive approach including importance of real TPT he changed his views on rehabilitation.I Absolutely do not disregard Gordon's works and capabilities just disagree when he's simplified TPT .this all.I am offering this link not to show off but maybe little bit to slow down you with rushing

to conclusions.

http://www.youtube.com/watch?v=5zrCDtSigK4

your friend.

Boris

 

Gary W Addis said:

In general I agree with you about everything you've said.  But I also believe everything Gordon has said.  Especially the part about it not being necessary to analyze everything (as I tend to do) but to follow the course the body is trying to set, if the therapist is listening. After all, every client we see isn't in a state of major duress.  Alright, I guess here I'm going to question the analysis of a scientist.  Doctor, if you can't produce scientific proof that more than 3 minutes of ischemic compression will result in myelosis sometime down the road, it's just supposition, an educated guess, which is essentially what Travell was doing in 1942, and Gordon's massage methodology--which has been helping his clients for more than two decades, and the clients of thousands of other massage therapists for, what, about a 100 years--is at least as medically sound as any other methodology mentioned here.

 

I mean, medicine is still in its infancy.  just about every day we read about some accepted treatment that is being debunked.  In the scale of things, just yesterday, respected doctors were draining blood from patients, to "let the bad stuff out."

 

I don't know anything about anything...yet.   I for one am striving to keep my mind open to all possibilities.  As a scientist, you shouldn't be speaking in absolutes, either, should you?

 

Boris Prilutsky said:

Hi Gary.

Energy work is a different topic and in many cases significant and real results is unexplainable phenomena just clinical proving. I do believe that some people gifted and can do some miracles that most of us cannot. At this discussion we are talking on trigger point therapy that must be adequate.here we talking on scientifically developed and clinically  proven protocols of medical massage. This protocols most of us who have a passion to treat people can learn and to provide real therapy. It is crucial not to confuse this.I believe in simple approach to medical massage, but not to simplify trigger points therapy to some light touch that really providing therapy. I mean touch as a physical stimuli for trigger point therapy.

More than this I don't believe that any pathology  and histology texts referring as well as describing muscle knots as a pathological changes within muscles or mentioning it at all. I believe that"muscle knots" is a sensation description by people who is suffering from pinpoint pain localization .As a practitioners we shouldn't keep  "muscle knots" as a pathology in our minds because it can lead to some techniques that can harm. I mean if pathology  is not existing and you trying to apply some techniques to "open up muscle knots"it can be not only not productive but also traumatizing.On the other hand morphology of trigger points is very much known fact, as well proposed treatment designed to address this blood supply  insufficiency to this particular inflamed cells. Have a proposal let's stop in our discussion to use this term, and let's stop simplify massage therapy in general including to simplify  adequate trigger point therapy that's a little bit more demanding  then you have  described .

Best wishes.

Boris

 

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Gary W Addis, LMT on July 8, 2011 at 8:20am

Stephen, I visited the other thread.  Interesting stuff.  Whatever was going on with me came about as a natural connection, it may not have had anything to do with energy flow, it may have been due to my connection with the client, my desire to ease her pain.  Could be nothing more than her sensing the caring in my touch--with my eyes closed I was certainly concentrating fully on her.  The difference between the touch of a lover on your shoulder and the touch of a casual acquaintance.  In the other thread a Reiki master decried the energy modalities usage of symbols and meridians that the poster seems to consider somewhat gimmicky.  Not having studied the stuff yet, at this moment I lean toward thinking the energy stuff "magic" meridians are akin to ritualism's usage of prayer beads.  They help the prayerful focus, but are hardly necessary in order to be heard.  I remain open though. 

Stephen Jeffrey said:

Great stuff Gary.....go with the flow, you are not alone.

http://www.massageprofessionals.com/group/massageandenergyworkunite...

Gary W Addis said:

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Gary W Addis, LMT on July 8, 2011 at 8:23am

Stephen, that's a great article, thanks for the link.

Stephen Jeffrey said:

Hi Dr Turchaninov

Deep stroking does seem to have gained considerable favour with some practitioners

 http://www.learnmuscles.com/mtj%20TrP%20article%20-%201-08.pdf  I look forward to your forthcoming debate in science of massage.

 

I would also like to hear your opinion of the Borgini Stecco research (available on pub med) to which I refered earlier with regard to  compressions/holds of  2 min minimum up to 5+ mins for chronic fascial conditions as presented by antonio stecco at the recent world massage conference.
I love the research work of Luigi Stecco, but cannot understand why Stecco's release technique phase would take so long if the target tissue is correctly prepared ?

 

 

Dr. Ross Turchaninov said:

Stephen,

 

You are completely correct when saying that 3 min compression is harmful. It is unacceptable way apply ischemic compression. One minute and some cases even less is more than enough. Unfortunately this recent idea of slow stroking instead of ischemic compression doesn't have any scientific data and we will shortly discuss it in the next issue of Journal of Massage Science

 

Dr. Ross Turchaninov

 

Stephen Jeffrey said:

Hi Therese,

we all had a bit of a ding dong over ishemic compression duration, over in joe muscolinos group http://www.massageprofessionals.com/group/joemuscolinotheartandscie...

 and two camps seemed to evolve = those that favour long slow static, follow the melt, and those that argue the last thing a knott deprived of blood/oxygen needs is more depravation of blood/oxygen and insist the on off repeated deep stroking  is best.

Now that long static holds (average 3 mins) are being "recommended"  by scientific researchers in the new field of  fascia research I believe that those favouring longer holds are actually more involved with rectifying fascial constrictions than blood/ishemic ones. 

 

IMO it is always best to consider your massage (eg TP work) as having effects on fascial mechanisms  because every technique you use on any human body will be effecting fascia in some way. This is yet to be fully recognised and acknowleged by the many treatment manuals and protocols that will need to be re written:)  

 

   
Therese Schwartz said:

Lucianna, it's my understanding that ischemia refers to lack of blood supply.  In that sense a muscle knot could be ischemic because it certainly has lost appropriate blood flow.  With compression techniques we deliberately create temporary ischemia in order to encourage the body to rush blood into the area when the compression is complete.

 

I do think that long-term isometric contractions are very damaging!  Some of the worst cases involve people with their monitors too low, and people who talk by holding the phone between their ear and shoulder.  Muscles are meant to have a rest phase and if they don't get it, it's trouble.

 

Gordon, I need to pay attention to when you post about TP's - I want to know too!!

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