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A typical experience
I had a new client the other day for an 80 minute massage. I asked him if there is anything that he wanted me to know. He told me that he suffers from a herniated disc that he has had for a few years. He has constant low back and right hip pain that at times radiates down the back of his leg to his knee. He told me that he has had two injections in his low back and has to stay on anit- inflamtory medication. Anything to avoid surgery. The pain is always there. I asked him if he ever saw a chiropractor for his pain. He said yes. But the adjustments hurt his hip so bad that he could not continiue. So here is a guy that thinks he is on the verge of surgery. I knew that there was a very strong probubllity that was not the case. The vast majority of pain people experience is nocioceptive pain( soft tissue- muscle, tendon, ligament, facia). MDs and Chiropractors see pain as neuropathic pain( nerve pain). With that asumption they give the wrong treatments and therapies. Now there is no denying that at times injections and surgery is needed. Not denying that. But most of the time - NOT. 70% to 85% of all pain comes directly from trigger points. Anyway I showed my client a testimonial from a client that I was able to help out of a very painful condition that she had delt with for a couple of years. I showed him that testimonial because all pain has a psychological eliment too it. I wanted him to start thinking maybe he is not on the edge of surgery. I palpated his entire back upper torso, both hips, and right leg. I found a very painful spot on his right L5 erectors. Another very painful spot on his right greater trochantor. A painful spot in the middle part of his lower right hamstrings. And also a tender spot on the right spinous of L3. I knew that if Iwas able to eliminate all those painful palaptory spots that I would most likely eliminate his pain problem. Because a healthy body had no painful spots even with deep massage. Ive been hunting and eliminateing trigger points for thirty years now. He walked out of the massage room pain free. He was pain free for the first time in years. All those other professional people misdiagnosed him because they assume neuropathic pain over nocioceptive pain. I assume the other way around. I'm a Massage Therapist.
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Replies to This Discussion
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Permalink Reply by Maryshka on
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My mistake, or my understanding of massage therapy that TrP work is a modality used in massage... used with effleurage. I understood it that you are a massage therapist who specializes in TrPs. A point I tried to make about the value of massage therapy. Clients need to find the right therapist for their conditions, meaning your client found the right therapist for what she needed (you). It's come to light that more emphasis on TrPs needs to be covered in massage schools perhaps.
Curious if you call yourself a massage therapist or have a different 'bodywork' title? How do you advertise yourself if someone doesn't know you/your work, or is trying to figure out what they need? Most people probably wouldn't know to ask for a 'trigger point' therapist...
Thanks for all the lessons.
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Permalink Reply by Gary W Addis, LMT on
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My business card reads "Gary Addis, LMT, and beneath that "Neuromuscular Therapist".
Schools that even mention the trigger points teach brutal ischemic compression-- dig in till the client nearly jumps off the table and hold the pressure for up to ten minutes. Gordon steered my self-study in the right directions. Today, I know better, quicker, less painful methods.
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Permalink Reply by Therese Schwartz on
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I wasn't even introduced to the idea of Trigger Points in school. And no, I didn't miss that section! :-) It's probably just as well; our main instructor, when asked what she does for a living, says "I make grown men cry".
I've used what I've learned from Gordon to really help people. I don't have his skill or understanding level, but I just put some pressure on the TrP (well within the client's tolerance) and then move the attached limb around slowly to massage the TrP from the inside. It seems to be working well, and not causing stress to my clients to work that way.
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Good for you! Few LMTs seem to care. Now, I watch Dalton's and Luchau's and Ben Benjamin's and Tom Myers' videos (when offered free). But not once do they ever mention trigger points. Their thinking seems to be, why cure in 15 minutes what I can extend to ten sessions using Rolfing techniques. I'd love to learn study Myers stuff, and I like Luchau's prsentations. But, Gordon is right: 99% of the time it's trigger points.
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I'm familiar with all those names but the only one I've studied is Lucau. I have his complete DVD set, and went to one of his 3-day classes. I'd love to do more, but I can only travel so much. He is really terrific! I should do more with Dalton; his home base is only about 75 minutes from me.
I've done a fair amount of work with fascia; many times, the fascia gets stuck and contorted and much can be done to help people by freeing that up. And scar tissue work is invaluable! Adding in the TrP work is taking my successful practice and making it even better! I have a waiting list this week!!
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all those mentioned have lots of youtube videos; you can pick up quite a lot that way w/o paying out a dime.
Therese Schwartz said:I'm familiar with all those names but the only one I've studied is Lucau. I have his complete DVD set, and went to one of his 3-day classes. I'd love to do more, but I can only travel so much. He is really terrific! I should do more with Dalton; his home base is only about 75 minutes from me.
I've done a fair amount of work with fascia; many times, the fascia gets stuck and contorted and much can be done to help people by freeing that up. And scar tissue work is invaluable! Adding in the TrP work is taking my successful practice and making it even better! I have a waiting list this week!!
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Permalink Reply by Gordon J. Wallis on
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I've owned those videos. They are excellent in their own way. But there is noting on those videos that would have helped that client who wrote the testimonial. I have Myers book, and some of his videos. Not one mention of trigger points. However I do use the information in his book to help people , like the testimonial client. Whats good about Myers book is its a great resource for further thinking. But not a mention of trigger points. And the techniques demoed would have not helped
her. And massage schools not even mentioning trigger points is not that uncommon. Which seems real bizare to me when you consider that 70% to 85% of all pain is from trigger points, and that trigger points are involved in 90% of all pain syndromes. Several years ago I was invited to give a brief talk at a local massage school. These people were ready to graduate. I was at the front of the room. I asked.. CAN anyone here tell me what a trigger point is. I got blank stares back. One young lady did raise her hand.. She said.. Isn't it an energy blockage? I looked at the lead instructor of the school.. I said do you know what a trigger point is?. She said no. After my little talk the instructor wanted me to teach at the school. And had me look over the curriculum. She left me alone as I culled through the material to be taught. When she came back she aasked me what I thought. I said.. Gosh I can't teach this. She said why? I said.. I don't know any of this stuff. Then she said.. But you are a professional massage therapist?. I said well, I guess you don't need to know any of this stuff to be a professional massage therapist. I've said many a time on this site that OUr education system needs to completely revamped. And you just heard why. But, what do I know?
Gary W Addis, LMT said:Good for you! Few LMTs seem to care. Now, I watch Dalton's and Luchau's and Ben Benjamin's and Tom Myers' videos (when offered free). But not once do they ever mention trigger points. Their thinking seems to be, why cure in 15 minutes what I can extend to ten sessions using Rolfing techniques. I'd love to learn study Myers stuff, and I like Luchau's prsentations. But, Gordon is right: 99% of the time it's trigger points.
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Gordon, I need help! I just got done working on a client; she's actually still here! I've done all kinds of work with her up to this point, and it's all been helpful. Today, I did something different and "accidentally" discovered that she has literally dozens of TrP's in each lateral hamstring and quad. Also tons in the hip rotators. I've never felt this many trigger points in one person before - it got my head spinning! What do you recommend I do to help her? Besides check out in detail the TrP website you have referenced?
I told her not to stretch for a couple of days, but to keep up the light exercise she's doing (1/3 mile on treadmill and 2 on recumbent bike). Should she keep that up, or take a break?
Any help would be greatly appreciated!!
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I think Gordon will agree with me that she should stop the exercising until after you have successfully treated the trigger points. TPs are injuries, they are contractures; they interfere with the free movement of a muscle, and forcing them to move despite the restrictions can incite the formation of antagonist muscle trigger points.
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I'm at work now. But I will give you some general advice when I get home from work.
Therese Schwartz said:Gordon, I need help! I just got done working on a client; she's actually still here! I've done all kinds of work with her up to this point, and it's all been helpful. Today, I did something different and "accidentally" discovered that she has literally dozens of TrP's in each lateral hamstring and quad. Also tons in the hip rotators. I've never felt this many trigger points in one person before - it got my head spinning! What do you recommend I do to help her? Besides check out in detail the TrP website you have referenced?
I told her not to stretch for a couple of days, but to keep up the light exercise she's doing (1/3 mile on treadmill and 2 on recumbent bike). Should she keep that up, or take a break?
Any help would be greatly appreciated!!
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Gary, I think that's what has happened for this poor woman - the formation of more TrP's. She's in so much pain all the time! I told her I'd email her if it was recommended by people who know more about trigger points than I do to stop exercising.
I just couldn't believe how many she has. I'm not exaggerating the number at dozens per leg; that may be conservative. And the density! They are almost on top of each other! It's unreal. I felt really out of my depth having that many to deal with, with no formal training.
Gordon, thanks! I appreciate everything you can tell me. She won't be back until next Monday; she's once a week.
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Just general thoughts (I'll leave the treatment recommendations to Gordon). Since her tps are in hips and hamstrings, they may be a reaction to overwork in the quads or even the iliacus...trying to achieve balance in anterior and posterior muscles. So, me? I'd first work the anterior, paying extra attention to the psoas, TFL, gracilis and on lateral leg, vastus lateralis.
That many TPs, she may flinch every time you touch one. It's important that you downshift the pain Gordon will explain how he does that.
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