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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 Gary W Addis, LMT on
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bones are attachments for muscles...muscles move the bones. So if there is a gap between the bones along the fracture, perhaps the opposing muscles are fighting a war, with the fractured bone as the battleground.
Therese Schwartz said:Hey Gordon! Based on what the xray looks like, the fracture has not healed at all. It's gapped open. The question to answer now is why is it not healed? And why did it happen, given that I didn't have a violent trauma? I can tell you that I have a LOT of trigger points as a result of having this fracture for so long! It has definitely caused a lot of problems. I have good people helping me with the soft tissue work.
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Permalink Reply by Therese Schwartz on
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No. That was 3 years ago and it was my left quad that took the brunt of it. I fell on my butt in sand in January and thought "ow" as both my SI joints flared with pain, but that was it. I got up and went on. It was shortly after that that this pain started, so it is probably related.
Gordon J. Wallis said:
Therese, remember when you got kicked by your horse a while back. Could that possibly have done it?
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If so, it's a hell of a war! I do have a lot of muscle tension - always have. The people who have done bodywork on me are amazed at the tension in the muscles and fascia. I've kept going and working on people for the last several months with this going on! So I'm sure I've added to the tension in the soft tissues.
Gary W Addis, LMT said:
bones are attachments for muscles...muscles move the bones. So if there is a gap between the bones along the fracture, perhaps the opposing muscles are fighting a war, with the fractured bone as the battleground.
Therese Schwartz said:Hey Gordon! Based on what the xray looks like, the fracture has not healed at all. It's gapped open. The question to answer now is why is it not healed? And why did it happen, given that I didn't have a violent trauma? I can tell you that I have a LOT of trigger points as a result of having this fracture for so long! It has definitely caused a lot of problems. I have good people helping me with the soft tissue work.
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Permalink Reply by Gordon J. Wallis on
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Hmm, it's amazing you were able to keep working. Only thing I can think of is maybe do some research as to what suppliments support strong bones and healing.
Therese Schwartz said:If so, it's a hell of a war! I do have a lot of muscle tension - always have. The people who have done bodywork on me are amazed at the tension in the muscles and fascia. I've kept going and working on people for the last several months with this going on! So I'm sure I've added to the tension in the soft tissues.
Gary W Addis, LMT said:
bones are attachments for muscles...muscles move the bones. So if there is a gap between the bones along the fracture, perhaps the opposing muscles are fighting a war, with the fractured bone as the battleground.
Therese Schwartz said:Hey Gordon! Based on what the xray looks like, the fracture has not healed at all. It's gapped open. The question to answer now is why is it not healed? And why did it happen, given that I didn't have a violent trauma? I can tell you that I have a LOT of trigger points as a result of having this fracture for so long! It has definitely caused a lot of problems. I have good people helping me with the soft tissue work.
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I recently worked on a pregnant women( six months ) that came in complaining of low back and hip pain, with the left side being the worst. Before starting her massage I palpated, through the sheet, for trigger points from her glutes to T12. I found medium level tender points in her Gluteus Medius on both sides. A medium level tender point in her Piriformis on the left. Tender points in her Quadratus Lumborum on both sides. The Quadratus Lumborum tender point on the left made her whole body flinch when palpated. It was the worst one. I eliminated all the tender points, then carried on with her massage.. It was an 80 minute massage and she was a young healthy women so I went ahead and massaged her hips and QL. Normally if it's a not to healthily a person or a chronic pain person, I won't massage over areas where I had previously released trigger points... I have found that sometimes the massage actually reactivates the trigger points. Anyway, before she left I repalpated the trigger pointed areas just to make sure they were gone when she left the spa. All were gone except the really bad QL one on the left. It came back. So I released it again. She left the spa pain free. In the attachment are the QL trigger points. The middle trigger point picture is the one I had to release twice on her left hip.. It was right on the Illiac crest.
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https://m.youtube.com/watch?v=telHwkbwhkY
If you are new to trigger points, this would be a good way to start. But like I've said previously, people tend to over complicate things. There is no need to do a postural analysis. That just takes up unnecessary time if you ask me. However, it does point out the fact that trigger points do and can distort posture. Everyone thinks they have to rip though fascia in order to address postural distortions. Also, no need to try and feel for the trigger point. My friend Gary has a hearing problem so he depends more on feel then one would normally have too.. Both her and Chaitow waist too much time, in my opinion, trying to feel for a trigger point. When they think they have found one, they press and ask if it hurts. Why not just press the muscle and have the client tell you when it hurts? Also, who cares if it radiates or not? It doesn't matter if it's an active or latent trigger point. A totally healthy muscle has no trigger point at all. You wanna get rid of it or down grad it. Usually the symptomatic trigger points will be somewhere within a foot or so of the area of complaint. After you have downgraded or eliminated those trigger points you can cary on with the massage informing the client to tell you if or when you go over another sore spot somewhere else on the body. But keeping the trigger point on a pain scale of 7 is a simple way to start doing trigger point work. Assuming that's what you want to do? It will make your work very affective compared to other health care professions that deal with pain. Unless those other professions are doing trigger point work themselves, which they usually are not 99% of the time. I don't use trigger point charts, but it's a good idea to show the clients why they hurt. Because they have probably been told that it's arthritis or pinched nerves or something un true by others. And if the client feels noticeably better after the session that it's important to tell them that they can feel like that all the time if those trigger points are gone, and inform them that follow up sessions will be most helpful in keeping and making them feel better.
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In the attachment below is a synopsis or introduction to a book on pain. I have not read the book, but I can guess that there is no mention of trigger points. The author correctly points out that the main reason for people to see their doctor is because of pain. He uses the word enigma when describing pain. In other words most pain is a mystory to physicians. And the author states that there is no way to objectively measure pain. All those statements make sense if one does not know about trigger points. And that's usually the case with most health care providers as I've said many times on this thread. A very high percentage of chronic pain is trigger points.. 85%. That's a lot. If you know about trigger points, then chronic pain is not so mysterious. And if you know about trigger points, pain can also be objectively measured. For example. When you do your first evaluation you find 10 trigger points. The next session there are only 8 trigger points. The next session there are 7 trigger points and so on. That's an objective measurement. I'm not an expert on pain, but I am through default, because no one knows anything about trigger points.
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I'm adding one of my testimonials, that you have seen before, to the attachment below. But it fits in with the above paragraph. This lady had hip pain for ten years!!! Went to all kinds of doctors that could not help her. Pain was an enigma. If you don't know about trigger points it certainly is. Her problem was really simple. I only had to see her two times. The misdiagnosises of pain is rampent.
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I've been in pain, but to me it rarely seems consistent with a broken bone. At times, though, it has been debilitating! But considering what's going on, I would think it would hurt worse than it does. I do have to admit that the constant nagging pain, even though it's not stopping me, has worn me down. Before I had xrays done, I was ready to cancel all clients for some good length of time. I still might have to! I will definitely be looking into supplements.
Gordon J. Wallis said:
Hmm, it's amazing you were able to keep working. Only thing I can think of is maybe do some research as to what suppliments support strong bones and healing.
Therese Schwartz said:If so, it's a hell of a war! I do have a lot of muscle tension - always have. The people who have done bodywork on me are amazed at the tension in the muscles and fascia. I've kept going and working on people for the last several months with this going on! So I'm sure I've added to the tension in the soft tissues.
Gary W Addis, LMT said:
bones are attachments for muscles...muscles move the bones. So if there is a gap between the bones along the fracture, perhaps the opposing muscles are fighting a war, with the fractured bone as the battleground.
Therese Schwartz said:Hey Gordon! Based on what the xray looks like, the fracture has not healed at all. It's gapped open. The question to answer now is why is it not healed? And why did it happen, given that I didn't have a violent trauma? I can tell you that I have a LOT of trigger points as a result of having this fracture for so long! It has definitely caused a lot of problems. I have good people helping me with the soft tissue work.
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I had a new client come in for a deep tissue massage. When ever I hear the words deep tissue. It usually means one of two things. They want a good massage, not just a soft oil rub, or they hurt and associate deep tissue with pain relief. So I asked the client which one she meant? She said both. She told me that she gets headaches all the time. Usually three or four times a week. I asked her if she had a headache now. She said no. I had some free time, so I thought I'd get a massage anyway. I asked her where she feels her headache when she has one. She told me on the right side only.. She feels it from her shoulder up through her neck to the base of her skull, and in her eye and the side of her head. All on the right side. But it's not there now..... So of course I'm thinking trigger points. And even though she has no headache now I'm sure they ( trigger points ) are going to be there. Latent trigger points. In other words none symptomatic, just waiting for the right stressor to activate. On palpation I found a couple upper T spine pain points, two very tender ( on palpation ) upper trap pain points. Three posterior neck pain points. Occipital pain point at the C1 level. A masseter pain point, and three pain points on her SCM.. All on the right side. I deactivated all of those trigger points. Now they were none symptomatic, but on palpation she felt the pain and the pain patterns. The rest of the time I spent giving her a good firm massage. Oh she also had a noticible trigger point on her right ankle that I was able to deactivate. I suggested that she come in for follow ups to see if we can get rid of those trigger points forever. She didn't quite understand what I was saying.. She comented that the next time she has a headache, she will come and see me. Well that might be a good idea, but if she comes in before she gets those headaches, there would be a chance that she would not get a headache. Anyway I will attatch a chart of her SCM trigger points. She had all of them. Combine that with her other trigger points. You get a good picture of her headache. Oh forgot to mention this. She told me that therapists are usually afraid to work on her neck, and she is afraid to let them. But she felt comfortable with me working on her neck. I though that was interesting.
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Her one sided pain can be viewed as in the attachement below.
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Wow! She had a lot going on!
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