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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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I will ALWAYS be skeptical of CST. Gordon, what you did by very briefly touching her skull was not CST-- you weren't moving bones of the skull, you were contacting a surface nerve that has Lovett Brothers Relationship with the coccyx...to release a trigger point at the coccyx. CST claims to manipulate sutures that weld permanently together in adulthood.
In my opinion (I assume I am allowed one), Cranial Sacral Therapy is entirely placebo effect, since (and science confirms this) the sutured plates of the skull cannot be manipulated. Scientific instruments are fabulous today, which have not been employed to prove that cranial bones can be moved even one micrometer
But, hey, placebo is a very real effect, and undoubtedly plays a part in all medical treatments (incl trigger point therapy). Testimonial evidence abounds that strong faith (placebo) has contributed to miraculous reversals of terminal illnesses.
Gordon J. Wallis said:Gary, you saw that video. You in the past you have been skeptical of Cranial Sacral Therapy. What you see in that video is not classical Cranial Sacral Therapy. But I did touch her cranium and the Coccyx pain vanished. Is that placebo or? That question goes for anybody, not just Gary.
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Permalink Reply by Therese Schwartz on
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I am replying because the public has access to this, and I want to have the correct story out there. Whatever people think of CST is fine; everyone is indeed allowed to have an opinion. However, science has been employed and has proved that the skull bones do actually move. You may think what you like about CST, but I want people to base their opinions in something other than bad science from almost 100 years ago. It doesn't take much searching (a few seconds really) to find articles. Here is one from Massage Today: http://www.massagetoday.com/mpacms/mt/article.php?id=13807
Here's another one: https://www.korenspecifictechnique.com/CuteEditor/FileUploads/Do_Cr...
Of course, you will find plenty of articles refuting this as well, because people don't change their dogma even with evidence. To do that, they would have to admit they are wrong and for some people that is impossible. Even people who experience positive results with CST but don't believe in it will find all manner of other reasons why they feel better. They are allowed to do that, of course.
Again, my point in this post is to put it out there that the concept of fused skull bones is based in bad science and is a century outdated (and wasn't even shared across the globe, ie not everyone believed that the skull bones fused in adulthood). I know that no amount of evidence will change anyone's mind because we aren't dealing with a debate about science, we are dealing with beliefs. But for those who are interested, they can follow the links to more information.
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Permalink Reply by Gordon J. Wallis on
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In osteopathy, abnormal dural tension is the fundamental principle used to explain cranial and ilio-sacro-coccygeal imbalances. Muscle dysfunction is always associated with abnormal dural tension.
So on that theory, what I'm doing is influencing the dura matter. Dura is in the sutures of the skull, surrounds the brain and spinal cord and into the sacrum. The coccyx to the sutures of the skull are connected. If you pull on one end of the shirt, it's felt on the other end of the shirt. But I'm not sure. It's just a theory. I could be a charismatic charlatan? I will add the video again.
https://www.youtube.com/watch?v=rWDML1jqGo8&sns=em
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no offense to you, Therese. I simply do not consider your sources as scientifically valid. You've invested hundreds of hours and thousands of dollars in CST, and practicing it probably provides a major portion of your income. And I'm sure you believe everything you've read, and have had many satisfied clients. Good for you, good for them.
I reiterate, however, that trigger point release does not rely on placebo effect: a trigger point is very real; when it releases the client relief is immediately happy.
Most of my elderly clients don't watch videos of anyone in action; the only explanation I provide beforehand is "I may be able to help you, but I certainly won't make it worse." I don't mention the term "trigger point" until the session is finished. In the course of a normal full body massage I find and apply very light compression to any TrP and using techniques I've learned from Gordon, almost always the tp instantly vanishes (I feel the tissue relax beneath my finger or thumb)... then I move on to the next tender spot. As I said, my touch is gentle, and I'm not asking for input while the client is on the table-- these are old folk and tend to drop off into a restful snooze while I work. When finished, with a tap to wake up the sleepers, I leave the room while they dress. The usual comment is "What did you do! I can move it without hurting!"
Not placebo effect: they've had the injections, swallowed the pills, visited a chiropractor, gone through physical therapy, some have had one or more operations on that joint and years later, the pain is still with them.
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Certainly find more to believe in your links than that from a DC's website. However, without investing the time to read the article, first impression is that the movement referred to is intercranial (pressure on the inside)-- not caused by CST practitioner merely resting the hands on the sutures and holding it for long minutes till it magically moves on its own. And I certainly do not accept the notion that cerebrospinal fluid flows through connective tissue of the body."Cerebrospinal fluid (CSF) is a clear, colorless fluid found in the brain and spinal cord. It is produced in the choroid plexuses of the ventricles of the brain. It acts as a cushion or buffer for the brain, providing basic mechanical and immunological protection to the brain inside the skull."
Pueppi Texas said:Gary W Addis, LMT said:
...sutures that weld permanently together in adulthood.Therese Schwartz said:
I am replying because the public has access to this, and I want to have the correct story out there. Whatever people think of CST is fine; everyone is indeed allowed to have an opinion. However, science has been employed and has proved that the skull bones do actually move.I have no stake in the CST argument, but I agree with Therese Schwartz --- it makes sense to discuss documented movement within the sutures, since many people think a weld means there is zero movement tolerance. I believe this tiny amount of movement is due to the Sharpey fibers that are within the sutures. I would just cite this article from Neurosurgery - 1993:
Neurosurgery. 1993 Nov;33(5):869-76; discussion 876-7. (https://www.ncbi.nlm.nih.gov/pubmed/8264886)
Role of cranial bone mobility in cranial compliance.Heisey SR1, Adams T.
Department of Physiology, College of Human Medicine, Michigan State University, East Lansing.
"Our data indicate that although the cranial bones move apart even with small (nominally 0.2 ml) increases in ICV, total cranial compliance depends more on fluid migration from the cranium when ICV increases are less than approximately 3% of total cranial volume. Cranial bone mobility plays a progressively larger role in total cranial compliance with larger ICV increases."
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Gordon, this fits with what I understand about the system.
Gordon J. Wallis said:In osteopathy, abnormal dural tension is the fundamental principle used to explain cranial and ilio-sacro-coccygeal imbalances. Muscle dysfunction is always associated with abnormal dural tension.
So on that theory, what I'm doing is influencing the dura matter. Dura is in the sutures of the skull, surrounds the brain and spinal cord and into the sacrum. The coccyx to the sutures of the skull are connected. If you pull on one end of the shirt, it's felt on the other end of the shirt. But I'm not sure. It's just a theory. I could be a charismatic charlatan? I will add the video again.
https://www.youtube.com/watch?v=rWDML1jqGo8&sns=em
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Gary, I have utmost respect for your gentle ways and results! I don't buy into trigger points, just like you don't buy into CST. But we both get results and have happy clients who are in less pain. Everyone wins!
Gary W Addis, LMT said:no offense to you, Therese. I simply do not consider your sources as scientifically valid. You've invested hundreds of hours and thousands of dollars in CST, and practicing it probably provides a major portion of your income. And I'm sure you believe everything you've read, and have had many satisfied clients. Good for you, good for them.
I reiterate, however, that trigger point release does not rely on placebo effect: a trigger point is very real; when it releases the client relief is immediately happy.
Most of my elderly clients don't watch videos of anyone in action; the only explanation I provide beforehand is "I may be able to help you, but I certainly won't make it worse." I don't mention the term "trigger point" until the session is finished. In the course of a normal full body massage I find and apply very light compression to any TrP and using techniques I've learned from Gordon, almost always the tp instantly vanishes (I feel the tissue relax beneath my finger or thumb)... then I move on to the next tender spot. As I said, my touch is gentle, and I'm not asking for input while the client is on the table-- these are old folk and tend to drop off into a restful snooze while I work. When finished, with a tap to wake up the sleepers, I leave the room while they dress. The usual comment is "What did you do! I can move it without hurting!"
Not placebo effect: they've had the injections, swallowed the pills, visited a chiropractor, gone through physical therapy, some have had one or more operations on that joint and years later, the pain is still with them.
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You are correct - CSF doesn't move through the connective tissue of the body. It flows through the brain and spinal cord, drains out and is picked up back into normal circulation.
Yes, intracranial pressure does cause the skull to expand and shrink minutely - if all is working well.
For the record, we aren't resting our hands on the sutures. We are oh so gently lifting the skull bones away from center (different directions based on structure) and allowing the body to release, just like your trigger point releases that melt the tissue or myofascial release (in concept, although it's not referred to as myofascial release).
Gary W Addis, LMT said:
Certainly find more to believe in your links than that from a DC's website. However, without investing the time to read the article, first impression is that the movement referred to is intercranial (pressure on the inside)-- not caused by CST practitioner merely resting the hands on the sutures and holding it for long minutes till it magically moves on its own. And I certainly do not accept the notion that cerebrospinal fluid flows through connective tissue of the body."Cerebrospinal fluid (CSF) is a clear, colorless fluid found in the brain and spinal cord. It is produced in the choroid plexuses of the ventricles of the brain. It acts as a cushion or buffer for the brain, providing basic mechanical and immunological protection to the brain inside the skull."
Pueppi Texas said:Gary W Addis, LMT said:
...sutures that weld permanently together in adulthood.Therese Schwartz said:
I am replying because the public has access to this, and I want to have the correct story out there. Whatever people think of CST is fine; everyone is indeed allowed to have an opinion. However, science has been employed and has proved that the skull bones do actually move.I have no stake in the CST argument, but I agree with Therese Schwartz --- it makes sense to discuss documented movement within the sutures, since many people think a weld means there is zero movement tolerance. I believe this tiny amount of movement is due to the Sharpey fibers that are within the sutures. I would just cite this article from Neurosurgery - 1993:
Neurosurgery. 1993 Nov;33(5):869-76; discussion 876-7. (https://www.ncbi.nlm.nih.gov/pubmed/8264886)
Role of cranial bone mobility in cranial compliance.Heisey SR1, Adams T.
Department of Physiology, College of Human Medicine, Michigan State University, East Lansing.
"Our data indicate that although the cranial bones move apart even with small (nominally 0.2 ml) increases in ICV, total cranial compliance depends more on fluid migration from the cranium when ICV increases are less than approximately 3% of total cranial volume. Cranial bone mobility plays a progressively larger role in total cranial compliance with larger ICV increases."
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Pueppi, you're right. Part of me just wanted to stimulate conversation on this website. But only you, Gary, and Therese ever comment reguardless. I just know that what I do works, reguardless of the mechanism. And it bothers me that I'm called a lier by all these other professional people. Anyway. I'm recognized now by the doctors I work with, and that cool.
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This whole thing about evidence based and non-evidence based medicine is interesting. Acording to the evidence based people, what I'm doing is placebo effect. And I'm no more then a charismatic charlatan. Or that I'm fooling myself and others into thinking that what I do is real? Well, if what I'm doing is really placebo effect, it's a very powerful form of placebo effect?
One of the people that I used my placebo techniques on was referred to me by the anesthesiologist that hired me. This was before I actually started working with him at his clinic.
She came to me with a rotator cuff injury that she had been dealing with for some time. Every technique I used on her was non-evidence based( placebo ). After two 25 minute sessions, her rotator cuff pain was completely gone. She happenens to be the CEO of the hospital where I'm now working.
I think that from now on. I'm going to tell people that what I do is a very powerful form of placebo effect? That way, no one will argue with me. Not even the evidence based people.
The attachment below makes me chuckle. - Attachments:
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IMG_3054.PNG, 102 KB
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Hey Gordon! There's an interesting article about this (placebo effect and manual therapy) coming out in Massage and Bodyworks soon. When it's out, I'll let you know (unless you get the magazine, in which case look for the article). I'm not sure exactly when it will be published.
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That might be an interesting read? We will have to look out for it.
I don't think there is anything I do that's evidence based? Why after 30 years would I advance to the point of placebo effect?
"Reality and perception. -- There is a difference:
- The world
- Our reaction to it
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