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I had a new client recently.. She came in saying she has had a stressful week and just needs to relax.. She is an attorney.  When I met her in the reception area I detected that she was in pain, by the way she carried herself.. I asked her if she hurt anywhere.. She told me her shoulder is killing her...She was touching her right upper chest as she spoke.  I asked her if she was seeing, or saw anybody else for her shoulder problem.. She told me that she had been seeing physical therapists for three months sometimes several times a week...I asked her if it helped...She said no.. And she quit seeing them on her own just a few days ago... She was standing in front of me in her spa robe as we spoke...I again noticed her touching her upper right chest.... So I palpated the area as she was standing and got a HUGE pain flinch response when I touched the pectoralis major clavicular head area...It was a BIG very sore trigger point.. The pain area was almost two fingers wide..A very nocioceptive spot.. I asked her if any of the PTs touched her on that spot... She said no... I asked her what kind of therapy were they doing... She said they ultra sounded her upper shoulder and had her lifting weights.  God knows what was in their minds when they came up with or how they came up with that useless therapy... She had to quit on her own after three months when she was just not getting any better...Its no wonder..I cant think of a worse possible therapy to do when you have someone massively trigger pointed like her.. That pec TP was as sore as a Boil... On further palpation I found several other TPs  mostly on her right side..although they were to a much lesser degree then that Pec major TP.   I found an upper trap TP, a supraspinatus TP, a spinal erector TP at T3 , a TP at C4, and another, the second most painful one  at L5 spinal erectors .All on the right side.  The only TP on her left was in the rhomboids.... So I knew that if I was able to eliminate those tender areas, especially the pec one... Her problem would be over.  The right side of her body was hyper-tense the left hypo-tense.  So I did a little bit of up- regulating the hypo-tense left side by having her make a fist with her left hand, relax and repeat that three a few times...I did some tapping and stimulating moves on the left side of her body.. Before I began working the trigger points on her right side..... Twenty one minutes after meeting her she was pain free.  She was very happy of course.. She is coming back in for a follow up visit..But thats it... It always amazes me that so few health care providers actually touch the pain...And why they had her keep coming back for weeks on end with no noticeable improvement. Its a pattern that Ive noticed over the years.  Its mind boggling...If someone comes to me hurt, and I cant noticeably help them in one or two sessions.. I tell them I can always massage them, but Im not going to be specific for their problem...And often times they come back anyway.....  I  have a High Art, simply because I touch the pain.   Kind of like a High Art by Default though.

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Another great story, Gordon!  Thanks for the diagram too.  That is helpful for my own knowledge.

I had a new client start a couple of weeks ago.  She's the mother of one of my clients, and it took a lot of convincing to get her to come to me.  The whole family has digestive problems.  I did abdominal massage, myofascial release and lymph drainage therapy on her.  She felt better immediately, and she's excited about coming, instead of not wanting to be touched!  She told me her clothes fit differently, which I think is great.  She told her daughter to tell me "I'm a believer!".  I love being able to make a difference to people!

Just finished working on a guy that had lower right back pain for eight months.. He just finished seeing a chiropractor for three months, with no help... he complained of lower right back pain...but under palpation I found no sore area there...However I did find a very sore spot around L1 on that same side. On the QL I believe or spinal erectors.  A trigger point in that area does send pain to the lower back....He is pain free now.. No one touched him there before...unbelievable.  A very simple problem. It took no skill level to help that man.  He is coming in for a 15 min. follow up on Tuesday..But his low back pain is history.  

That is fantastic!  It really isn't that complicated to truly help people.  I don't know why it's so rare.

Give yourself more credit though - I'm guessing after doing this for 30 years you do have a high skill level! :)

 http://www.triggerpoints.net/triggerpoints/iliocostalis-lum-longiss...   it was the lower X in the right picture...That was his problem.  He complained of pain on the illiac crest...but it was coming from that trigger point higher up on the erectors.   That picture is a close fit....Three months is ridicules.  All I can say is an awful  lot of people are getting the wrong kind of therapy for their pain.  Those offices are very busy.

Therese Schwartz said:

That is fantastic!  It really isn't that complicated to truly help people.  I don't know why it's so rare.

Give yourself more credit though - I'm guessing after doing this for 30 years you do have a high skill level! :)

That is so helpful - I have a client who has pain on the right iliac crest exactly where it shows in the diagram (but on the left). Now I know where to look!  I don't know why I don't think to use that website...I never think about trigger points unless I'm reading one of your posts.  I need to change that!

Seriously, I wish you could work on me.  I hurt all over - I'm 42 and my whole life I've been tense.  That combined with a very long list of sports and horse related injuries has left me in constant pain.  I've just started a new plan to do yoga every morning and some form of exercise much more often than I have been.  Movement really helps me feel better!

I wish I could work on you Therese.  Keep working on yourself... I stretch every day.  I look at it as a form of self massage.   Lots of massage styles eliminate trigger points without even thinking of them...But if you think in trigger points.. Your ability to help people improves dramatically.  Thats been my truth.   People will go through thousands of dollars worth of therapy with little to know improvement in their condition.  Health care providers of all types dont think in trigger points.  If trigger points are still there.. so is the patients pain problem.  Now Rolfers dont think in trigger points.. But they rip right though them..Several soft tissue approaches fall into that category .. So I guess they dont need too...But thats expensive and takes time...If I run into a trigger point...Its got ten to sixty seconds of existence left... lol   When it comes to aches and pains, sometimes debilitating aches and pains. A massage therapist can make a huge difference in someones life very quickly.  Way faster then most Physical Therapists or Chiropractors treatment plans.. Unless they themselves are doing quality soft tissue work(rare).  Pretty much every day I have a client that is or has been getting the wrong kind of therapy for their pain problem.. Almost every day.  Its mind  boggling.  I even run into massage therapists that are running to chiropractors for something that they can fix themselves. They don't know their own potential.  If I cant help someone. They know it fast.. and Im not going to rip them off with endless treatment plans.. At that point they might want to briefly try another type of body worker or go see an MD pain specialist.  If they haven't already.


Therese Schwartz said:

That is so helpful - I have a client who has pain on the right iliac crest exactly where it shows in the diagram (but on the left). Now I know where to look!  I don't know why I don't think to use that website...I never think about trigger points unless I'm reading one of your posts.  I need to change that!

Seriously, I wish you could work on me.  I hurt all over - I'm 42 and my whole life I've been tense.  That combined with a very long list of sports and horse related injuries has left me in constant pain.  I've just started a new plan to do yoga every morning and some form of exercise much more often than I have been.  Movement really helps me feel better!

Actually, I went to two different chiropractors earlier this year.  I finally figured out that an Egoscue Posture Exercise I have that takes about 90 seconds (maybe 2 minutes) to do solved the problem!  And I don't have to do it every day or even all the time.

One of my regulars (twice a week!) came in today and one of his problems was pain over his iliac crest on the right.  This was not the client I was thinking of earlier...but I was able to use the info you posted and solve his pain issue!  It was great!

Ok cool...so he was sore higher up on the erectors?   Actually.. You dont need to know the pain patterns..That might help...But you really dont need to know them....Usually within a foot of the area of complaint, you will find a sore spot.. Then you do what ever you can to make that sore spot go away or down grade its level of intensity.... If you can do that. More often then not, you solve their pain problem..  Technically a healthy body has no sore spots, even with deep massage. So if you are able to decrease those high intensity spots.  You get clinical results.. Sometimes easier said then done..but thats about it...Awesome.  Way to go !!   The only reason I posted this thread is because these people had very tender sore nocioceptive spots that were not even touched by other professional health care providers...And that happens more frequently then naught. There is no serious palpation of the patients condition...I mean Im a massage therapist...what else can I look for but sore muscles? lol   

Therese Schwartz said:

Actually, I went to two different chiropractors earlier this year.  I finally figured out that an Egoscue Posture Exercise I have that takes about 90 seconds (maybe 2 minutes) to do solved the problem!  And I don't have to do it every day or even all the time.

One of my regulars (twice a week!) came in today and one of his problems was pain over his iliac crest on the right.  This was not the client I was thinking of earlier...but I was able to use the info you posted and solve his pain issue!  It was great!

Gordon, good job explaining this stuff.  In every post you make, there's a confirmation of something we knew and forgot, or (more often the case) a new way at looking at things we have been seeing every day.  Thanks, buddy.

Gordon, I assumed he was sore in the QL's; it was right at the QL attachment to the spine and ribs that I found the muscle knot and sore spot.  Actually, he was sore all the way along the inferior edge of his last rib.  The iliac crest felt much better after all that was loosened up!

That is really good info about looking in about a foot radius of the problem area!  Makes sense to me.  Simple and elegant - just how I like things!

I tell people all the time that it's my job to find the sore spots! :)

Gary, I've learned some of the best, simplest techniques from Gordon.  Ways of looking at my clients that solve problems very quickly and easily.  Thanks Gordon!

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