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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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When an anesthesiologist puts a patient to sleep prior to surgery, is it the nervous system that prevents the pain, or is it the drugs coursing through the veins that block the nervous system's ability to send the pain signal?
Likewise, when Gordon, or I, or any other manual therapist skilled in treating pain says he or she "made the pain go away," that is 100% true-- the nervous system, in conjunction with the trigger-pointed muscle, created the pain. Intervention by the therapist restored proper communication between the muscle and the CNS...the muscle relaxed, so the pain stopped.
A trigger point , as painful as it can be, is not a life threatening condition; its purpose is to prevent movement of what the CNS perceives to be an injured muscle(s). Usually, but not always, the condition is self-correcting: in a few days or weeks or months, whatever was going on within the tissue heals itself, communication to the CNS is fully restored, the TP relaxes, the pain stops. I say, not always, because we have all encountered clients who had been hurting continuously for 20 years, and with out skills, we discovered the painful trigger point(s), encouraged them to release using a variety of techniques, and therefore made the pain go away.
Stacey L Brown said:"......what I do is way beyond dry needling or what anybody knows in that article".
Be careful Gordon, a cavalier attitude is a dangerous place to work from.
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Permalink Reply by Gordon J. Wallis on
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Uhm, everything I do, I did not learn in massage school. Everything I do, is not evidenced based. I have almost none of the normal notions that other massage therapists have. Medical doctors won't even listen to me cause I'm so weird and out of the box to them.. I dont really understand what you are trying to say? If it will improve my outcome with clients, thats cool. If somebody comes in bent over with back pain, and they leave straight without pain. Thats good right.? . Even if its just temporary ..So as a masssage therapist, what am I supposed to do or say to the client?. I usually say, Ok, I will do my best to take your pain away. What do you want me to say? Uhh well I could try to take your pain away, but everyting i do is based on fantasy, so I wont even try? If Im personally, as a massage therapist not taking their pain away with my hands on techniques , and there is another deal happening, it's alright with me. I will watch the youtube video with an open mind. But if it does not say or show me anything that will improve the results I'm getting now, I will disreguard it like I have done with a lot of other ideas and things over the last thirty years. RESULTS OVER THEORY, is what I'm after.
Stacey L Brown said:Hi Gordon -
I think it's exciting to share our triumphs with others and again, I applaud your hard work and efforts with your clients.
As a profession I think it's time for us to start asking more questions and challenging these long held notions of what we think we are doing in the name of massage therapy and the outcomes we see with our clients.
Much of what we were taught and still teach in massage school is incorrect and in many cases, unsupported by credible research, and is based mostly on what we think we are seeing and feeling and how our client's feel post massage.
I urge you to watch a 20 mins. Youtube video with Lorimer Moseley; https://www.youtube.com/watch?v=gwd-wLdIHjs
His talk on our relationship with pain is a game changer for the field of manual/massage therapists and that of our current (clinical) applications. I now question almost everything I learned in massage school. Not so much to point a blaming finger as much as to bring awareness and curiosity to what it is we are doing or as the case may be, not doing.
All the best to you Gordon and thank you for indulging me.
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1. Research your own experience.
2. Absorb what is useful ( theories, information from outside sources).
3. Reject what is useless.
4. Add what is essentally your own.
BRUCE LEE
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You are right, the nervous system does controle everything. I can just manipulate it ( the nervous system ) around a little bit. Just enough to release those tight muscles. So I guess we dont really disagree.
Stacey L Brown said:Er, we/you are not making the" pain go away", the nervous system does that - we are merely facilitators. It's imperative we keep that in the forefront of our mind and while we're at it, share that with our clients so they have a more accurate take on who we are and what it is we are really doing.
And regardless of the outcome of your/our sessions; "what we do", "the changes we think we are making" and "how we explain that to our clients" is largely based on outdated information and we owe it to ourselves, the profession and our clients more accurate explanations than what we have been, historically telling them.
I am not doubting that you are doing good work and that your clients are without a doubt, very grateful for that. :-)
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Here I am, manipulating the nervous system to release a tight sore muscle. I don't disagree with what you said.. The Nervous system controles everything. We just manipulate it.
Gordon J. Wallis said:
You are right, the nervous system does controle everything. I can just manipulate it ( the nervous system ) around a little bite. Just enough to release those tight muscles. So I guess we dont really disagree.
Stacey L Brown said:Er, we/you are not making the" pain go away", the nervous system does that - we are merely facilitators. It's imperative we keep that in the forefront of our mind and while we're at it, share that with our clients so they have a more accurate take on who we are and what it is we are really doing.
And regardless of the outcome of your/our sessions; "what we do", "the changes we think we are making" and "how we explain that to our clients" is largely based on outdated information and we owe it to ourselves, the profession and our clients more accurate explanations than what we have been, historically telling them.
I am not doubting that you are doing good work and that your clients are without a doubt, very grateful for that. :-)
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I've understood that the nervous system controles everything for years.. I just didn't initially understand what you were saying. Sorry about that. My whole deal is based on manipulating the nervous system in order to relax painful tight muscles. If you have read the entire thread you will realize thats what I'm really saying and doing. Somewhere on this thread, when I talk about how I helped this fibromyalgia client, you will see that I'm working with the nervous system. We have no disagreement at all.
Stacey L Brown said:Hi Gary -
"Likewise, when Gordon, or I, or any other manual therapist skilled in treating pain says he or she "made the pain go away," that is 100% true-- the nervous system, in conjunction with the trigger-pointed muscle, created the pain. Intervention by the therapist restored proper communication between the muscle and the CNS...the muscle relaxed, so the pain stopped".
Going to have to disagree with you there, Gary. You, me or Gordon absolutely do not make the pain go away, 100% or .01% of the time.
If pain is created by the CNS/brain, then suffice to say the CNS/brain takes the pain away (aka; restores communication).
We do however deliver mechanical input/stimuli by way of our techniques, it is then that the nervous system decides what to do with that sensory input.
Gary W Addis, LMT said:When an anesthesiologist puts a patient to sleep prior to surgery, is it the nervous system that prevents the pain, or is it the drugs coursing through the veins that block the nervous system's ability to send the pain signal?
Likewise, when Gordon, or I, or any other manual therapist skilled in treating pain says he or she "made the pain go away," that is 100% true-- the nervous system, in conjunction with the trigger-pointed muscle, created the pain. Intervention by the therapist restored proper communication between the muscle and the CNS...the muscle relaxed, so the pain stopped.
A trigger point , as painful as it can be, is not a life threatening condition; its purpose is to prevent movement of what the CNS perceives to be an injured muscle(s). Usually, but not always, the condition is self-correcting: in a few days or weeks or months, whatever was going on within the tissue heals itself, communication to the CNS is fully restored, the TP relaxes, the pain stops. I say, not always, because we have all encountered clients who had been hurting continuously for 20 years, and with out skills, we discovered the painful trigger point(s), encouraged them to release using a variety of techniques, and therefore made the pain go away.
Stacey L Brown said:"......what I do is way beyond dry needling or what anybody knows in that article".
Be careful Gordon, a cavalier attitude is a dangerous place to work from.
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Sigh. Of course the CNS creates the pain, the CNS stops the pain-- when the reason the pain signal is initiated ends. Intervention by MD's drugs or the skilled hands of a manual therapist coupled with the body's own healing power enables the CNS to stop the pain.
I don't understand why you cannot grasp what I'm saying. The CNS needs help sometimes. Surgery is often necessary to correct a dysfunctional organ or to replace a crushed bone with an artificial hip socket: the CNS doesn't understand that the scalpel is performing a life-saving service, so before the incision, the CNS must be quieted-- dare I say controlled?-- temporarily.
Life, all forms of life in my opinion are the product of intelligent design, not mere happenstance. Pain is involuntary, outside conscious control. The CNS itself is completely outside our conscious control. When it senses that the life it serves is in danger from, for example, a flame, it reacts by sending excruciating pain so that the conscious mind responds and removes the hand from the flame.
Myofascial pain falls under our purview. Eighty-ninety percent of myofascial pain is either directly due to trigger points formation; or, quite often, trigger points form as part of the CNS' attempt to prevent further damage to muscle tissue. The CNS can initiate the pain, but the CNS acting on its own will not stop the pain until it senses that the danger to the life of the organism has passed.
Ischemic compression to a painful trigger point forces the contractured muscle sarcomere to open its gates so that sodium can flow out and potassium can flow in, allowing the contracture to relax, and the nerve signal can pass through unimpeded. With communication restored, the CNS stops the pain. You want exact language? Okay, the CNS itself stops sending the pain into the tissue-- but just as the CNS itself cannot heal crushed bone, it cannot correct muscle dysfunction due to a trigger point.
Stacey L Brown said:Hi Gary -
"Likewise, when Gordon, or I, or any other manual therapist skilled in treating pain says he or she "made the pain go away," that is 100% true-- the nervous system, in conjunction with the trigger-pointed muscle, created the pain. Intervention by the therapist restored proper communication between the muscle and the CNS...the muscle relaxed, so the pain stopped".
Going to have to disagree with you there, Gary. You, me or Gordon absolutely do not make the pain go away, 100% or .01% of the time.
If pain is created by the CNS/brain, then suffice to say the CNS/brain takes the pain away (aka; restores communication).
We do however deliver mechanical input/stimuli by way of our techniques, it is then that the nervous system decides what to do with that sensory input.
Gary W Addis, LMT said:When an anesthesiologist puts a patient to sleep prior to surgery, is it the nervous system that prevents the pain, or is it the drugs coursing through the veins that block the nervous system's ability to send the pain signal?
Likewise, when Gordon, or I, or any other manual therapist skilled in treating pain says he or she "made the pain go away," that is 100% true-- the nervous system, in conjunction with the trigger-pointed muscle, created the pain. Intervention by the therapist restored proper communication between the muscle and the CNS...the muscle relaxed, so the pain stopped.
A trigger point , as painful as it can be, is not a life threatening condition; its purpose is to prevent movement of what the CNS perceives to be an injured muscle(s). Usually, but not always, the condition is self-correcting: in a few days or weeks or months, whatever was going on within the tissue heals itself, communication to the CNS is fully restored, the TP relaxes, the pain stops. I say, not always, because we have all encountered clients who had been hurting continuously for 20 years, and with out skills, we discovered the painful trigger point(s), encouraged them to release using a variety of techniques, and therefore made the pain go away.
Stacey L Brown said:"......what I do is way beyond dry needling or what anybody knows in that article".
Be careful Gordon, a cavalier attitude is a dangerous place to work from.
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http://www.stretchingusa.com/active-isolated-stretching
I first started thinking consciously about manipulating or getting the nervous system on my side while doing my bodywork way back in the early 90s I think. When I first discoverd Active Isolated Stretching which avoided the nervous systems Stretch Resopons. Then shortly after that a Britsh Sports Massage therapapist integrated Active Isolated Stretching along with Massage movements with outstanding results for his clients. He called it Soft Tissue Release. That greatly boosted postive results with my clients especially for arm and leg trigger points and injuries.
http://www.softtissuerelease.com
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Sory, I'm kind of dislexic and mis spell words all the time, get letters in the wrong place and so on.
See I said Sory when I ment to say Sorry. lol Gordon J. Wallis said:http://www.stretchingusa.com/active-isolated-stretching
I first started thinking consciously about manipulating or getting the nervous system on my side while doing my bodywork way back in the early 90s I think. When I first discoverd Active Isolated Stretching which avoided the nervous systems Stretch Resopons. Then shortly after that a Britsh Sports Massage therapapist integrated Active Isolated Stretching along with Massage movements with outstanding results for his clients. He called it Soft Tissue Release. That greatly boosted postive results with my clients especially for arm and leg trigger points and injuries.
http://www.softtissuerelease.com
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Grinning. I'm not dyslexic, but I'm a lousy typist...I mistype. And in my old age, I just plain out msspell common words (I was a spelling bee champion for my school district in the 6th grade).
Gordon J. Wallis said:
Sory, I'm kind of dislexic and mis spell words all the time, get letters in the wrong place and so on.
See I said Sory when I ment to say Sorry. lol Gordon J. Wallis said:http://www.stretchingusa.com/active-isolated-stretching
I first started thinking consciously about manipulating or getting the nervous system on my side while doing my bodywork way back in the early 90s I think. When I first discoverd Active Isolated Stretching which avoided the nervous systems Stretch Resopons. Then shortly after that a Britsh Sports Massage therapapist integrated Active Isolated Stretching along with Massage movements with outstanding results for his clients. He called it Soft Tissue Release. That greatly boosted postive results with my clients especially for arm and leg trigger points and injuries.
http://www.softtissuerelease.com
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I've had many successes and happy clients over the last few days. And I may comment on some of them later. But for now, this is an interesting one. A new client came in the other day. When I went out to greet her in the waiting room, I could tell she was depressed. When I got her into the room I aaked her what she needed from this massage today. She said I've had a headache for two days now and its going on three. I thought a massage might help. I asked her where she felt her headache. She told me mostly on top of her head. I told her, Here is the deal. I can give you a really good spa massage, and that might make your headache go away. However I've been doing this kind of work for thirty years, and I have learned and aquired a very high skill set. Especially when it comes to this sort of thing. So my understand is the main reason you are here today is to find some relief or end this two day going on three day headache.. She said yes. In that case your best chance of that happening is if I focus and do everything I have learned over the last thirty years with the specific intent of making that headache go away.. Now if I do that. It is not a spa massage, its an acupressure trigger point session. Its very different. But from my experience it has been very effective for the type of pain you are dealing with. Then I showedd her a 50 second video clip of me doing acupressure on a client. Then I said.. Do you want me to focus and do everything I can to make that headache go way, or do you want me to give you a very good spa massage.. She said take my headache away. So I did my thing.. I palpated from her hips to the top of her head, front, back, and sides. I found three very tender spots arond the L2, L3 area on the right side of her paraspinals. That area of the back has a direct corrilation to the neck. And most of the neck head area is inervated from C2 and C3.. So they were important. A couple Teres tender spots left and right. A coupld Rhomboid tender spots on the right. A very tender T1 spinsous on the left. And a very tender right Temporalis TP on the right side. I was able to palpate the entier upper torso of her body and eliminate all those tender spots within her 50 minute session. Durring the session I would periodically ask her her how her headache was doing. Long story short. At the end of the session, when I was finishing up some cranial work I again asked her how headache felt.. She said it was gone. I thought to myself Success, mission accomplished. However after the massage, even though she thanked me, she still seemed very depressed. I escorted her down stairs and helped her get into the changing room. Then ran back upstairs to clean up my room and get ready for mey next client. Then I walked downstairs to the front desk to check my schedule. The front desk ladies told me. Gordon, your client was very unhappy with your massage. She said that you made her headache go away but that she came in expecting a massage, not acupressure. So we did not charge her for your massage, and set her up next week for a massage appointment with another therapist.
"I've missed more then 9000 shots in my career. I've lost almost 300 games. 26 times, I've been trusted to take the game winning shot and missed. I've failed over and over and over again in my life. And that is why I succeed."
MICHAEL JORDAN
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The attachments below show the relationship between the lower back and neck.
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image.jpg, 139 KB
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