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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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Permalink Reply by Gordon J. Wallis on
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Another interesting client came in the other day. She initially wanted a full body massage however, do to a recent bicycle accident, she wanted me to focus a little more time on her right leg. She said her right leg hurts from her hip down. I then showed her a testimonial and a video clip of a client that I had helped out of pain. Then she looked at me and said.. In that case I'd like you to check out my left leg as well. Ive had chronic pain problems there for three years. Ive seen my Chiropractor and an Orthopedic doctor, but they can't figure out whats wrong? Gosh, when I hear that. I almost know for sure that I can help the person. Because I know that its only a rare few that look for or think Trigger Points. I'm talking about her chronic left leg now. Not her more acute right leg injury. She has not seen anybody for that. So I did my usual Trigger Point exam. Surprisingly she only had one Pain Point ( Trigger Point ) on her left hip ( SI Joint ) and none on her right hip. However she did have a very tender spot on her lateral left leg just below her Trochanter. And another very tender spot on her lateral left (almost anterior ) leg a few inches below. Also on the left leg a very tender spot on her upper Tibialis Anterior as well as a very tender spot on the same muscle just above her ankle. She commented that the pain runs down her leg when its bad. Also on the left leg a Very Very Tender spot that elicited a withdrawal reflex on the lateral portion of her left Ilicac Crest. Now on the right leg, the more acute injury side, I also found Pain points in the same areas except below the knee. Most of her pain so far was found on the lateral sides of her lower body.. So I wanted to make sure i checked the lateral sides of her upper body.. Because to me, its the same muscle.. The side muscle. And sure enough on both sides of her body I found Very Ticklish and sore spots on her lower lateral ribs. That usually means Diaphram involvement. If you are in a sudden accident, if you see it coming or not, it can take your breath away. The diaphram connects to the lower ribs. She also told me that her neck bothers her.. I found three Sore Pots on her lateral right side of her neck and one tender spot on the left side of her neck. Also, her right Terres or Latissimus Dorsi, had a tender spot. Anyway, I was able to eliminate, at least temporarily, all those Painful Palpatory Areas within her fifty minute session. She rescheduled for another session.
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I recently had a new client that came in complaining of low back, SI joint , and lateral leg pain. She has delt with this for years. The medical docs told her she had Degenerative Disk Disease. She had a deep tissue massage years ago that she discribed as very painful. And it made her sick and hurt more afterwards. She seemed very worried about me touching her. I had met her earlier in the month and talked her in too coming in and seeing me. She says in the morning she cant even bend forward and has difficultly moving. She has to stretch gingerly for a while before she can move relatively pain free. Later in the day she can handle the discomfort during her work day. She said the only thing that helped her in the past was when she went to a Chiropractor that used a large electrical massager ( Gennie Rub ) on her sacrum for a few minutes. It gave her relief for a while. I did my Pain Point palpation over her entire body. I found a right Piriformis pain point as well as a Pain Point on her Illiac Crest where the QL might conect, as well as a couple inner thigh Pain Points also on the right side. On the left I found a very painful Point on her Trochanter as well as one on her Vastis Lateralis. I also found a Painful L5 paraspinal on her left side as well as one on her Iliac Crest just like on her right side. I found no pain points on or near her Sacrum or SI joints. All those Pain Points vanished with my release work. She also told me that she often feels numbness across her upper hips and Sacrum. She seemed concerned that I did not find any Pain Points in her Sacrum SI joint areas. She says thats where the majority of her pain is, along with the numbmess. I found no Pain Points on the front of her body. However when she was laying on her back she was uncomfortable and discribed a pressure on her upper sacrum SI joint areas. I palpated again that area as she was on her back and found no Pain Points. When she sat up I could see her straining and she said now her SI area hurts. There was clear strain on her face. I palpated the area while she was sitting and found two very painful Pain Points on both the left and right side of her Sacrum. She said thats it.. For whatever reason those Points did not show up on palpation when she was lying on her back or stomach. Only a vague numbness pressure feeling.. But sitting allowed two very painful spots show up that were easily palpated. I released them as she was sitting. She got up and felt a lot better.. She was amazed. Her SI joint area was no longer painful. Now Im sure they or some of the pain points will come back. But I think after a few short sessions, she should be very noticibly better. The fact that all the Pain Points went away, is a very clinically positve indication that her problem may soon be over or at least more manageable in the near future. The look on her face when she left the room told me a lot.
Any way, body position can make a big difference when palpating for Trigger Points. The interesting thing is that it was all blamed on Degenerative disc Disease.
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Not too long ago a client came in with pain that she has had for a month. I asked her where she felt the pain. She touched her upper right Sacrum. She indicated that it hurt worst when she was sitting or standing. I asked her if she could feel the pain now as she was standing, she said yes. Getting rid of the pain was her whole reason for scheduling a 50 minute massage. Now I had worked on her before, but never for any pain issues. I explained to her that a regular massage would not fix her problem. I let her read a testimonial and view a short video clip of me doing trigger point work on a client that I was able to help. I pointed out to her that on the video clip the client was wearing clothes, and that she would have to feel comfortable with me working through just a sheet. She said no problem. I palpated from her hips up to the top of her neck plus her right leg for pain points. I found three pain points. One on her right Gluteus Medius, right Para Spinals an inch or inch in a half from the Spinus of L4 (right on the Illiac Crest), and another on the right side of the T12 or L1 Spinus. They all deactivated easily. I was finished within 20 minutes of meeting her. We decided that would be it for her session. I also gave her an exercise that her husband could help her with until the next session. When she got up off the table she felt no pain while sitting or standing. I told her not to worry if the pain comes back, and that in the mornings things are alwase the worst. But the fact that she felt no pain now, was a very good sign that her one month pain problem will soon be history. As a side note, she was surprised that where she felt the pain( upper right Sacrum ) was not tender on palpation. I explained to her that it was referred pain from those other Palpatory Painful Spots.
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This is cool. I work with around 50 or 60 people every day. I remember several weeks ago hearing in passing, one of my co-workers complaining of ear pain and possible infection. I didn't think about it because I of course was busy with my work day. Anyway, the other day she( the co-worker )came up to me and siad. "Gordon, can you do anything for an ear infection?. " I initially said no. But then I remembered her complaining of it several weeks ago. So I said, " Let me look at your ear. " It was her left ear. I saw no redness or swelling. I asked her if it was inside her ear? She said no, but its sore on the Cartledge, but I do feel in in my ear too( Teagus, Concha). She also comented that it hurts to turn her neck. Then I remembered that Trigger Points in the Masseter and the Ptergoids can cause ear pain. I quickly found and empty room and began palpating those areas on her jaw and face. And sure enough three Pain Points in the right places. When palpated they made her wince. I was able to eliminate those areas quickly within a couple minutes. When she got up off the table she commented that she felt way better, and that she could turn her head without any pain. She was really surprised, as was I. Well, not really when I think about it. Its almost always Trigger Points. We work together so I will be able to see her again, and her problem should soon be over. The attachment below shows the Trigger Points involved. As a side note, remember she said that she had trouble turning her head. Pain in the jaw muscles can effect the entire body. The nerves that come out of the neck basically controle the entire body, and often is directly related to the hips and low back. Because the nervous system always wants to keep the eyes parallel to the ground. Its a very important area to check if you have a pain or headache client.
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Someone asked me why the jaw would effect the entire body? Well without getting into too much detail( you can do your own research ). The Massiter is inervated by C2. C2 is very important for neck rotation. Remember the client had some pain when turning her neck. C2 also has a direct connection to the Dura. Basically a coating that surounds the brain and spinal cord all the way down to the Sacrum. Also the vertebrae are paired in order to compensate for any imbalances in the body because the nervous system( brain )wants to keep the eyes parallel to the ground. C2 is paired with L4. So you can see how the Massiter muscle can effect distal parts of the body. I mean what other muscles does L4 innervate? What other muscles does C2 innervate besides the Massiter? I usually don't think about all these various connections in the body when I'm working. I don't often need too. But thats why I want to check out the entire body of any pain client reguardless if its only a small portion of their body that hurts. I'm looking for latent trigger points that may be hidden in various muscles of the body. Sometimes very distal to the area of complaint, and seemingly unrelated. Sometimes a client may ask me.. How come you are checking out my calf when its my neck that hurts? Well C2 is paired with L4. And L4 inervates the calf. It may not be necessary, but I want to be thorough. Just today a co-worker came up to me and said. Gordon, I hear you are good with pressure points? I said is something hurting? She told me that the left side of her neck has been hurting pretty bad for three weeks. I had a half hour before my next appointment. Got her into a room. Sure enough I found three painful Trigger points on the left side of her neck as well as her left upper Trap. I immediately suspected left hip involvement becasue of the paired cervical /lumbar relationship( Lumbar spine inervates a large part of the hip. And wow her left hip, unknowing to her was full of latent trigger points( painful ones) . Glute. Med, Piriformis, and Glute max. Her right hip and right neck were Trigger point free. She was greatly relieved after a few minutes of TP work, and is coming in on a follow up in a few days. There is an obscure branch of Chiropractic that thinks all you gotta do is make sure C1 and C2 are functioning properly, and all problems will be solved. I'm not sure about that. But because of the connection to Dura at C2 and the paired relationship between the Cervical spine and the Lumbar spine. The Massiter muscle can have a major influence on the rest of the body.
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https://franc066.wordpress.com/2014/02/06/r-equals-c-lovett-brothers/
Information that goes along with the previous entry on spinal relationships.
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The above link about the Cervical/Lumbar relationship is Chiropractic Speak.. But what everyone doesn't seem to realize is the fact that Muscles Move Bones. And a Trigger Pointed Muscle is a shortened( contracted )muscle. It's best to think on things, otherwise ----- Truth remains hidden . . . like a shadow . . . in darkness.
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Truth is a fact, and the fact can be understood only when the various things that have been placed between the mind and the fact are removed. - Jiddu Krishnamurti
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I'm exhausted yet greatly relieved. A couple days ago a new client came in that was in obvious pain. A healthy looking young women, but I could tell by the way she carried herself and the look on her face that she was not feeling good and in need. She told me her sole reason for getting a massage was because she was hurting. I asked her to tell me where she hurt. She said everywhere, her right knee being her main concern right now. It hurts so bad that she can hardly walk in the mornings. But her whole back neck and shoulders hurt too. Dispite all that she has been running on a regular basis. However she recently had to stop because of her right knee. I'm a very confident therapist. But when I hear knee pain, a bit of worry comes over me. I'm really good at eliminating Trigger Points. But my biggest fear with knees is Ligament damage( ACL, MCL,PCL ), which is a different animal. Anyway, I let her read a couple reveiws and watch a short one minute clip of me working my Trigger Point thing on a client. She said go for it. She was dressed for a Massage, which means she had noting on underneeth her spa robe. I explained to her that she would have to feel comfortable being covered only by a sheet as I work on her. She said that's not a problem I'm hurting. So I did my trigger point thing. Now her main complaint was her right knee. But because of all the various distal conections, like the neck and low back that I talked about in previous entries on this thread, I wanted to check her entire body for trigger points.. Head to toe, front, back, and sides. And OH WOW. I know why she was hurting. There was a Trigger Point on almost every square inch of her body. Im exaggerating a little bit, but she could have been a poster girl for one of those laminated Trigger Point charts you can buy from Amazon.com. She had every single Trigger Point on those charts and then some. She had an hour and a half Massage scheduled, but I had two hours before my next client. It took me exactly two hours to palpate and clear out every Trigger Point on her body, front, back, and sides. The good thing was that every Pain Point I palpated on her right knee and leg area vanished as well. If you touch and injured Ligament, it hurts too, like a Trigger Point. Only thing Ligament Pain won't vanish, not even temporarily like Trigger Point pain would. Now the bad thing was, and the reason for my exhaustion today was that after I had worked on her I realized that I had never done Trigger Point work for that long, and had never released so many of them in one setting. I was not sure of the after effects of such dramatic release work? As I was waiting for her to come out of the room I begain to worry that perhaps I had inadvertantly over done things, and maybe should have stopped at a half hour or so to allow her body to recover some and continiue at a later date with several short follow up sessions. When she came out of the room I asked her how she felt. She looked at me and said her body is humming. She said she feels light, loose, and humming. Taller, and more straight. She felt a humming vibration through out her whole body. An energy..... I asked her if she hurt.. She said no, not now. She said she would re-schedual in a couple days. And that she would not work out or run according to my suggestion. I had one more massage before the end of my day.. At the end of the day I asked the front desk for her number. I wanted to text her, keep in contact with her in order to find out if she was having any negative reaction from the two hour Trigger Point Release deal. I texted her that evening. And never got another text back. Or the next day for that matter. I interpeted that as a bad sign. She did not text me back saying how wonderful she feels. So I did not sleep well last night. When I got to work yesterday, she was not on my schedule at any point during the week. I want to help people so much.. The last thing i want to do is make someone worse, or cause them more suffering. Especially someone that came in with great need like her. So I did not sleep good last night. But she came in today. I felt relief as soon as I saw her.. I asked her if she was hurting the next day after her session? . She said no. But I was sick and nauseated all day.. I said oh God I'm sorry. She said don't worry. I saw your sincerity, passion, and I believed in you. And today I'm feeling much better then i did when I first saw you.. I said ok good. I felt relieved, but I was right.. I did over due it.. And will never do that again. If she would have been an older not so fit a person.. She probably would have hurt for a week and never come back .. Anyway, again she had scheduled an hour and a half massage..But this time things were dramatically different. It only took 50 minutes to clear out every Trigger Point in her body front, back, and sides. Half of those Trigger Points were gone! . And GONE IS GOOD when it comes to Trigger Points. After this session she was smiling and said she feels so much better.. Her next session is scheduled for 25 minutes. That's all its going to take in order to whipe out whats left of her Trigger Points next session. And I think, based on my experience, that she will need only two or three more 25 minute sessions before its all over. And then she will only be dealing with a normal level of tension that we all experience every day.. Gosh, after worrying so much. I may have more Trigger Points then she does now? . But anyway, I feel good again, and should sleep tonight. You see, even after 30 years, Learning Never Stops.
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I forgot to mention that initially the above client had at lest 100 active and latent Trigger Points ! Can you imagine???? She had maybe 30 today.
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Permalink Reply by Therese Schwartz on
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Wow, Gordon!! What a fantastic session to share with us. It's also a good reminder that even gentle work can take it out of both therapist and client. I tell people all the time "just because the work is gentle doesn't mean it isn't profound".
I have similar problems if I am worried that I overworked someone! I have one client that still haunts me - she's a really good friend of one of my regulars. She came for 3 sessions, and she has some issues that are just a huge challenge to deal with. The first 2 sessions went really well so I did just a teeny tiny bit more during the 3rd session and it was too much. She was in pain for a week, and I haven't seen her since. Learning never stops, and sometimes it stinks! "Wisdom comes from experience, usually bad experience"!
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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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