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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 June 20, 2016 at 4:12pm
https://m.youtube.com/channel/UC1nuuoTkJ4xqSulGQYJd7Ng

Go to my YouTube page. It's not meant to teach, but you should be able to see a lot of those above principles in action.
Permalink Reply by Therese Schwartz on June 20, 2016 at 5:40pm

I don't have time to watch the videos right now, but I subscribed to your channel so it will be easy for me to find them!

Gordon J. Wallis said:

https://m.youtube.com/channel/UC1nuuoTkJ4xqSulGQYJd7Ng

Go to my YouTube page. It's not meant to teach, but you should be able to see a lot of those above principles in action.
Permalink Reply by Gordon J. Wallis on June 22, 2016 at 2:32pm
I did some of my best work the other day. One client with back pain was told that she has an arthritic spine. As she described her arthritic pain it was very clear to be in one area. On the left paraspinals T9 and T10 level. She had three really active trigger points in that area. After I deactivated them I massaged the area with hot stones in order to draw blood to the area. She left the spa without her arthritic pain. Another client came in complaining about her neck as being tight and sore. And it hurt when she turns her head, the worst when she it right. She also told me that one hip is higher then the other and as a result sometimes has sciatica. She had trigger points in all the right areas. Upper traps, several posterior neck ones , Occipitalis , masseter, and really painful SCMs.. In addition she had pain points on the lateral spinous in the lumbar area, sacrum, and right hip. One of the hip muscles being the piriformis. That neck hip connection I've talked about. She left the spa with full pain free range of motion in her neck.
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Permalink Reply by Gordon J. Wallis on June 25, 2016 at 12:03pm
This is what gets me. Massage therapists can't diagnose, yet I see all kinds of misdiagnosises all the time? Pretty much on a daily level. The other day I met a new client. When I asked her if she had any aches and pains, she told me she has just been diagnosed with arthritic knees. And she is scheduled for cortisone injections next week. She said her knees ache and are swollen. She said it just came on all of a sudden. You guys, as she is telling me this, I am doubting it. As she started to go into more detail about it I interrupted her and told her that I doubt that she has arthritic knees. Then she said , " But my knees hurt." I told her that I'm not doubting her pain, I just don't think it's arthritis. I told her that I would know in short order if she had arthritis or not if she let me check her knees out before we start the massage. She had an 80 minute massage, so there was plenty of time. She saw I was serious so she gave me permission to check her knees out. As I suspected, can anyone guess? It was trigger points. Way more then one. Without being specific. In her quads, lateral thigh, inner thigh, anterior muscles below the knee. Only the hamstrings and calf were trigger point free. The rest of her body had no trigger points except for her neck, which kinda doesn't surprise me because the neck and low back relationship. The lumbar segments controle a lot of the lower body. I eliminated all those trigger points within 30 or 40 minutes. The rest of the time she got a really good back and foot rub. She made several comments during the massage that she could not believe that her knees don't hurt. And chuckled as she said it. If you look at a trigger point chart at all the anterior, lateral, and inner leg muscles, their related trigger points and pain patterns, you will see her knee pain. Travell and Simons were very worried about the misdiagnosises of pain. They devoted most of their entire medical careers studying trigger points. I don't diagnose, but my accuracy of diagnosis is almost 100%. And I only know one syndrome. Myofascial Pain Syndrome. For all practical purposes, it's never diagnosed. Her knees did not hurt when she left the spa. You can not massage away arthritis. She rescheduled for a few follow ups.
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Permalink Reply by Gordon J. Wallis on June 28, 2016 at 8:11pm

This is interesting and related to my concept of there being only twelve muscles in the human body. A new client came in the spa the other day, a tourist, for a massage before her flight to go back home in the evening. I told her that my regular massage would be good, but no better then anyone else's. However, if she was hurting anywhere, I have an advanced skill set that could perhaps help her, even if she is or has seen other health care providers for the problem. She then told me that she has a shoulder problem that is coming from her neck. A pinched nerve. She said it's a lot better now, but she can still feel it, and it's starting to come back. She said that she would appreciate me spending more time on her neck because of the pinched nerve. I asked her what kind of treatments she had for her shoulder pain. She said that she went to physical therapy twice a week for six weeks. I asked her what kind of therapy she received at the physical therapy clinic. She said a lot of neck traction ( a neck traction device )and massage. Hmm."...Pinched nerve, I've heard that one like a billion times. I asked her if anyone mentioned the word trigger points? She said no. Everybody assumes pinched nerves. Nobody assumes trigger points? But I do. Because I know that 85% of all pain comes directly from trigger points, and that 95% of all pain has a trigger point component. I also know that neck traction is not likely to make trigger points go away. As a matter of fact she told me that it was very uncomfortable. So there is a possibility right there of a perpetuating factor for trigger points. Unbelievable to me. They ( doctors and physical therapists ) actually thought that they needed to create more disc space in her neck in order to free the pinched nerve that was causing her shoulder pain. If it really was a pinched nerve, I guess that would help. But trigger points are so common, so very common. And the massage therapy I'm sure helped, but without the knowledge of trigger points it would surely be inefficient. Now she is standing in her robe telling me all this. I asked her if I could palpate her shoulder and for her to tell me if I touch a sore spot. She said ok. I palpated her upper trap and found nothing. She told me no, the pain is between her shoulder blade ( by the way it's her right shoulder that has the problem ). She had two trigger points between her shoulder blade and spine at the T5 and T6 vertabrae level. Those areas are inervated by T4 and T5 approximately. At any rate those areas are not inervated by any of the vertarae in the neck. So? What's the neck traction deal? Anyway when she got on the table under further palpation I found another trigger point at C5 and a very tender one at C1(occipital area ) all on the right side. So far all the trigger points have been on the right back muscle ( remember I only work with 12 muscles not 650 ). So the back right muscle is trigger pointed. Not having a lot of time to check her entire body for trigger points, sense she is coming in for an expensive exotic water massage in a $50,000.00 water massage room, I decided to at least finish checking out the rest of the right back muscle before starting her massage. . I found a very tender trigger point on her right paraspinals at the L3 level and another very tender trigger point on her right side sacrum( also L3 is related to C3 which controles the neck that had trigger points ). The rest of the back right muscle was trigger point free. After I eliminated all those trigger points I carried on with her service. Before the end of her service I rechecked all those same trigger points and they were no longer there. After the service she said it was amazing not to feel anything of her shoulder problem. This pinched nerve thing is getting to me.
Therese Schwartz said:

Gordon, that is the kind of simplicity that leads to brilliance!  I really love your perspective on this.

Gordon J. Wallis said:

There are approximately 650 to 850 muscles in the human body, depending on which expert you ask. Trigger points can develope in any one or more of those 650 to 850 muscles. When you think about it, it's kind of a complicated overwhelming thought. But for me, there are only 12 muscles in the human body. Not nearly as complicated or overwhelming as a 650/850 muscle system. To me, there are only 12 muscles that can develope trigger points. So I only have to know how to release 12 muscles. In the attachment below you will see 4 of the 12 muscles. I will name them. 1. The right back muscle. 2. The left back muscle. 3. The right front muscle. 4. The left front muscle.
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Permalink Reply by Gordon J. Wallis on July 1, 2016 at 12:39am
I met this client too late, sort of. Of course she came in for a relaxing massage. But after talking with her briefly, I found out that she recently( three weeks ago ) got an injection of some kind in her right hip do to severe pain. She tossed and turned all night because of pain. It's the second time that she has needed to get that same injection. The doctors told her that a muscle has separated from the bone? Prior to this last injection she had several weeks of physical therapy that did not work. She said the PT was painful. She comented that she knows the injections are not good for her, and that its temporary. But she tried everything, including massage and physical therapy to no avail. I asked her about the massage. She said it was useless. They just rubbed oil on her hip. So I'm thinking, of course, this is a trigger point deal if there ever was one. But she already got the injection in her hip and it does not hurt now. I asked her if she hurt anywhere else. She said yes. Her low back on the right, as well as the right side of her right leg and right calf. Until the injection it was pain from the low back down the right hip, down the side of her leg, with her calf in spam at night. Only difference now is the hip doesn't hurt. She gave me permission to do my trigger point work instead of a massage. All these trigger points are on the right. L4 and L5 paraspinals. Glute min. , Vastus lateralis , a really painful popliteus , and one in her lateral calf. Also L3 and L4 lateral spinouses on the right were very tender. In addition she had a pain point on the left upper side of her sternum, two right posterior neck trigger points ,one at C6 the other at the C2 level. She also had a left masseter trigger point. Oh I almost forgot. . She also had a very painful right QL trigger point just above the Illiac crest. Most of the trigger points involved the back right muscle( my twelve muscle method ). All those trigger points deactivated and were no longer there on repalpation. She had me email her information on trigger, points , which I did tonight, and is planning to see me again when the injection wears off, if not sooner. I may be wrong, but I think you can safely assume that her hip pain is trigger points. These people do not know trigger points. The client in the testimonial below had a very similar complaint that went misdiagnosed for ten years.
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Permalink Reply by Gary W Addis, LMT on July 1, 2016 at 6:16am

It's criminal that she was sent to a PT with that complaint-- and that treatment.  The usual PT's "stretch and strengthen" to a muscle diagnosed (wrongly) as "separated from the bone" ???  Now how in hell can a PT or strength coach or anyone else exercise a muscle that has even a partial tear in its tendon or, because it's hip,  maybe to the glute attachments to iliotibial band?)

Permalink Reply by Gordon J. Wallis on July 1, 2016 at 10:03pm
She told me the PTs keep calling her and telling her she needs more of their therapy. And as far as the diagnosis goes? I've heard all kinds of weird things over the years. But it doesn't matter. All I do is look for and eliminate trigger points. 95% of the time when I do that. Whatever their incoming complaint is goes away. I have another new client. I think I see him again tomorrow or the next day? He came in with left shoulder pain. Two days before he saw me he was in a great deal of pain and could not even lift his left arm. But when I saw him it was better. He could lift it while in a great deal of pain. I asked him where he felt the pain, he indicated the anterior portion of his left deltoid and comented that at times it runs up his neck. While he was sitting on the table in his robe I asked him if I could palpate his shoulder. He said yes. I began palpating his left infraspinatus when he tried to stop me by telling me that it did not hurt there and that I need to check his deltoid where it does hurt. I had to stop palpating and explain to him that it was important to palpate every muscle involved directly with his shoulder. He was very worried that it was a rotator cuff injury. I told him that it was. He looked very stressed when I told him that , until I explained that it doesn't nessicarily mean his joint, that it's most likely muscular. I then continiued with the palpation. He had a trigger point, as I suspected in his infraspinatus, three in his paraspinals between his spine and shoulder blade, one in his left posterior neck. He also comented that his left chest felt swollen and higher then his right chest. I want to point out that this guy was scared. I had to calm this guy down if I was ever going to have the possibility of helping him. I looked him in the eye and told him that I'm an expert at what I do. And I would know very shortly if I could help him or if he should see someone else. He relaxed and then I palpated his left chest. O wow. He had a very painful withdrawal reflex when I palpated his pectoralis major. That was obviously the main trigger point for his problem. All those trigger points deactivated by the way. It was cool. So he left the spa feeling pretty good. My only worry is that those trigger points, especially the pectoralis major, are going to need a couple more treatments before they are totally gone. He may wake up in the morning to find his shoulder hurting again, think that I can't help him. And I won't see him again. Anyway, we will see. But those trigger points are his shoulder problem. When I palpated where he said he hurt there was no withdrawal reflex or trigger points. I will load a trigger point chart of the pectoralis major pain pattern.
Gary W Addis, LMT said:

It's criminal that she was sent to a PT with that complaint-- and that treatment.  The usual PT's "stretch and strengthen" to a muscle diagnosed (wrongly) as "separated from the bone" ???  Now how in hell can a PT or strength coach or anyone else exercise a muscle that has even a partial tear in its tendon or, because it's hip,  maybe to the glute attachments to iliotibial band?)

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Permalink Reply by Gordon J. Wallis on July 1, 2016 at 10:13pm
Here is the pain pattern of the infraspinatus trigger point. You can easily see how come trigger points in those muscles are often mistaken to be an actual joint problem. And if you are a practitioner that never palpates and knows nothing about trigger points, that's exactly what happens. Travell and Simons were worried about that very thing. Injection time. He had both of those trigger points at the same time. Also he did nothing physical that he could think of that would cause a sudden injury to his shoulder. This means latent trigger points that that activated( became symptomatic ).
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Permalink Reply by Gary W Addis, LMT on July 1, 2016 at 11:58pm

This is off-topic:  Gordon, have you ever heard of "Voodoo Floss Bands?"  Check them out on youtube.  They are used to compress muscles of a painful, restricted joint.  By partially cutting off circulation into the muscles, sports trainers say that this forces recruitment of muscle fibers that are called upon only when maximum effort is required, and also leads to breakdown of fascial adhesions and scar tissue. 

On their highly paid pro athletes, the trainers use expensive computer-controlled machines that safely eliminate nearly all circulation, which is then put through low -intensity exercises covering all movements the joint is capable of.  Research claims that recovery from the injury is 70% faster-- can even lead to growth of new muscle strength and girth.  Supposedly it often saves the athlete from having to have career-ending surgery.  If you want to check this out, search for "occlusion therapy for professional athletes" or some such.

The Voodoo banding works similarly, with the same extraordinary results.  My bad shoulder been bothering me for weeks?  I tried the voodoo banding yesterday around shoulder and arm, because I was applying it to myself, I couldn't get it tight enough to greatly reduce circulation, then I moved the arm for maybe 30 reps in all directions, then removed the wrapping and began working out.  Gordon, for the first time in weeks, working chest and shoulders and arms didn't hurt.  Yeah, possibly some of that was placebo effect-- because I really want it to help. 

Sorry, don't mean to hijack the thread.

Gordon J. Wallis said:

She told me the PTs keep calling her and telling her she needs more of their therapy. And as far as the diagnosis goes? I've heard all kinds of weird things over the years. But it doesn't matter. All I do is look for and eliminate trigger points. 95% of the time when I do that. Whatever their incoming complaint is goes away. I have another new client. I think I see him again tomorrow or the next day? He came in with left shoulder pain. Two days before he saw me he was in a great deal of pain and could not even lift his left arm. But when I saw him it was better. He could lift it while in a great deal of pain. I asked him where he felt the pain, he indicated the anterior portion of his left deltoid and comented that at times it runs up his neck. While he was sitting on the table in his robe I asked him if I could palpate his shoulder. He said yes. I began palpating his left infraspinatus when he tried to stop me by telling me that it did not hurt there and that I need to check his deltoid where it does hurt. I had to stop palpating and explain to him that it was important to palpate every muscle involved directly with his shoulder. He was very worried that it was a rotator cuff injury. I told him that it was. He looked very stressed when I told him that , until I explained that it doesn't nessicarily mean his joint, that it's most likely muscular. I then continiued with the palpation. He had a trigger point, as I suspected in his infraspinatus, three in his paraspinals between his spine and shoulder blade, one in his left posterior neck. He also comented that his left chest felt swollen and higher then his right chest. I want to point out that this guy was scared. I had to calm this guy down if I was ever going to have the possibility of helping him. I looked him in the eye and told him that I'm an expert at what I do. And I would know very shortly if I could help him or if he should see someone else. He relaxed and then I palpated his left chest. O wow. He had a very painful withdrawal reflex when I palpated his pectoralis major. That was obviously the main trigger point for his problem. All those trigger points deactivated by the way. It was cool. So he left the spa feeling pretty good. My only worry is that those trigger points, especially the pectoralis major, are going to need a couple more treatments before they are totally gone. He may wake up in the morning to find his shoulder hurting again, think that I can't help him. And I won't see him again. Anyway, we will see. But those trigger points are his shoulder problem. When I palpated where he said he hurt there was no withdrawal reflex or trigger points. I will load a trigger point chart of the pectoralis major pain pattern.
Gary W Addis, LMT said:

It's criminal that she was sent to a PT with that complaint-- and that treatment.  The usual PT's "stretch and strengthen" to a muscle diagnosed (wrongly) as "separated from the bone" ???  Now how in hell can a PT or strength coach or anyone else exercise a muscle that has even a partial tear in its tendon or, because it's hip,  maybe to the glute attachments to iliotibial band?)

Permalink Reply by Gordon J. Wallis on July 2, 2016 at 12:55pm
No worries about hijacking the thread. That's good news Gary. It sounds kinda like this concept. Www.therossitersystem.com. I use my own version of that voodoo banding on my forearms by clamping my muscles with my other hand and rotating my clamped wrist and forearms.
Permalink Reply by Gordon J. Wallis on July 2, 2016 at 1:20pm
Another off subject. I just found out ,because of these new Alaska massage laws, I have to take one of those certification exams. The MBLEX or NCEMTMB/NCETM. My perspective, those exams are responsible for keeping our profession from meeting its maximum potential. All the money that I've put out ( license fees )and the time waisted memorizing things for an exam , plus the cost of the continiuing education requirements and exam, has all but stopped my real learning. Thank God this happened near the end of my career. I wonder how many trigger point questions they will have on those exams? I don't know. No one else that I know seems to be bothered by all this? I just see the world differently. Oh, the other thing that gets me is this. Structural integration people don't need a massage license here in Alaska. When I inquired why? I was told they work with fascia.

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