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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 Gordon J. Wallis on
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After scowereing YouTube, I notice that what I call a biceps trigger point, others call it biceps tendinitis. The word trigger point is not even used. They use words like tear or adhesion instead. The word trigger point has no meaning to a lot of health care professionals. Hence the very frequent misdiagnosis of pain that Travell was so concerned about. If you are bored, go ahead and do a YouTube search on "biceps tendinitis. You can also see how they treat what they call biceps tendinitis.
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Permalink Reply by Gary W Addis, LMT on
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Pueppi, Gordon will certainly speak for himself, but, no, he isn't saying that at all.
Trigger points always have a central tender point. Tendinitis/tendonitis/ligament tears produce pain that extend over a wider/ longer area. While a tp in one of the muscles that interact with a joint can indeed cause diffuse pain that is felt in or very near its origin as well along the muscle's entire length, if a trigger point exists, both the client and the therapist will immediately be able to distinguish the difference when pressure is applied to it. And, no, not all TPs refer pain elsewhere: some produce only localized pain.
It is a fact that many, not all but many MDs, PTs, DCs have little or no understanding of the nature of trigger points. The knowledge is available to all, so if they don't know, maybe it's because in the learning, medical ethics would force them to refer many of the patients they can't help to massage therapists knowledgeable in the use of advanced trigger point therapies. Their indifference/antagonism often has a monetary basis-- for the pain that a skilled MT can eliminate in one or two sessions can be a continuing income stream to a DC or PT for months. Surely, Pueppi, you don't deny that this exists. And many. many times every day needless surgeries are performed for myofascial and nerve pains -- for instance, for carpal tunnel and thoracic outlet syndrome, painful disorders that can very often be eliminated by releasing trigger point in scalenes, pec minor, coracobrachialis or one of the forearm muscles. I could provide scads of other examples.
Pueppi, you've been visiting this thread long enough to comprehend that Gordon Wallis knows how to differentiate between a ligament tear, a fascial adhesion, a tendon strain and a trigger point. However, it is factual that many if not most of the above diagnoses are just flat out wrong...are nothing more serious than a couple of easily, quickly eliminated trigger points. The AMA itself states that the majority of back surgeries, carpal tunnel surgeries and a big percentage of joint replacement surgeries were unnecessary.
http://www.usatoday.com/story/news/nation/2013/06/18/unnecessary-su...
An excerpt:
"Tens of thousands of times each year, patients are wheeled into the nation's operating rooms for surgery that isn't necessary, a USA TODAY review of government records and medical databases finds. Some, such as Stelly, fall victim to predators who enrich themselves by bilking insurers for operations that are not medically justified. Even more turn to doctors who simply lack the competence or training to recognize when a surgical procedure can be avoided, either because the medical facts don't warrant it or because there are non-surgical treatments that would better serve the patient.
The scope and toll of the problem are enormous, yet it remains largely hidden. Public attention has been limited to a few sensational cases, typically involving doctors who put cardiac stents in patients who didn't need them.
“Baseball was my life, and he took that away.”
Jonathan Stelly, 34, whose MLB dreams were dashed by a pacemaker
In fact, unnecessary surgeries might account for 10% to 20% of all operations in some specialties, including a wide range of cardiac procedures — not only stents, but also angioplasty and pacemaker implants — as well as many spinal surgeries. Knee replacements, hysterectomies, and cesarean sections are among the other surgical procedures performed more often than needed, according to a review of in-depth studies and data generated by both government and academic sources.
Since 2005, more than 1,000 doctors have made payments to settle or close malpractice claims in surgical cases that involved allegations of unnecessary or inappropriate procedures, according to a USA TODAY analysis of the U.S. government's National Practitioner Data Bank public use file, which tracks the suits. About half the doctors' payments involved allegations of serious permanent injury or death, and many of the cases involved multiple plaintiffs, suggesting many hundreds, if not thousands, of victims."
Pueppi Texas said:I think what you are trying to say, is that mis-diagnosis occurs. But, it reads as though you are trying to say that what you call a trigger point and what someone else calls tendonitis are the same thing. There may be similar symptoms, but that does not mean they equal each other. That is why we have differential diagnosis (DDx). In order to figure out the problem.
Yes, therapist do have a tendency to listen to the body differently than many other health care professions. But, I am not comfortable with the way you discount the other health care professions, either. There are good and bad practitioners in all fields.
And, when you say something like: "The word trigger point is not even used. They use words like tear or adhesion instead.", I'm sure you don't mean it like this... but, it appears you think that a TP, a tear and an adhesion are the same. They are absolutely NOT the same things. And, I would assume you agree, that anyone who thinks they are should be put out behind the barn and given a come-to-Jesus talking to.
For those who are sold on TP's being the result of most every pain, here is a link that may be of use in regard to how a DDx works in regard to the TP's in different regions. I am not promoting the site as a whole, as I have not delved into it, but it does give some brief information that may be helpful in the case of the biceps brachii and differential diagnosis: http://www.webmanmed.com/disorders/disorders_files/musclgd/upxtrm/1... which is what my response to the above comment is covering.
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Pueppi, thank you for your response. Some times it's difficult to express what I mean to say. A trigger point, tendinitis, and a tear, are different problems. I know they are different. However it seems a lot of physical therapist and other providers don't. Trigger points are not even in the equation? Thats what my thread is about. I hear all these different diagnosises for people's pain problems, but never trigger points. When that's exactly what they have. I have most them out of pain within five sessions simply because I'm eliminating trigger points. There is no need for me to even try to diagnoses. If they say they are hurting, I just palpate for trigger points. Almost all of them have major trigger points. I get them out of pain for a couple hundred bucks. The health care professionals that have failed them for weeks, months, and years are billing insurance companies literally thousands opon thousands. I know there are very good people in the chiropractic, physical therapy, MD., Osteopathic, fields. Because Ive learned from them. But they are rare. All the clients I've talked about in here were misdiagnosed. I write a lot in here. But I can't write about all of them. There are too many. And I do know that the vast majority of pain on the planet is trigger points. I will read the website you posted soon. The client I talked about that works in the PT clinic that's been in pain sense 2007, is covered with painful trigger points. .She never heard of the word trigger point? There are a lot of people that go to that physical therapy clinic that are in pain. The attachment below is true. That's what I'm talking about. Also I want to add this. I'm not sure that what's often called tendinitis is not really a trigger point? All I know for sure is. If I can make it go away, it's what I call a trigger point.
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it's hard sometimes to express what I mean. Especially sense my keyboard doesn't work and I have to hunt and peck now. Pueppi, I like people commenting in here if they feel like it. In the past various threads in here got kind of violent. Those people that participated in those threads got so upset with each other they are no longer here. And a lot of those people were really intelligent. I think Gary remembers some of them? I really got attacked a few times myself. I was called a lier and accused of deceiving the minds of young people. I try to back up what I say in here But ultimately I'm talking "my truth". Anyway if what I say in here is confusing, or makes no sense , or not true. Feel free to comment.
Pueppi Texas said:
@Gary, please re-read what I wrote. I mentioned it "reads as though" and it "appears"...
I added my two cents so that others who stumble on this thread (maybe even in the future) realize that what it looks like he is saying and what he is actually saying are two different things.
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Gotcha. I imagined the accusatory tone. You said, "I assume....". My point is that after reading his posts for so long, and (I assume) watching some of his videos, by now you should know not assume that he knows-- you know?
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Gary, that's a really good article about the unnecessary surgeries. I put it as a perminent link on my home page.
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thanks
Gordon J. Wallis said:Gary, that's a really good article about the unnecessary surgeries. I put it as a perminent link on my home page.
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I'm thinking about maybe teaching( privately) that concept of 12 muscles in the human body as it applies to releasing trigger points. I think I can do it over the phone along with viewing some of my videos. So that I would not be overwhelmed, I'd only accept two people at a time. It's just an idea at this point. But if you are interested. Friend and email me in here.
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 Therese Schwartz on
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That would save you flying all over the country, too! Good idea!
Gordon J. Wallis said:I'm thinking about maybe teaching( privately) that concept of 12 muscles in the human body as it applies to releasing trigger points. I think I can do it over the phone along with viewing some of my videos. So that I would not be overwhelmed, I'd only accept two people at a time. It's just an idea at this point. But if you are interested. Friend and email me in here.
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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https://theconversation.com/what-is-chronic-pain-and-why-is-it-hard... This is an artcle tilted " Why is chronic pain so hard to treat?" To me it's a no brainer. They don't know anything about trigger points. When you consider that 75% to 85% of all pain comes directly from trigger points. No wonder it's a mystery for them. In that article there is no mention of trigger points.
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I think I'm going to end this thread, and let it slowly drift off into the nethers of the Internet. I've said pretty much what I've wanted to say anyways. I wonder where our profession will be at in 2116 ?
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in the article there is this: "In addition, many medical and dental programs in the United States devote as little as one hour in their curriculum to teaching pain mechanisms and pain management. Thus, most of our health professionals are poorly prepared to diagnose and treat chronic pain, which contributes to both the under treatment of pain and the abuse of opioids."
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