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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 December 17, 2016 at 2:12am
I watched a Douglas Nelson webinar the other day and pulled down some interesting statistics that fit into this thread. For whatever reason I can only post one attachment at a time. The numbers and percentage of trigger point involvement in all these pain issues are right inline with this thread. Just look at the numbers and percentages. In these particular statistics they are talking about neck pain, and headaches, both tension type and migraine.
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Permalink Reply by Gary W Addis, LMT on December 17, 2016 at 10:11am

Yep, trigger points.  I've had 100% success treating headaches.  Not claiming that I am a miracle worker who can magically cure spinal problems.  But of the headaches I've encountered, I have had 100% success.  Sometimes it's sinus pressure that causes the headache; this  requires a different treatment, obviously.  But both sinus and trigger points pain are 100% curable.  Sinus headaches, well, some people get a lot of them due to that particular body's mucus production, etc, that I personally can't affect.  But when they flare up, I can release the pressure and give at least temporary relief.  Trigger points, too, can flare up again, for if the client's movement patterns at work and play and sitting in front of a TV or computer stress a particular muscle or set of muscle, trigger points, maybe the same ones successfully treated last week will flare up again.  

But on the day of the session, every client has left my table without the pain they brought to me.  Almost always trigger points are involved in the creation of and maintenance of sinus pain, also.  Clogged sinuses can cause the birth of TPs, and TPs can cause the compression that clogs the sinuses. 

I would rather treat a batch of trigger points than eat when I'm hungry-- that smile of relief in the eyes of a suffering client is a great feeling.  And thanks to you, Gordon, I am a much better therapist than I would have become in 30 years of practice without your guidance.

Permalink Reply by Gordon J. Wallis on December 17, 2016 at 9:04pm
Bummers. I just finished typing a really good client experience, then I some how accidentally deleted everything I typed. Bummers. I don't wanna re-type it. It's time for me to do some stretching, work on myself, and eat dinner. What a bummer.
Permalink Reply by Gary W Addis, LMT on December 18, 2016 at 1:25am

Gordon, there's a browser add-on called Lazarus Form Recovery; Firefox browser has it, I don't know if available for Microsoft browser. Anything you type into a form, the app remembers, so if oyu accidentally or purposely delete then change your mind, you just right click in a form and click on the Lazarus icon then choose the text you want to post into the form.

Do get it: Lazarus Form Recovery add-on.



Gordon J. Wallis said:

Bummers. I just finished typing a really good client experience, then I some how accidentally deleted everything I typed. Bummers. I don't wanna re-type it. It's time for me to do some stretching, work on myself, and eat dinner. What a bummer.
Permalink Reply by Gordon J. Wallis on December 18, 2016 at 1:27pm
Had a new client the other day. I could tell she was not feeelin happy because of her body language. When I got her into the room and asked what she needed from the massage she told me,"Just to relax I guess." Then she went on to tell me that for the las three months she has had pain in her left shoulder and neck, and that it's getting worse. Now it hurts when she turns her head to the left, and sometimes the pain even runs down her arm. She doesn't know if she pinched a nerve or what?
I told her that my massage was good, but not any better then anyone else's. However, for your condition, I can't think of any body better to see then me. I don't care how much alphabet they have before or after thei name. When I said that, she let out a sigh, and you could see her whole body relax. When I heard and saw that, I had a lot more confidence in my ability to help her. Her brain stopped catastrophizing and I just got the placebo effect on my side. I then let her watch a one minute video of me working on a client, so she would see that I'm not talking about a normal massage with oil. I'm talking about trigger point work. And that I would be working on her through a sheet. She said do it. " I want this over."
Interestingly enough she had no trigger points front back or sides until I got to her shoulder blades. And even then the trigger points weren't so bad. She had a few mild trigger points between her shoulder blades. Nothing that would justify her pain symptoms? At this point I was getting a little nervous, that maybe this is not a trigger point deal, and she may need to see someone else? I did find a Levator scapulae trigger point on the left side, but it took a firm pressure for her to notice it, but it could have something to do with the pain when she turns her head to the left. I found a mild Upper Trapezius trigger point on the left as well. Again it did not seem to have the intensity to validate her pain symptoms ? It wasn't until I got to her posterior neck that I begain to find the painful active nocioceptive trigger points that caused flinch responses when touched. She had two really bad ones on the left transverse processes. One at C6 and another around C2. She had one milder one on the right around C5 or 6 as well. All those trigger points deactivated.. But it wasn't until I had her turn over before I found the real culprits that were causing her pain. Her left SCM. She had very painful trigger points at both the origin and insertion that made her wince when lightly palpated. I found only one other noticible trigger point right on the spinous of C3. Anyway all those trigger points deactivated. She got up off the table pain free. And she could turn her head without hurting. I told her that she needs a half hour follow up within the next two to four days. She was happy. That was cool.
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Permalink Reply by Gordon J. Wallis on December 23, 2016 at 9:18am
Check this out..... You might find it interesting?

https://www.youtube.com/watch?v=4PJ216ZlLbE&sns=em
Permalink Reply by Gary W Addis, LMT on December 23, 2016 at 2:52pm

yep, as always.  Merry Christmas, brother Gordon.

Permalink Reply by Gordon J. Wallis on December 24, 2016 at 12:45am
One of my clients came into day specifically because of pain... She had won a gift certificate for a massage in another spa or clinic. She said it was the worst massage she has ever had in her life. She said it was so painful. The therapist told her that she had a lot of knots that needed to be worked out. Here is the thing. She told me she felt fine before the massage. She hurt after the massage. And it's been two weeks sense that massage and her pain symptoms are getting worse. Her neck and shoulders ache, enough to keep her up at night. And now it hurts to turn her head to the left or the right. In addition her hips and legs are hurting mainly in the front, but also the back.
This therapist said he was working on her knots, but what he was actually doing was creating knots. Without listing all the trigger points in detail. She had five really painful trigger points in her neck, two of them in the occipital area C1,C2. She had trigger points in her hips, hamstrings and quads. Unbelievable, this guy actually created trigger points. I worked on her for fifty minutes hunting and releasing trigger points. When we finished she felt way better, but there was still pain when turning her head. So I had to work on her neck again for a few minutes , finding new trigger points and releasing some of the others again. Then she got up off the table completely pain free. That was cool. So, massage can create trigger points, as well as make them go away.
Permalink Reply by Gordon J. Wallis on December 24, 2016 at 2:46pm
One of my clients that I'm working on came in with what he said was sciatica. Low back pain, numbness and tingling in his lower left leg from the nerves being pinched. He had so many trigger points in his lumbar area as well as his T spine and neck, that I forgot about checking his lower leg out. Anyway, his fourth visit he was doing much better. He made a comment that although his back is feeling much better the nerves are still being pinched and he still has pain and tingling in his lower left leg. He was thinking that he might have to see a doctor for that? I said, "Let me check that out." He had several very painful trigger points in his Tibialis anterior. When palpated they elicited a flinch response and a loud verbal ouch. So now, after Christmas he will come in for me to do some mopping up what's left of his low back trigger points and to work on the ones in his Tibialis anterior. After my initial work on his Tibialis he said it felt 60% better. Everyone thinks pinched nerve. Everyone. And although that does happen, it's very rare compared to trigger points. I haven't seen a real pinched nerve in years. I said Tibialis anterior. He also had trigger points in his Peroneus.
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Permalink Reply by Gordon J. Wallis on January 7, 2017 at 2:10pm
This was interesting. I had a client the other day that was six months pregnant. Her incoming complaint was low back pain, buttock pain, and pain in the back of her legs.
We have the Body Support System( a set of ergonomically designed cushions ) so she was able to lay comfortably on her stomach. Her main reason for getting the massage was pain relief. She had Gluteus Medius trigger points , PSIS trigger points, Gluteus Maximus trigger points, and Piriformis trigger points in each hip. She also had QL trigger points both sides, along with Paraspinal trigger points both sides of the spine about the L5 level. On the right leg she had a Semi Memibranosis or Adductor Magnus trigger point near where those muscles connect to the pelvis. She also had a trigger point closer to the knee on the Biceps Femoris. On the left leg she had only one trigger point on her inner thigh , on of the Adductor group. Because of the hip and low back involvement I also wanted to check out her neck. I found three trigger points on the left posterior side , one of them in the Occipital area. And on the right side of her neck She had a trigger point on the C6 area. No wonder she was hurting. Anyway all the trigger points deactivated, and she left the spa feeling good. You always hear about Sciatic Nerve pain during pregnancy. In her case, it was not the case. It was trigger points. In the attachment is an interesting chart that shows an inter connectedness between the lower and upper body. That's why, if the client lets me, I want to check the entire body for trigger points, even if the incoming complaint is a local one. The shin bone is connected to the knee bone kinda thing.
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Permalink Reply by Gordon J. Wallis on January 9, 2017 at 1:53pm
Just a short addition to this thread. One client told me she has constant right foot pain do to arthritis. It was trigger points. Another client was in physical therapy for a year because of shoulder pain. Supposedly because of a partial labrum tear. She was so stressed about it, it's ruining the quality of her life. She wakes up in pain every morning. She said she is doing all the exercises, and she still hurts. I told her the exercises are why she is still hurting. Stop doing them. It was trigger points in her T spine along the edge of the scapula. She came in the next day. When she saw me she cried and gave me a big hug. She woke up for the first time in a year without pain. I'm shocked. All I did was press on trigger points for 30 minutes. I was a bit worried I may have over treated her. I can't imagine what's in the minds of these other professionals? I don't know what they are teaching in college? It's a seriously sad situation. Another client told me her hips often go out. Whatever that means? She has to see a chiropractor often, she never heard of trigger points. She was loaded with them. All over her hips and legs. There is no adjustment that would make those trigger points go away. Impossible. She was surprised to feel so good after I worked on her. When I first told her that her pain is not because of her hips going out. She got a bit defensive, but when I started working on her, she got into it. The whole thing is just weird to me. The misdiagnosis of pain is rampant. Unbelievable. Another thing that gets me is...I know other therapists that have attended Continiuing education seminars by well known educators in our field that teach techniques to eliminate pain. Yet those very same therapists don't know about trigger points after the seminar?

"What's simple is simply seen......And what's simple is rarely under stood."
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Permalink Reply by Gordon J. Wallis on January 10, 2017 at 10:08pm
I asked her what she needed from the massage today. She told me that she is a connoisseur of massage, and gets a massage every week. And that she loves them. And was very excited about her massage today. She was a very nice lady. I then asked her if she had any aches or pains? She told me that she took a bad fall a month ago and sense then has had pain in her tail bone. She then added, it's nothing Massage can help. I asked her why. She then told me that it's very deep inside. I then said.. I can help. I could see the doubt in her eyes. But I know, if you take a fall, there's bound to be trigger points somewhere. Anyway, she gave me permission to try.
She felt the pain in her Coccyx, but when I palpated the area, it was pain free. She reminded me that the pain was very deep. I then palpated the left hip and found no trigger points. But on the right hip, I found a very tender Gluteus Medius that she was not aware of. She flinched and vocalized when I touched it. She also had a flinch and vocal response when I palpated her right PSIS, as well as her Piriformis where it connects to the edge of the Sacrum. All those trigger points deactivated. Often times when there is pain on the edge of the sacrum like that, there is also pain on the inner thigh muscles of the same side. And sure enough there was a very tender trigger point in that area that made her flinch and vocalize as well. She was very surprised and not aware of any of those four trigger points. Anyway the Adductor trigger point deactivated as well. I then checked her neck, and it was trigger point free. She had an 80 minute massage so I went ahead a continued with the massage. But before I had her turn face up I re-palpated those four trigger points. All were gone except for the PSIS. So I re-deactivated it. After the massage her tail bone did not hurt any more. I recommend that she may need another short session in order to make sure those trigger points stay gone. The interesting thing for me about this is that she did not think or expect to have her problem taken care of or helped by a massage therapist. Even though she loved massages and gets them all the time.
The attachment has nothing to do with the above paragraph. It has to do with trigger points though.
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