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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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This lady had a shoulder problem and was in physical therapy for a year!!! But look what happened when I went after the trigger points. I wonder how much money that physical therapy clinic made off of her in one year?????? It's like I keep saying. "TRUTH IS OFTEN HIDDEN, LIKE A SHOWDOW IN DARKNESS."
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I did some good work lately. I mean successful. Eliminated some pain. I could write about those clients but another client is a bit more interesting. Because I'm not sure if I can help her or not? However, I might be able too? Her main complaint was severe tension in her neck at night. Not pain, but tension. So bad she can't sleep. The medical docs gave her some kind of diagnosis, I can't remember what. But the bottom line is, they told her that eventually she will need to have her neck fused. I palpated her neck and she had full range of motion, however she did have three pain points on the posterior neck . Anyway the pain points were not that intense. I mean I might have a pain point on my neck. As a massage therapist her neck did not seem that bad? But who knows? However she had a lot of pain along her T spine. On the lateral spinuses. I mean a lot. From T2 all the way to T11. Very painful. Not normal. One side of the spinus would be tender the other not.. All together she had about nine really painful points on the left and right lateral spinuses on her T spine. I was able to eliminate of down grade all those pain points. Now I don't know for sure. But I have a feeling that if I'm able to eliminate or down grade that spinus pain in her T spine. She won't have that neck tension at night? Anyway I just find that interesting and I hope I can help her?
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In the attachment below there is an excerpt from an email conversation I had with a chiropractor a few days ago. What he says, fits into this thread.
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Ya know, if someone has a headache thats bothersome enough, they have choices as to who they can see for their headache. I'm not advocating one choice over the other. I just want to point out, like I have been in this whole thread, that soft tissue work is a more viable choice then most people think( including massage therapists ). A client came in the other day with a month long medium level headache. She had no history of migrains or headaches prior to a month ago. She first went to a medical doctor, and after diagnositc tests, they found nothing wrong. She then went to a chiropractor for several treatments to no effect. She had a gift certificate to the spa where I work for an 80 minute massage. She told me of her headache. I asked her if she ever heard of the word trigger points. She said no. I strongly suspected trigger points as the cause of her month long headache. After all the medical docs ruled out all the really mean bad nasty stuff that could cause her headache. And chiropractors are just not going to address trigger points as effectively as a good soft tissue workor could. Unless the chiropractor themself does soft tissue work. I told her about trigger point work, let her read a testimonial, and showed her a short video clip of me doing trigger point work. She said go for it, but she still wanted a good relaxing massage. I palpated from T12 up to the top of her head, front, back, and sides. I found several pain points on her T-spine( para spinals and rhomboids ). I found two mild upper trap pain points( GB 21 ). Three posterior neck pain points. One really painful one on her right occiput area. Two painful points up higher on the occipital portion of the skull on both left and right sides. Also a painful point on the left currogator on the coner of the eye near the nose. She also had two pain points in each temporal muscle. After devoting maybe 25 minutes to all those areas I asked her how her headache felt. She much better, but it was still there a little bit. I asked her how much better. She said 80%. I knew she wanted a relaxing massage so I fiugured 80% was pretty good and that its possible with another hour of massage left, It might just wipe her headache out for good. That happened a few other times with headache people when I could not completely remove their headache after the trigger point work.. Anyway after the massage, when she came out of the room. She looked at me and said with a big smile. My headache is gone. As a side note. She originally complained of feeling her headache mostly in her lower forhead and between her eyes.
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Permalink Reply by Dawn Bellanca on
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Thanks for sharing! This is why we love doing what we do!!!
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I walk to work. It only takes 15 to 25 minutes depending on the weather. I'm in Alaska, and this time of year its snowy and cold out. After arriving at the spa I have to take all my cold weather gear off. I'm layered so it takes a few minutes to unlayer. Where I do that is very near one of the hair stations. So one day as I'm hanging up my coat and so on I over heard a conversation going on between ther hair stylist and her client. The client was complaining about her hip pain. Some days she can hardly walk. She has been seeing a chiropractor three times a week for three months and its not helping at all. So I walked up to them and explained that I could not help overhearing their conversation and introduced myself to the client. I told her that its possible that I could help her very quickly, and that it would not take long to find out. As it was there was only a few minutes left for her hair service and I had 25 minutes before my first appointment of the day. The client said she would be willing to see if i could help her. That was after I showed her a testimonial and a short video clip. She told me that when she asked the chiropractor why she was not getting better, she felt that he was annoyed and she felt guilty for asking. Anyway, three times a week for three months. Id be asking too??? She was paying out of her pocket. I did not charge her that day because it was just to find out if I could help her. If so, then she could schedule with me and we would go from there. The chiropractor told her that she was hurting because her hips were tilted and that her sacrum was out of alignment. A lot of good that diagnosis did? Three times a week for three months with no effect. When she tries to lift her right leg it really hurts. She can't get her shoes on without pain. Anyway..... I palpated several very tender pain points in all the various glute muscles as well as on the border and on the sacrum itself. A QL pain point right on the border of the illiac crest. A vastus lateralis pain point on the effected side. But the worst pain point was near her groin area perhaps were the pectinius or adductor longus would connect. Now with that muscle being trigger pointed so intensely you can see how lifting the leg would hurt intensly. Long story short I worked all those areas as best i could within 20 minutes. She was stunned when she got off the table. She could not believe it. She was still sore, but not nearly as sore as she was the prior three months. She made another appointment when she left. The next time I saw her it was a a paid visit. The first thing she said when she came into the room was. I can't believe how much better I feel?? I actually put my shoes on this morning with no pain? She has cancelled her future chiropractic appointments. I'm guessing maybe three or four more short sessions and her problem is over. Her last visit the other day only took 17 minutes and she even felt better when she got off the table. Her worst pain points are on her sacrum and that adductor longus pectineus area. They will be the last ones to go. I also had time after the session to explain what trigger points are and show her charts of some of her trigger points. So she is dramatically better after only two short 20 minute trigger points sessions. Compare that to 36 chiropractic sessions with the diagnosis of a tilted hip and out of alignment sacrum. I don't need to diagnose anything. if there are trigger points involved. And in her case it was a very noticeable deal. I don't care what kind of therapy you are doing. If it does not make the trigger points go away. The problem is not going away. It just isn't. Sometimes I just wish I could hang out in front of one of those clinics and offer a free session to every patient that comes out the door. That would be interesting? The testimonial you have seen before in this thread. Its a different person then I'm writing about now. But its the same kind of thing. A Typical Experience. Trigger Points. For most people, including massage therapists. THINGS ARE OFTEN TIMES NOT WHAT THEY SEEM. also, WHAT IS SIMPLE, IS SIMPLY SEEN. AND WHAT IS SIMPLE, IS RARELY UNDERSTOOD.
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Two kinds of pain.. Well more then that but.... The two kinds of pain that I deal with the most are... Symptomatic pain, and palpatory pain. Symptomatic pain is the complaint the client comes in with.. Like, my low back hurts, my neck hurts, I have sciatica, or what ever. Palpatory pain is what ive been talking about in this thread. Trigger points and pain points. Both those types of pain don't always line up. Here is what I mean. Someone may complain of low back pain. But on palpation their low back is fine. Its pain free. However their Glutes may have a lot of palpatory pain. I mean sometimes their low back hurts and there is palpatory pain in that area, but not always. Now often times if you get rid of the palpatory pain, you get ride of the symptomatic pain. The few times that does happen, they have a more serious problem then trigger points. In that case the trigger points are a side affect of something beyond muscle pain. Perhaps ligiment pain or herniated disc, or what you always here... A pinched nerve. But that only happens 15% of the time, in my experience. With that said.... A new client came in today. A referral from another client that I was able to help. This guy had two months of back pain. That was his symptomatic complaint, back pain. He had seen a chiropractor a few times without relief. When I asked him where he hurt. He indicated the area from T12 to T3. I palpated his entire body. Feet to the top of his head, front, back, and sides. This is what I found. Painful upper glute TPs.. Really painful Illiac crest TPs. One where the QL might connect. The worst ones were on ther very lateral side of his Illiac crest, perhaps where some abdominal oblique connects. Another most painful spot was on his lateral paraspinals at about the L3 level. And when I mean painful.. I mean his whole body flinched when I palpated those areas. Now he was also sore in his area of symptomatic complaint..But they werer mild pain points compared to the areas I just mentioned. He had several of those mild TPs in the Rhomboids and Paraspinals in his symtomatic areas. Interestingly enough he also had a noticable Trigger Point in the middle of both left and right Hamstrings. I was able to down grade or eliminate all of his pain points. He was pain free when he left the spa. Now Im sure he will become symtomatic again tomorrow or the next day. I told him he needs a few follow ups to completely resolve his two month back pain problem. So its up to him now. He was happy when he left.
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Cool, thank you...Uhm... I only talk my truth in here.. Just what I think, and my esperience. Sometimes I wonder if anyone really reads what I say??? Not that it matters.. lol
Dawn Bellanca said:Thanks for sharing! This is why we love doing what we do!!!
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Permalink Reply by Gary W Addis, LMT on
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Gordon, your thread is followed, read, by hundreds of MTs, all of whom (and their clients) benefit from their distant association with you. On behalf of all of us, I thank you, brother.
Gordon J. Wallis said:Cool, thank you...Uhm... I only talk my truth in here.. Just what I think, and my esperience. Sometimes I wonder if anyone really reads what I say??? Not that it matters.. lol
Dawn Bellanca said:Thanks for sharing! This is why we love doing what we do!!!
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Permalink Reply by Therese Schwartz on
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Gary, if we had the ability to "Like" comments on this site I'd give your comment an enthusiastic one!
Gary W Addis, LMT said:Gordon, your thread is followed, read, by hundreds of MTs, all of whom (and their clients) benefit from their distant association with you. On behalf of all of us, I thank you, brother.
Gordon J. Wallis said:Cool, thank you...Uhm... I only talk my truth in here.. Just what I think, and my esperience. Sometimes I wonder if anyone really reads what I say??? Not that it matters.. lol
Dawn Bellanca said:Thanks for sharing! This is why we love doing what we do!!!
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Had an example of symptomatic pain and palpatory pain today. The client came in complaining of low back pain. It was a low level pain thing that wasn't bad enough for her to go see anyone for, like a chiropractor or Medical doctor. She figured that it was just part of life and it didn't stop her from doing things, so she never worried about it too much.. However, she did mention it to me when she came in with her gift certificate for a spa massage... And Im a Trigger point freak, so I decided to palpate from her hips up to T12. That would be my minimum area of palpation for low back pain. I found two Glute medius pain points on her right hip. I found a Glute medius pain point and another on the PSIS on her left hip. But the worst pain point was in the middle of her Piriformis on the left side. She had zero pain points anywhere on her lumbar area. So her symptomatic complaint was low back pain. But the palpatory pain was in her hips. I made the palpatory pain go away. On re palpation there was no more pain. When she got up off the table, her symptomatic pain was also gone. Just thinking about it, there is one symptomatic pain complaint that I see causing misdiagnosis often. If anyone comes in with the complaint of pain deep inside there shoulder at the Greater tubercle or top of the Deltoid area. You might want to palpate the Infraspinatus for a Trigger Point or two. I see that often enough. Its often times blamed on an Arthritic joint or some other kind of joint pathology. Or a pinched nerve in the neck. Also, often times trigger points in the Infraspinatus will restict shoulder abduction or movement as well as radiate pain down the arm. And when that happens, it often validates that bad joint diagnosis or pinched nerve diagnosis.. But if you make the Infraspinatus pain points go away, and the client moves their shoulder pain free with greater range of motion. You know the joint and neck are ok, even if it there is a little Arthritis or pathology. Of course you also need to palpate other shoulder muscles for possible trigger points.. But I have seen that one muscle( Infraspinatus ) go unchecked for weeks, months and even years because its assumed a joint or pinched nerve problem.
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another great reminder! thanks, brother.
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