Questions about Trigger Point, Myofascial.....

Replies to This Discussion

Permalink Reply by Kay Warren on May 20, 2014 at 1:24pm

Gordon,

Drunk posting to a thread where a non-professional is desperate for help is not professional, I really hope you are joking.

Gordon J. Wallis said:

Uhh, yea I watched it twice.  But uhm, I was drunk.   So thats why I didn't see anything.  Lol.    

Kay Warren said:

Gordon,

You watched the video twice, and you didn't see it? Really?  Holy Moly!  Maybe you think you're looking for a broken bone.  You're not. What you're seeing in the video is a terrifyingly damaged transverse alar ligament. This is potentially lethal!

 

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Permalink Reply by Gordon J. Wallis on May 20, 2014 at 2:06pm

Sorry Kay, Yes I got drunk. Sorry I'm not perfect.  I've done thousands of massages..  Worked Almost every day.  And I have just seen one too many clients that have spent thousands of dollars, gone through all kinds of doctors and therapay. Many of them for years.  And they dont get well until they come to a spa on a gift certificate and accidently get me.  And all Im doing is removing their trigger points.  It gets to me sometimes.  sorry.  I think of the money involved and the needless suffering they have gone through.   The last person I worked on had low back pain for three years. She was told by medical doctors that the only way her pain could possibly go away was with surgery. .  She told me it would be a miracle if I could make her pain go away.  I did.  All I did was remove four trigger points.  It was just one too many times.. Yea I got drunk.. Sorry.   I should just stop writing on this site anyway..  I just keep saying the same thing over and over again anyway.. Like a broken record.  

Kay Warren said:

Gordon,

Drunk posting to a thread where a non-professional is desperate for help is not professional, I really hope you are joking.

Gordon J. Wallis said:

Uhh, yea I watched it twice.  But uhm, I was drunk.   So thats why I didn't see anything.  Lol.    

Kay Warren said:

Gordon,

You watched the video twice, and you didn't see it? Really?  Holy Moly!  Maybe you think you're looking for a broken bone.  You're not. What you're seeing in the video is a terrifyingly damaged transverse alar ligament. This is potentially lethal!

 

• ▶ Reply

Permalink Reply by Maryshka on May 20, 2014 at 9:25pm

Good points again Kay. Thank you. What is not being openly considered by Gordon, IMO, is the source of chronic TrPs. Why such long term spasms? Or reoccurring spasms? Could it be that the muscles are constantly firing to hold the instability where ligaments have failed or are failing?? Not just MVAs, could be from a lifetime of playing sports, repetitive motions, yes, even poor body mechanics, etc.

 

http://www.hockeyprimetime.com/news/columns/crosby-saga-continues-t...

Like Great Lakes weather patterns, if you don’t like the latest diagnosis or prognosis for Sidney Crosby, wait five minutes – it’ll change.

Kay Warren said:

ok, I just did some more extensive back reading.  Have you had head or neck trauma? if so when, and what kind? Maryshka metnioned digital motion x-ray (DMX),  and I'm going to second her. It's not hard to have a small accessory ligament tear after an accident or head trauma. They are very difficult to see. What to they do? Well, like all ligaments they hold bone to bone, the the specific action of these particular ligaments is that when you tilt or shift your head from side to side, they help the bones spring back into their proper vertical position. If they are torn, they will leave the vertebrae tilted tone side, leaning on the nerve, which could definitely cause your light sensitivity, headaches, nausea etc.  I believe that this may very well be the issue.

Digital x-ray takes 30 frames per second.  It takes 450 shots to equal the x-ray exposure of 1 traditional x-ray. They will need to shoot from the front with your mouth open to see these tiny ligaments.

As for chiropractors. Some are great, some... well, some of them shouldn't be practicing. There is a chiropractic methodology call orthagonal chirporactic. The force is very light, about a pound, delivered very precisely. Once the instability is found, short of surgery, this would be the safest way to correct it. There is one in Augusta GA that I know of, and probably more.  I'd like to suggest that you Google "DMX" and your town's name. There is probably one within 50 miles of you, if not 100. If I'm correct, and you do indeed have an instability, you're going to have to be very careful about massage, and chiropractic from here on out. Trigger point doesn't need to be rough, and you will probably need a little of it, and you should definitely find a good craniosacral therapist. But honestly, at this point, and after this amount of time, I think a DMX is your smartest next move, and I'll thank Maryshka for reminding me of it.

• ▶ Reply

Permalink Reply by Maryshka on May 20, 2014 at 9:31pm

No Gordon, you should continue to contribute your experiences with massage and TrPs. I have learned a lot from you. We learn from each other. I related my experiences and available Tx options hoping they may be of help to others. It was a miserable 2 years before I looked into regenerative medicine options based on my symptoms (which I Googled). I appreciate what you share. Don't ever discount the value of what you share with us.

Gordon J. Wallis said:

Sorry Kay, Yes I got drunk. Sorry I'm not perfect.  I've done thousands of massages..  Worked Almost every day.  And I have just seen one too many clients that have spent thousands of dollars, gone through all kinds of doctors and therapay. Many of them for years.  And they dont get well until they come to a spa on a gift certificate and accidently get me.  And all Im doing is removing their trigger points.  It gets to me sometimes.  sorry.  I think of the money involved and the needless suffering they have gone through.   The last person I worked on had low back pain for three years. She was told by medical doctors that the only way her pain could possibly go away was with surgery. .  She told me it would be a miracle if I could make her pain go away.  I did.  All I did was remove four trigger points.  It was just one too many times.. Yea I got drunk.. Sorry.   I should just stop writing on this site anyway..  I just keep saying the same thing over and over again anyway.. Like a broken record.  

Kay Warren said:

Gordon,

Drunk posting to a thread where a non-professional is desperate for help is not professional, I really hope you are joking.

Gordon J. Wallis said:

Uhh, yea I watched it twice.  But uhm, I was drunk.   So thats why I didn't see anything.  Lol.    

Kay Warren said:

Gordon,

You watched the video twice, and you didn't see it? Really?  Holy Moly!  Maybe you think you're looking for a broken bone.  You're not. What you're seeing in the video is a terrifyingly damaged transverse alar ligament. This is potentially lethal!

 

• ▶ Reply

Permalink Reply by Kay Warren on May 20, 2014 at 10:05pm

Maryshka,

Entirely possible. If there is head trauma involved, once the alignment issue has been handled and stabilized,  I think a visit to a highly experienced CST would also be in order. Orthagonal Chiropractic is also pretty interesting.  Look it up. It's lighter than even activator, and more precise. One of my clients clued me in. If I had severe neck trauma, it's the only way I'd allow myself to be adjusted. Speaking of interesting things, look up Kevin Pauza in Tyler Texas. He's developed what is essentially fix-a-flat for your discs. It's a very crude analogy, but CBS Sunday Morning did a piece on him a couple of years ago. He's expecting full FDA approval in 2015. He's currently in human trials in 22 locations across the US.

I'm sure there is plenty going on, and often you don't find out about it until several sessions later, and they often think it's unrelated. I do trigger point pretty extensively, have for 30 years, but I can tell a muscular issue from a neurological one. It doesn't hurt that I spent 5 years with an orthopedic surgeon, an old school adjusting osteopath, and I'm working with my   6th DC.  I've been with this one 7 years. I'm working on getting the resources together to open a proper brick & mortar facility.

Maryshka said:

Good points again Kay. Thank you. What is not being openly considered by Gordon, IMO, is the source of chronic TrPs. Why such long term spasms? Or reoccurring spasms? Could it be that the muscles are constantly firing to hold the instability where ligaments have failed or are failing?? Not just MVAs, could be from a lifetime of playing sports, repetitive motions, yes, even poor body mechanics, etc.

 

http://www.hockeyprimetime.com/news/columns/crosby-saga-continues-t...

Like Great Lakes weather patterns, if you don’t like the latest diagnosis or prognosis for Sidney Crosby, wait five minutes – it’ll change.

Kay Warren said:

ok, I just did some more extensive back reading.  Have you had head or neck trauma? if so when, and what kind? Maryshka metnioned digital motion x-ray (DMX),  and I'm going to second her. It's not hard to have a small accessory ligament tear after an accident or head trauma. They are very difficult to see. What to they do? Well, like all ligaments they hold bone to bone, the the specific action of these particular ligaments is that when you tilt or shift your head from side to side, they help the bones spring back into their proper vertical position. If they are torn, they will leave the vertebrae tilted tone side, leaning on the nerve, which could definitely cause your light sensitivity, headaches, nausea etc.  I believe that this may very well be the issue.

Digital x-ray takes 30 frames per second.  It takes 450 shots to equal the x-ray exposure of 1 traditional x-ray. They will need to shoot from the front with your mouth open to see these tiny ligaments.

As for chiropractors. Some are great, some... well, some of them shouldn't be practicing. There is a chiropractic methodology call orthagonal chirporactic. The force is very light, about a pound, delivered very precisely. Once the instability is found, short of surgery, this would be the safest way to correct it. There is one in Augusta GA that I know of, and probably more.  I'd like to suggest that you Google "DMX" and your town's name. There is probably one within 50 miles of you, if not 100. If I'm correct, and you do indeed have an instability, you're going to have to be very careful about massage, and chiropractic from here on out. Trigger point doesn't need to be rough, and you will probably need a little of it, and you should definitely find a good craniosacral therapist. But honestly, at this point, and after this amount of time, I think a DMX is your smartest next move, and I'll thank Maryshka for reminding me of it.

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Permalink Reply by Gary W Addis, LMT on June 16, 2014 at 11:18am

Ysabel,  your English is fine; you express yourself well.

1-A) trigger point therapy seeks and releases trigger points (TrPs) that are usually referred to as "knots" in a taut band of muscle.  A trigger point is usually but not always locally tender when palpated; it usually but not always refers pain to another muscle. For example, TrPs in infraspinatus muscle (located on the posterior side of the shoulder blade (scapula) may refer pain to the anterior deltoid muscle, or its pain field may extend only a couple of inches surrounding the location of the TrP--an anterior deltoid TrP may cause an intense ache in the anterior deltoid.  While the AMA as an organization accepts the existence of trigger points, individually a percentage of MDs scoff at the very notion. 

1-B) All trigger points ARE myofascial trigger points. However, Myofascial Release (MFR) has little to do with trigger points.  Although, properly used by a skilled practitioner, MFR can take out TrP, its purpose is the removal, the release of sticky, restrictive adhesions that develop within the fascial sheath that attaches skin to muscle, binds muscle bands into muscle bundles..  Fascia is connective tissue, it cannot contract, but when sensors within the muscle sense that the muscle is at risk, its fascial wrapping releases a substance that makes it extremely sticky; in essence it clamps down on the muscle to help prevent injury.  But when it does, because it is not muscle, it cannot release its hold on its own.  Hours or days or months may be required for normal everyday muscle movement to break the adhesion loose.  That's where MFR technique comes in.  An LMT employing MFR, working slower than a snail crawls can break the adhesion loose in a single session.

2) TrP therapy is far more likely to end your symptoms than MFR. Fascial adhesions may limit movement of a muscle or muscles, which may instigate nociceptive pain, but themselves adhesions are not painful. Trigger points are painful.

3) IMO, the physical therapy is counter-productive, is as you remarked, likely exacerbating your symptoms.  Without doubt you do have trigger points in several neck and shoulder and scalp muscles; a trigger point is an injury at the microscopic sarcomere level of the muscle.  Calcium is released into the sarcomere in order to initiate movement ordained by the CNS, but due to dysfunction, the calcium cannot be recovered, so the sarcomere cannot relax when ordered to.  Sensors interpret this as abnormal, so pain will usually be the result.  PT's most prevalent treatment for a condition such as yours is to stretch and/or strengthen muscles.  A trigger point is an injury...a leakage of calcium and other electrolytes at the microscopic level.  You wouldn't tug and stretch on a wound in your skin, would you? Neither should you stretch or attempt to strengthen a trigger pointed (injured) muscle. 

First, your therapist should release trigger points,.  This can take as few as a single treatment or multiple treatments to multiple treatments to release them all.  When you can go 2-3 days without the trigger points reactivating, then and only then begin normal activity, gently extending to your once-normal ROM.

Trigger points can indeed be the cause of all your symptoms.  Trigger points in face and neck and scalp can exert pressure into the ear canal, disrupting the free movement of fluid and the wee stones of the inner ear that maintain balance.  A single trigger point long untreated leads to the development of satellite trigger points in its agonist (helper) muscles and, to counter that constant tension, trigger points will eventually form in antagonist muscles as well.  All this pain and contracture within muscles may lead to systemic sensitization-- fibromyalgia.  In extreme cases, even clothing rubbing across the skin or changes in barometric pressure can cause excruciating pain.  Based on your diagrams of your pain patterns, however, I personally doubt the diagnosis of FM.  All your symptoms seem to be concentrated in your shoulders and head, correct?  A diagnosis of FM is supposed to require tenderness in at least 11 of 18 points in the body for three months continuous-- these points are not restricted just to the upper body.  Using drugs and other traditional treatments, it is said to be incurable.  

Using methods taught me by Gordon, I too have had great success treating FM.  Because there is such widespread sensitivity,  first step needs to be desensitization.  A TENS unit temporarily blocks nociceptive pain by flooding the nerve channels with far less intense signals from the mechanoreceptors of the skin.  A skilled therapist such as Gordon accomplishes this using the massage stroke called effleurage.  Light but rapid rubbing of wide areas of the skin will temporarily lessen the sensitivity of FM tender points (just another name for a trigger point, IMO) so that these points can be palpated without causing intense pain.  A highly skilled trigger point specialist can release trigger points using a smorgasbord of advanced, virtually painless techniques.  Successful systemic desensitization can require months of weekly treatments, however.  But I do not hesitate to claim that, using Gordon's desensitization / tender point release techniques, I cured my sister in law's diagnosed fibromyalgia in six weeks-- its been 18 months now without a relapse of her FM extreme sensitivity..

But, as I said, in my personal opinion based solely on the information given, you don't have FM.  A few sessions with an advanced trigger point therapist should alleviate your symptoms.

 

 

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Permalink Reply by Maryshka on June 19, 2014 at 12:22pm

This is SO true: "I know how it feels to be in pain and to want to get better and still feel like the 'professionals' aren't listening and only make the issue worse. The best thing you can do for yourself is to know that nobody can understand what is going on inside your body like you can.  A good Therapist will want to work with you, not force you in anyway."

I was a massage therapy patient before I became a massage therapist. Aside from the MT, I can say that some professionals think that your pain is all in your head (and further covertly categorize the patient/client as a malingerer) when they can't see some external fixation device holding bones together or some other impediment. If our bodies were covered in glass and not skin, we'd see more and judge less. The scars are on the inside... and yes, in SOME ways, the pain is all in our heads (with painful TrPs and myofascial adhesions)... so the need to find the right person is essential.

Kimberly Schadewald said:

Ysabel,

Everyone has given you a lot to think about.  There are a lot of therapies out there and from the amount of people I've talked to, and what I've been fortunate enough to learn is that no two people experience a treatment the same.  So I want to offer you the best of luck in your search and would say there is a lot of good to be said for Cranio-Sacral and for Neuromuscular Therapy (Trigger Point Therapy).

I think the most important question you asked is about how to find a good Therapist. These are my rules:

1) Do they really listen when you explain the issue and what you've been through?

2) Do they take a history and go over your medical information seriously?

3) Do they seem to genuinely care about your concerns and health?

4) If you allow them to work on you, do they listen to what you are feeling during the treatment and adjust to your comfort level?

  A big mistake I hear is that people allow themselves to go through a treatment that leaves them in a lot of pain.  I am a full believer that good therapy is uncomfortable at times but never painful.

I know how it feels to be in pain and to want to get better and still feel like the 'professionals' aren't listening and only make the issue worse. The best thing you can do for yourself is to know that nobody can understand what is going on inside your body like you can.  A good Therapist will want to work with you, not force you in anyway.

Best of Luck and many blessings.

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Permalink Reply by Neal Lyons on February 1, 2015 at 3:10pm

the concept of trigger point massage is simply what it sounds like. to identify and work on the trigger point causing pain in certain parts of the body. we just developed an iPhone app on this that therapists can use in their practice. prior to developing the app, we received many questions from our students clarifying what it is, how to use it in practice, and most importantly how to best understand the hundreds of trigger points in our bodies and the differing pain referral patterns they cause, etc.

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