Response to "Knot in a muscle' post

Replies to This Discussion

Permalink Reply by Gordon J. Wallis on July 7, 2011 at 2:57pm

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

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Permalink Reply by Lucianna Johnston on July 7, 2011 at 3:04pm

So, I'm on Part I and am enjoying this information. So, what I have just read (just for my clarification) is that long term static isometric contraction is more damaging to the muscle's resting contraction than isotonic contractions (bank teller v. construction worker)..so this is why I see so much damage from someone who is at the computer all day right? Have you had much experience with sherrif's/correctional officers etc? I believe they also would have a static isometric contraction in their ES group from the work belts they wear correct? They all develop hypertonic muscles on the right side of their back which appears in the same way as the postural pattern of mild scoliosis. Also, I want clarification on the term ischemia. When you are talking about Local Ischemia are you referring to the site of the trigger point? In my understanding up to now I have referred to the hardened muscle "knots" as ischemia...is that correct?

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Permalink Reply by Stephen Jeffrey on July 7, 2011 at 3:26pm

Gary, the nearest I palapate to what you describe is on the thigh,  as in cellulite, these nodules do skid away a quarter inch as you describe, otherwise, heck, I don't know.

And your are right about the squerming of the hypertonic tissue, if you try to pin with just one thumb or digit it'll get away from you, use two digits/thumbs, slightly either side, then as you sink the tissue cannot escape eg lateral fbers lower traps.

I'll say this Gary your palpation skills are way ahead of most at your stage of learning. Hats off to ya.    

Gary W Addis said:

   I find these in many bodies I've worked on, incl my fellow students--and they in turn find them on me.  They are about the size of a small person's fingernail or smaller, they roll around even before pressure is applied.  Light effleurage can reveal them if the practitioner is paying attention.  When pressed, they usually don't elicit pain--the mobile ones I'm talking about.  Others of about the same size and density do feel somewhat tender, but the mobile one don't. If pressed lightly, after a few seconds they scoot away just enough to escape the pressure.   In such cases i follow the mvmt but apply even less pressure to either side and slightly on the spot itself and after a minute or so it often dissolves.

 

The otehr kind I mentioned are not like bumps or knots at all, but along the length of a muscle, usually nearing its junction with other muscles.  When I feel it begin to move I lighten  pressure and stay right there till it flattens and relaxes, usually a couple of minutes.  Before I learned to slow down and there was movement of the strand, the clients always reported that although he could feel the "jump", it wasn't painful.

 

Boris Prilutsky said:

Hi Gary.

you are saying:"When pressed, they scoot away a quarter inch."it is difficult for me to understand on  what phenomenon we are talking about therefore cannot reply, but using the opportunity and given to the importance would like to repeat:"

often MTs proposing “diagnosis”: “you having muscle knots “  and “let me help you get rid of it”. Very often this kind of treatment and up with  vigorous pressure on so called “muscle knots”. In most cases this “muscle knots “ is a new formations  that of course  bulging  and therefore one can feel it  under fingers. Just using the opportunity would like to remind  to everyone that this is contraindicated to press against any  new formations  that of course  bulging including but not limited  to lipomas, any other tumors, cystic formation etc. let's keep in mind if  one will decide to press against mentioned above formations one can cause irreversible as well very significant damages.

Best wishes.

Boris

Gary W Addis said:

Boris, what I'm referring to is not bulging, but sorta like a mobile mouse beneath, or in muscle, not bulging above skin.  When pressed, they scoot away a quarter inch.

Boris Prilutsky said:

Hi Dr Ross.

To all  what  you have said I would like to add  that often MTs proposing “diagnosis”: “you having muscle knots “  and “let me help you get rid of it”. Very often this kind of treatment and up with  vigorous pressure on so called “muscle knots”. In most cases this “muscle knots “ is a new formations  that of course  bulging  and therefore one can feel it  under fingers. Just using the opportunity would like to remind  to everyone that this is contraindicated to press against any  new formations  that of course  bulging including but not limited  to lipomas, any other tumors, cystic formation etc. let's keep in mind if  one will decide to press against mentioned above formations one can cause irreversible as well very significant damages.

Best wishes.

Boris

• ▶ Reply

Permalink Reply by Therese Schwartz on July 7, 2011 at 3:42pm

Lucianna, it's my understanding that ischemia refers to lack of blood supply.  In that sense a muscle knot could be ischemic because it certainly has lost appropriate blood flow.  With compression techniques we deliberately create temporary ischemia in order to encourage the body to rush blood into the area when the compression is complete.

 

I do think that long-term isometric contractions are very damaging!  Some of the worst cases involve people with their monitors too low, and people who talk by holding the phone between their ear and shoulder.  Muscles are meant to have a rest phase and if they don't get it, it's trouble.

 

Gordon, I need to pay attention to when you post about TP's - I want to know too!!

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Permalink Reply by Lucianna Johnston on July 7, 2011 at 3:54pm

That is my understanding too Theresa, I just wanted to clarify since I don't see the terminology too often. I have been finding variances in terminology lately :) Have you had many experiences with sherrifs/corr. officers...or any other professional required to wear a belt that is typically heavier on one side? Just curious, if yes, what is your approach and/or advice to them?

• ▶ Reply

Permalink Reply by Stephen Jeffrey on July 7, 2011 at 4:20pm

Hi Therese,

we all had a bit of a ding dong over ishemic compression duration, over in joe muscolinos group http://www.massageprofessionals.com/group/joemuscolinotheartandscie...

 and two camps seemed to evolve = those that favour long slow static, follow the melt, and those that argue the last thing a knott deprived of blood/oxygen needs is more depravation of blood/oxygen and insist the on off repeated deep stroking  is best.

Now that long static holds (average 3 mins) are being "recommended"  by scientific researchers in the new field of  fascia research I believe that those favouring longer holds are actually more involved with rectifying fascial constrictions than blood/ishemic ones. 

 

IMO it is always best to consider your massage (eg TP work) as having effects on fascial mechanisms  because every technique you use on any human body will be effecting fascia in some way. This is yet to be fully recognised and acknowleged by the many treatment manuals and protocols that will need to be re written:)  

 

   
Therese Schwartz said:

Lucianna, it's my understanding that ischemia refers to lack of blood supply.  In that sense a muscle knot could be ischemic because it certainly has lost appropriate blood flow.  With compression techniques we deliberately create temporary ischemia in order to encourage the body to rush blood into the area when the compression is complete.

 

I do think that long-term isometric contractions are very damaging!  Some of the worst cases involve people with their monitors too low, and people who talk by holding the phone between their ear and shoulder.  Muscles are meant to have a rest phase and if they don't get it, it's trouble.

 

Gordon, I need to pay attention to when you post about TP's - I want to know too!!

• ▶ Reply

Permalink Reply by Dr. Ross Turchaninov on July 7, 2011 at 9:56pm

Lucianna,

 

You are completely correct that prolonged isometric contractions are more damaging to the muscles than isotonic contractions. A lot of isometric contractions which are associated with everyday job is one of the major reason for the formation of active trigger points.

 

Dr. Ross Turchaninov

 

Lucianna Johnston said:

So, I'm on Part I and am enjoying this information. So, what I have just read (just for my clarification) is that long term static isometric contraction is more damaging to the muscle's resting contraction than isotonic contractions (bank teller v. construction worker)..so this is why I see so much damage from someone who is at the computer all day right? Have you had much experience with sherrif's/correctional officers etc? I believe they also would have a static isometric contraction in their ES group from the work belts they wear correct? They all develop hypertonic muscles on the right side of their back which appears in the same way as the postural pattern of mild scoliosis. Also, I want clarification on the term ischemia. When you are talking about Local Ischemia are you referring to the site of the trigger point? In my understanding up to now I have referred to the hardened muscle "knots" as ischemia...is that correct?

• ▶ Reply

Permalink Reply by Dr. Ross Turchaninov on July 7, 2011 at 10:01pm

Gordon,

 

This is a questionable statement. What you described as a treatment option transfers active trigger point into latent or sleeping state with activation in the future despite of initial improvement you may observe. Insufficient compression as well as excessive compression of the tissue in the area of the active trigger point are equally responsible for the formation of the core of myogelosis there.

Dr. Ross Turchaninov

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Dr. Ross Turchaninov on July 7, 2011 at 10:06pm

Stephen,

 

You are completely correct when saying that 3 min compression is harmful. It is unacceptable way apply ischemic compression. One minute and some cases even less is more than enough. Unfortunately this recent idea of slow stroking instead of ischemic compression doesn't have any scientific data and we will shortly discuss it in the next issue of Journal of Massage Science

 

Dr. Ross Turchaninov

 

Stephen Jeffrey said:

Hi Therese,

we all had a bit of a ding dong over ishemic compression duration, over in joe muscolinos group http://www.massageprofessionals.com/group/joemuscolinotheartandscie...

 and two camps seemed to evolve = those that favour long slow static, follow the melt, and those that argue the last thing a knott deprived of blood/oxygen needs is more depravation of blood/oxygen and insist the on off repeated deep stroking  is best.

Now that long static holds (average 3 mins) are being "recommended"  by scientific researchers in the new field of  fascia research I believe that those favouring longer holds are actually more involved with rectifying fascial constrictions than blood/ishemic ones. 

 

IMO it is always best to consider your massage (eg TP work) as having effects on fascial mechanisms  because every technique you use on any human body will be effecting fascia in some way. This is yet to be fully recognised and acknowleged by the many treatment manuals and protocols that will need to be re written:)  

 

   
Therese Schwartz said:

Lucianna, it's my understanding that ischemia refers to lack of blood supply.  In that sense a muscle knot could be ischemic because it certainly has lost appropriate blood flow.  With compression techniques we deliberately create temporary ischemia in order to encourage the body to rush blood into the area when the compression is complete.

 

I do think that long-term isometric contractions are very damaging!  Some of the worst cases involve people with their monitors too low, and people who talk by holding the phone between their ear and shoulder.  Muscles are meant to have a rest phase and if they don't get it, it's trouble.

 

Gordon, I need to pay attention to when you post about TP's - I want to know too!!

• ▶ Reply

Permalink Reply by Gary W Addis, LMT on July 7, 2011 at 10:09pm

I may have had that or something similar to what you mean tonight in NMT class.  My trade off partner has serious problems in neck area, says it frequently locks up, and that in the past she took a lot of pain medications and effectively forever dulled her pain receptors.  In a year of school, she has not permitted anyone, even an instructor to work on the area after the first week.  Tonight she trusted me.  I sure as heck wasn't going to use much pressure.  In SCM, I found & released two TPs with a light touch, essentially just holding and waiting. In upper traps one side contained a huge roll of HT tissue--actually it was perhaps anterior to traps, scalenes maybe?.  I held on it for several minutes with no change, then, concentrating, my eyes closed on their own and for the first time ever I envisioned energy flowing through me, and in a few seconds the tension dissolved!  Now, I haven't studied any of the energy modalities yet, and I have been...doubtful about whether they were mumbo jumbo.  Still don't know what I believe--but in this one instance, I felt the flow of...something, and it did help relax her tissue.   

Gordon J. Wallis said:

After you get through all your training and exams.. I will tell you how to remove trigger points easily using only light fingertip pressure, without actually working the trigger point itself.

Gary W Addis said:

I hear you, Gordon.  You are saying, I think, that if it is painful, work to remove it. If it isn't painful or otherwise troublesome, best course may be to leave it alone.

• ▶ Reply

Permalink Reply by Gary W Addis, LMT on July 7, 2011 at 10:26pm

I'm a day student.  I begged an exception to the rule and got into the night NMT class because one afternoon during a volunteer event, with one touch Mike Smelser cured an ache I had been carrying for weeks.  He knows his stuff and what more is enthusiastic about teaching it.  My schedule is screwed up this quarter, both days and nights, but I'm certain I won't regret it. 

I am proud to know all of you.  In a sense all MTs are competitors. But I haven't come across any jealousies or deviousness, either online here on out in the world.  Sorta like during my days in competition bodybuilding-- onstage we were enemies, but in the gym we were family, and would do anything to help one another.  I am proud of my new profession.  You're all winners.

Stephen Jeffrey said:

Gary, the nearest I palapate to what you describe is on the thigh,  as in cellulite, these nodules do skid away a quarter inch as you describe, otherwise, heck, I don't know.

And your are right about the squerming of the hypertonic tissue, if you try to pin with just one thumb or digit it'll get away from you, use two digits/thumbs, slightly either side, then as you sink the tissue cannot escape eg lateral fbers lower traps.

I'll say this Gary your palpation skills are way ahead of most at your stage of learning. Hats off to ya.    

Gary W Addis said:

   I find these in many bodies I've worked on, incl my fellow students--and they in turn find them on me.  They are about the size of a small person's fingernail or smaller, they roll around even before pressure is applied.  Light effleurage can reveal them if the practitioner is paying attention.  When pressed, they usually don't elicit pain--the mobile ones I'm talking about.  Others of about the same size and density do feel somewhat tender, but the mobile one don't. If pressed lightly, after a few seconds they scoot away just enough to escape the pressure.   In such cases i follow the mvmt but apply even less pressure to either side and slightly on the spot itself and after a minute or so it often dissolves.

 

The otehr kind I mentioned are not like bumps or knots at all, but along the length of a muscle, usually nearing its junction with other muscles.  When I feel it begin to move I lighten  pressure and stay right there till it flattens and relaxes, usually a couple of minutes.  Before I learned to slow down and there was movement of the strand, the clients always reported that although he could feel the "jump", it wasn't painful.

 

Boris Prilutsky said:

Hi Gary.

you are saying:"When pressed, they scoot away a quarter inch."it is difficult for me to understand on  what phenomenon we are talking about therefore cannot reply, but using the opportunity and given to the importance would like to repeat:"

often MTs proposing “diagnosis”: “you having muscle knots “  and “let me help you get rid of it”. Very often this kind of treatment and up with  vigorous pressure on so called “muscle knots”. In most cases this “muscle knots “ is a new formations  that of course  bulging  and therefore one can feel it  under fingers. Just using the opportunity would like to remind  to everyone that this is contraindicated to press against any  new formations  that of course  bulging including but not limited  to lipomas, any other tumors, cystic formation etc. let's keep in mind if  one will decide to press against mentioned above formations one can cause irreversible as well very significant damages.

Best wishes.

Boris

Gary W Addis said:

Boris, what I'm referring to is not bulging, but sorta like a mobile mouse beneath, or in muscle, not bulging above skin.  When pressed, they scoot away a quarter inch.

Boris Prilutsky said:

Hi Dr Ross.

To all  what  you have said I would like to add  that often MTs proposing “diagnosis”: “you having muscle knots “  and “let me help you get rid of it”. Very often this kind of treatment and up with  vigorous pressure on so called “muscle knots”. In most cases this “muscle knots “ is a new formations  that of course  bulging  and therefore one can feel it  under fingers. Just using the opportunity would like to remind  to everyone that this is contraindicated to press against any  new formations  that of course  bulging including but not limited  to lipomas, any other tumors, cystic formation etc. let's keep in mind if  one will decide to press against mentioned above formations one can cause irreversible as well very significant damages.

Best wishes.

Boris

• ▶ Reply

Permalink Reply by Boris Prilutsky on July 7, 2011 at 11:16pm

Hi Dr.Ross.

Would like to add,that this recent idea of slow stroking instead of ischemic compression not only doesn't have any scientific base but also is a dangerous idea /phenomenon of pain  inhibition that some viewing as a positive clinical outcome. This  false "satisfactions" of some practitioners as well as by  patients actually preconditioning  clients to further pathology developments. Many time we  can hear clients complaining that years they used to suffer from painful symptoms, and massage therapists have helped to get read of it, and now no one can help them.this kind of not adequate treatment of myofascial dysfunctions including but not limited  to adequate TPT,fueling  degenerative changes within  spine,and other  joints.excessive degenerative changes within spine, is not only expressing themselves by pain and sometime requiring surgeries but also disturbing normal functions of organs and systems that receiving innervation from this levels. I would say that everyone who deciding to treat people who suffer from skeletal muscular diseases should not   simplify treatment to pain inhibition only. Honestly I believe that protocols including fascia/connective tissue massage, muscular mobilization,TPT. as well as post isometric relaxation techniques is a very simple to learn and understand as well as easy to perform techniques.One just have to spend some time to understand and to learn and then to take on themselves mission.

Best wishes

Boris

 

Dr. Ross Turchaninov said:

Stephen,

 

You are completely correct when saying that 3 min compression is harmful. It is unacceptable way apply ischemic compression. One minute and some cases even less is more than enough. Unfortunately this recent idea of slow stroking instead of ischemic compression doesn't have any scientific data and we will shortly discuss it in the next issue of Journal of Massage Science

 

Dr. Ross Turchaninov

 

Stephen Jeffrey said:

Hi Therese,

we all had a bit of a ding dong over ishemic compression duration, over in joe muscolinos group http://www.massageprofessionals.com/group/joemuscolinotheartandscie...

 and two camps seemed to evolve = those that favour long slow static, follow the melt, and those that argue the last thing a knott deprived of blood/oxygen needs is more depravation of blood/oxygen and insist the on off repeated deep stroking  is best.

Now that long static holds (average 3 mins) are being "recommended"  by scientific researchers in the new field of  fascia research I believe that those favouring longer holds are actually more involved with rectifying fascial constrictions than blood/ishemic ones. 

 

IMO it is always best to consider your massage (eg TP work) as having effects on fascial mechanisms  because every technique you use on any human body will be effecting fascia in some way. This is yet to be fully recognised and acknowleged by the many treatment manuals and protocols that will need to be re written:)  

 

   
Therese Schwartz said:

Lucianna, it's my understanding that ischemia refers to lack of blood supply.  In that sense a muscle knot could be ischemic because it certainly has lost appropriate blood flow.  With compression techniques we deliberately create temporary ischemia in order to encourage the body to rush blood into the area when the compression is complete.

 

I do think that long-term isometric contractions are very damaging!  Some of the worst cases involve people with their monitors too low, and people who talk by holding the phone between their ear and shoulder.  Muscles are meant to have a rest phase and if they don't get it, it's trouble.

 

Gordon, I need to pay attention to when you post about TP's - I want to know too!!

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