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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 June 19, 2014 at 9:29pm

Well its simple but thorough.  Uhm, I don't always palpate the entier body at first.  Eventually I do.  Depends on the situation and the client.  A few posts back I talked about the lady with the radiating pain down the arm at night. I did not palpate her chest until the fourth massage.  And thats when I found her problem.  Lets say I have someone come in complainging of low back pain.  I may initially palpate from the hips up to her mid back, and focus on deactivating any tender spots I find in that area.  But Low back pain can also come from the abdominal area or even from the calf( soleus).   But lets say their incoming complaint is a headache.   So you might only palpate from their upper back, shoulders neck( front and back) , face( jaw, eyes) to the top of their head.  Also people that have a history of migrains the abdomin is a place to check.  Internal organ stress causses trigger points in that area.  And those trigger points only exasperate the internal organ stress.  Its common with migrainers to have trigger points in that area.    Like today.. I had a new client that has had chronic pain for years.  I palpated her entier body. I found and deactivated 20 to 25 trigger points.  She had a headache and I deactivated one in each SCM. Another on the left C4 area, her right upper trap, her left masseter, and a right base of the skull TP( don't know what muscle, doesnt matter).  Then did some scalp massage , and she left headache free.   She has had pain chronically for years.  Done the chiropractic thing, and massages.  But I just totally went after trigger points.  She could feel the difference.  I think I see her again on Tuesday.    So if somebody complains of top of the shoulder pain.  You might just palpate the upper back up to her neck( front back and side).  If there are no trigger points.  It does not take long.   I deactivate them as I go.   But Ive been doing this work for 30 years.  So It might be better to just find all the TPs.. Note them.  The the next session work on down grading or deactivating as many of them as you can.  Then each time the client comes back( within 2 to 5 days), you recheck those areas in order to check for improvement.   There is pretty much a corrilation( not perfect), but close.  That if you can wipe out those trigger points, you can eliminate their pain problem.   
Remember the client is telling me when I touch a sore spot. I don't try to feel or intuit anything.  I find that too subjective.  If they say its sore or flinch.  There is no question.  A healthy body has no tender spots even with deep massage.  
Maryshka said:

Do you palpate the entire body in a simple initial pain exam those few minutes or just the area of concern that the client mentions?

Sorry if this sounds remedial (it is)...

Gordon J. Wallis said:

Well my protocal is very simple, reguardless of your approach or style.  Take note of the sore spots, especially the ones that cause your client to flinch.  And do whatever you can to down grade or eliminate those tender spots.  It may take more then one session.   But if those tender spots are still there.  So is the problem, usually.   Usually( example is one client that came in complaining of hip pain, sciatica.   Now she no longer has the symptomatic pain,  however she  still has a couple inactive (tender on palpation only)trigger points left to fully eradicate.   All my new clients with pain complaints I do a simple initial pain exam.  Only takes a few minutes.  I palpate for tender spots.  I may go over how I do that in the future.  But it gives you a pain map of your client.  And something to measure your progress with.

Permalink Reply by Gordon J. Wallis on June 20, 2014 at 9:04pm

When I get a new cleint.  If they have no particular complaint, and just want to relax.  I will often times do a quick one or two minute pain exam from their hips up through their neck.  Based on their response,  that gives me a very good idea on how best to massage them.   It only takes about a minute or two.  If they flinch a lot or indicate enough sore spots, I know i better focus on trigger point work and less massage.

Gordon J. Wallis said:

Well its simple but thorough.  Uhm, I don't always palpate the entier body at first.  Eventually I do.  Depends on the situation and the client.  A few posts back I talked about the lady with the radiating pain down the arm at night. I did not palpate her chest until the fourth massage.  And thats when I found her problem.  Lets say I have someone come in complainging of low back pain.  I may initially palpate from the hips up to her mid back, and focus on deactivating any tender spots I find in that area.  But Low back pain can also come from the abdominal area or even from the calf( soleus).   But lets say their incoming complaint is a headache.   So you might only palpate from their upper back, shoulders neck( front and back) , face( jaw, eyes) to the top of their head.  Also people that have a history of migrains the abdomin is a place to check.  Internal organ stress causses trigger points in that area.  And those trigger points only exasperate the internal organ stress.  Its common with migrainers to have trigger points in that area.    Like today.. I had a new client that has had chronic pain for years.  I palpated her entier body. I found and deactivated 20 to 25 trigger points.  She had a headache and I deactivated one in each SCM. Another on the left C4 area, her right upper trap, her left masseter, and a right base of the skull TP( don't know what muscle, doesnt matter).  Then did some scalp massage , and she left headache free.   She has had pain chronically for years.  Done the chiropractic thing, and massages.  But I just totally went after trigger points.  She could feel the difference.  I think I see her again on Tuesday.    So if somebody complains of top of the shoulder pain.  You might just palpate the upper back up to her neck( front back and side).  If there are no trigger points.  It does not take long.   I deactivate them as I go.   But Ive been doing this work for 30 years.  So It might be better to just find all the TPs.. Note them.  The the next session work on down grading or deactivating as many of them as you can.  Then each time the client comes back( within 2 to 5 days), you recheck those areas in order to check for improvement.   There is pretty much a corrilation( not perfect), but close.  That if you can wipe out those trigger points, you can eliminate their pain problem.   
Remember the client is telling me when I touch a sore spot. I don't try to feel or intuit anything.  I find that too subjective.  If they say its sore or flinch.  There is no question.  A healthy body has no tender spots even with deep massage.  
Maryshka said:

Do you palpate the entire body in a simple initial pain exam those few minutes or just the area of concern that the client mentions?

Sorry if this sounds remedial (it is)...

Gordon J. Wallis said:

Well my protocal is very simple, reguardless of your approach or style.  Take note of the sore spots, especially the ones that cause your client to flinch.  And do whatever you can to down grade or eliminate those tender spots.  It may take more then one session.   But if those tender spots are still there.  So is the problem, usually.   Usually( example is one client that came in complaining of hip pain, sciatica.   Now she no longer has the symptomatic pain,  however she  still has a couple inactive (tender on palpation only)trigger points left to fully eradicate.   All my new clients with pain complaints I do a simple initial pain exam.  Only takes a few minutes.  I palpate for tender spots.  I may go over how I do that in the future.  But it gives you a pain map of your client.  And something to measure your progress with.

Permalink Reply by Gordon J. Wallis on June 27, 2014 at 9:18pm

I had a new client the other day.  I asked her if she had any aches or pains,  and showed her one of my testimonials.  She told me she has chronic pain in her low back and between her shoulders, mostly on the left side, because she has Scoliosis.  She said it like, that explains her pain.  Well maybe? But I have met people with Scoliosis that have no pain.  And I have met people with perfectly straight backs( no Scoliosis) that have lots of low back and between the shoulder pain.  I told her that we would find all her very most sore spots by palpating from her hips up to the base of her skull.  I found a very tender trigger point on her Gluteus medius  left side( low back pain), and three very tender trigger points between her spine and shoulder blade on the left side.  As well as a very tender spot about T3 level on her right side.   Everywhere else was pain free.   I was able to deactivate all those trigger points within her 80 minute massage.  Her chronic pain was gone when she left the massage room.  She is going to come in on a follow up in a few days.   Some of those trigger points will come back. If they do, I will just deactivate them again.  She is young and healthy,  so I may only have to do that two more times.  Even if the Scoliosis is causing the trigger points( I kind of doubt it).  At least she knows that she can come in every once in a while , if it gets bad enough,  and walk out without that discomfort.   I find that a lot of people that complain of low back pain, scoliosis or not,  have Gluteus medius trigger points.   You can see the pain pattern in the attached  file.  

Attachments:
Permalink Reply by Gary W Addis, LMT on June 27, 2014 at 11:03pm

in another forum yesterday, I got involved in a discussion about scoliosis. Two of the posters were claiming to cure/correct severe, chronic scoliosis in one session.  Not talking about trigger points, they are claiming to correct years of bad posture due to injury or...bad posture held during long hours of daily repetitious labor in just one 1-hour session.  Nonsense!-- if Gordon Wallis cannot eliminate scoliosis in a single session, no one else can either!

Not possible to correct chronic scoliosis, kyphosis, or flat back overnight.  During the years the condition took to develop, muscles on the "leaning side" have grown shorter and stronger; on the antagonist side, muscles have grown longer and become weaker; spinal problems such as a bulging disc may have developed as well.  Just not possible to correct such a condition overnight. 

A great massage therapist can certainly take out the trigger points in a few minutes that sometimes develop because of such bad postural balance.  But the misalignment will still persist due to the anatomical changes already mentioned, so the trigger points will flare up again...and again...and again.  But, short of surgical correction (probably a very bad idea except in very extreme cases, which few are), the very best possibility of a permanent fix depends on the client finding a highly skilled massage therapist, and coming to him or her bi-weekly, for as long as it takes for the body to heal itself.  And even for a massage therapist of the caliber of Gordon Wallis, it would probably take months. 

Permalink Reply by Gordon J. Wallis on June 28, 2014 at 10:42am

Gary, I totally agree with you... I don't know who wouldn't? About curing scoliosis   However , I have met people with that condition that don't hurt.  They feel fine.  We will see how this lady feels after a couple sessions.  It may be that the perpetuating factor is her scoliosis.  But I kind of doubt it.  I think and I hope, that once those trigger points are gone.  They  will stay gone for a long long time.   Her condition did not seem that severe to me.  I feel that the label of scoliosis,  in her case, was an unnecesary excuse for her back to be sore.  

Gary W Addis, LMT said:

in another forum yesterday, I got involved in a discussion about scoliosis. Two of the posters were claiming to cure/correct severe, chronic scoliosis in one session.  Not talking about trigger points, they are claiming to correct years of bad posture due to injury or...bad posture held during long hours of daily repetitious labor in just one 1-hour session.  Nonsense!-- if Gordon Wallis cannot eliminate scoliosis in a single session, no one else can either!

Not possible to correct chronic scoliosis, kyphosis, or flat back overnight.  During the years the condition took to develop, muscles on the "leaning side" have grown shorter and stronger; on the antagonist side, muscles have grown longer and become weaker; spinal problems such as a bulging disc may have developed as well.  Just not possible to correct such a condition overnight. 

A great massage therapist can certainly take out the trigger points in a few minutes that sometimes develop because of such bad postural balance.  But the misalignment will still persist due to the anatomical changes already mentioned, so the trigger points will flare up again...and again...and again.  But, short of surgical correction (probably a very bad idea except in very extreme cases, which few are), the very best possibility of a permanent fix depends on the client finding a highly skilled massage therapist, and coming to him or her bi-weekly, for as long as it takes for the body to heal itself.  And even for a massage therapist of the caliber of Gordon Wallis, it would probably take months. 

Permalink Reply by Gary W Addis, LMT on June 28, 2014 at 11:22am

I suspect that when there is no pain the condition was a long time developing.  As a teen I worked in textile mills.  Everyone who had been working their entire adult lives stooped over the machines had a huge dowager's hump, and a very flat back too.  The body had adjusted, has grown stronger where it needed to and stretched out where it needed to in order to maintain that position for 8-16 hours per day, five-six days per week for their entire working lives.  Because the body adjusted to the demands, there was no pain-- I don't think even surgery could straighten those misaligned spines.

Gordon J. Wallis said:

Gary, I totally agree with you... I don't know who wouldn't? About curing scoliosis   However , I have met people with that condition that don't hurt.  They feel fine.  We will see how this lady feels after a couple sessions.  It may be that the perpetuating factor is her scoliosis.  But I kind of doubt it.  I think and I hope, that once those trigger points are gone.  They  will stay gone for a long long time.   Her condition did not seem that severe to me.  I feel that the label of scoliosis,  in her case, was an unnecesary excuse for her back to be sore.  

Gary W Addis, LMT said:

in another forum yesterday, I got involved in a discussion about scoliosis. Two of the posters were claiming to cure/correct severe, chronic scoliosis in one session.  Not talking about trigger points, they are claiming to correct years of bad posture due to injury or...bad posture held during long hours of daily repetitious labor in just one 1-hour session.  Nonsense!-- if Gordon Wallis cannot eliminate scoliosis in a single session, no one else can either!

Not possible to correct chronic scoliosis, kyphosis, or flat back overnight.  During the years the condition took to develop, muscles on the "leaning side" have grown shorter and stronger; on the antagonist side, muscles have grown longer and become weaker; spinal problems such as a bulging disc may have developed as well.  Just not possible to correct such a condition overnight. 

A great massage therapist can certainly take out the trigger points in a few minutes that sometimes develop because of such bad postural balance.  But the misalignment will still persist due to the anatomical changes already mentioned, so the trigger points will flare up again...and again...and again.  But, short of surgical correction (probably a very bad idea except in very extreme cases, which few are), the very best possibility of a permanent fix depends on the client finding a highly skilled massage therapist, and coming to him or her bi-weekly, for as long as it takes for the body to heal itself.  And even for a massage therapist of the caliber of Gordon Wallis, it would probably take months. 

Permalink Reply by Gordon J. Wallis on July 1, 2014 at 8:35pm

I saw the scoliosis client today for her second session.  She was like hyper happy and excited.  She said she has been feeling really good,  but was begining to feel it in her left shoulder again.  And could  not wait for another session.  I re-palpated the trigger pointed areas, but this time there were only two trigger points instead of three between her spine and shoulder blade on the left side.  And the one on the right at the T3 area was gone too.  The Glute Med was still there.  I released them all again.  So she had way less symptomatic pain and two less trigger points.  I will see her again within a week.  And I think I forgot to mention in the post below that she also had a trigger point on the left errectors at the L1 area.  That was still there today too.  But over all, very good improvement.  I could tell by her face.

Gordon J. Wallis said:

I had a new client the other day.  I asked her if she had any aches or pains,  and showed her one of my testimonials.  She told me she has chronic pain in her low back and between her shoulders, mostly on the left side, because she has Scoliosis.  She said it like, that explains her pain.  Well maybe? But I have met people with Scoliosis that have no pain.  And I have met people with perfectly straight backs( no Scoliosis) that have lots of low back and between the shoulder pain.  I told her that we would find all her very most sore spots by palpating from her hips up to the base of her skull.  I found a very tender trigger point on her Gluteus medius  left side( low back pain), and three very tender trigger points between her spine and shoulder blade on the left side.  As well as a very tender spot about T3 level on her right side.   Everywhere else was pain free.   I was able to deactivate all those trigger points within her 80 minute massage.  Her chronic pain was gone when she left the massage room.  She is going to come in on a follow up in a few days.   Some of those trigger points will come back. If they do, I will just deactivate them again.  She is young and healthy,  so I may only have to do that two more times.  Even if the Scoliosis is causing the trigger points( I kind of doubt it).  At least she knows that she can come in every once in a while , if it gets bad enough,  and walk out without that discomfort.   I find that a lot of people that complain of low back pain, scoliosis or not,  have Gluteus medius trigger points.   You can see the pain pattern in the attached  file.  

Permalink Reply by Gordon J. Wallis on July 10, 2014 at 9:14pm

Four days ago a young lady came in for an 80 minute massage.  A gift certificate.  I asked her what she needed from this massage today.  She said just to relax I guess.  When they say I guess, it often means they have some sort of problem and are seeing someone for that problem, or use to see someone for that problem.  I showed her one of my testimonials.  Then she told me that she has been seeing a chiropractor for back pain.  I asked her how long she has been seeing the chiropractor, she said several months.  I told her that the testimonial she read was real and that there was a very good chance I can really help her with her pain.  And explained to her that it would not be a normal spa massage.  And that we would search for every sore spot on her body and attempt to down grade it or eliminate it.  She said go for it.  She said that she is not benifiting from the chiropractic treatments.  She had trigger points all over her back and neck.  Right on her spine as well as more lateral.  I asked her if she gets menstral cramps or has any kind of digestive problem.. She said yes.  So I also palpated her abdominal area.  She had five trigger points in her abdominal  area as well as three very tender points on her right sternum.   All together it was 45 minutes of trigger point work. A lot of trigger points.   After the session she felt really felt good.  She canceled her chiropractic appointments.   When I saw her for the second time it only took 15 minutes of trigger point work.  A great many of those trigger points were gone.  She had only four on her back.  One on her neck.   She had four abdominal trigger points instead of five,  and still had the three sternal trigger points.   But it was only 15 minutes of work compared to 45 minutes for the first session.   Its like I say.  If there is no underlying pathology, its soft tissue work all the way.  Muscles move bones.   And its not just muscles we effect.  Abdominal trigger points often exasperate internal organ problems.  We can greatly bring symptomatic relief and effect the internal organs in a positive way.  I will include attachments that talk about that.   I never go outside the perameters of my license.  I just down grade or eliminate sore spots.  But the effects can be profound.  I messed up on the attachments.  I will attach them bellow on a seperate Reply.  

Permalink Reply by Gordon J. Wallis on July 10, 2014 at 9:25pm

The attachments below explain abdominal trigger points.

Attachments:
Permalink Reply by Gordon J. Wallis on July 13, 2014 at 11:25am

I had an interesting day.  I was able to help all my clients dramatically.  A fibromyalgia client refered to my by another client. When I first met her in the room she had a very depressed look about her.  I would almost say a doomed look, as she told me she has fibromyalgia.  I asked her how long she has had this fibromyalgia.  She said two years.  I never really know if I can help someone.  I don't let the client know that.  At the same time I'm not into false advertising and manipulating a bunch of appointments with no clinical improvement.  I showed her two of my testimonials.  One was a testimonial from a previous fibromyalgia client that I was able to help dramatically.  I spent a fare amount of time talking too her explaining what I was going to do.  And that I would have a very good idea if I could help her or not.  I asked her where she hurt.  She said all over. Mostly her back and arms.  I found a bucket load of trigger points on her back and shoulders.  None on her arms.  But I did find trigger points in her scalenes, which could be refering pain down her arms.  I was able to down grade and eliminate all those TPs.   She had about twenty very active TPs.  One can imagine all those pain patterns.  After the session,  I was looking at a different women.  I saw a smilling face.  I'm sure some of those TPs will return, but not all of them.  I feel confident that if I'm able to eliminate all those trigger points, her fibromyalgia should be over.  Another client, a soldier, again referred from another client, came in with chronic low and upper back pain that he has been dealing with for a couple years sense he came back from the middle east.  He has been to chiropractors, physical therapists, MDs, and even a Rolfer.  Nothing helped him.   No one mentioned the word trigger points( Not a suprise to me anymore).  He told me the physical therapists were trying to stretch his spine out.  Its like everyone thinks nerve pain.   He told me all that was done to him.   It was the most perfectly thing to do to perpetuate trigger point pain.  I found lots of trigger points on that young man.  More then the fibromyalgia client I just talked about.   That man was happy after the session.  He felt freakin good.  He was young and healthy not counting the trigger points.  He had good healthy muscle tone.  Some of those TPs will come back.  But I know his problem is over.  He knows too.  The only possible delay in his recovery is the Army exercise and training he does every day.  Normally I recomend not to work out or stretch until trigger point free.  But he is going to be fine.   No one thinks Trigger Points.  Truth Remains Hidden.  

Permalink Reply by Gary W Addis, LMT on July 13, 2014 at 7:12pm

Tui Na practitioners 7,000 years ago treated trigger points using ischemic compression in conjunction with basic "Swedish" massage strokes.  Of course, knowing nothing about the physical body, they blamed the dysfunction on imbalance of chi.  But whatever it is called, a trigger point is the source of almost all pain.

Permalink Reply by Gordon J. Wallis on July 14, 2014 at 1:46pm

I'm not sure what the ancient Chinese healers knew or didn't know about the physical body?  But I utilize those ancient acupuncture meridians all the time in my work.  Because they are not just lines on the body.  As the attachmemts below indicate.

Attachments:

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