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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 February 11, 2017 at 9:22am
A new client came in for a 50 minute massage. She told me that she needs a towel or pillow placed under her stomach ( doctors orders ) if she gets a massage because she broke her L5 vertebrae. And not to press down too hard on the low back( again doctors orders). I asked her when she broke her vertebrae? She told me two years ago when she took a hard fall. I'm thinking, two years is plenty of time for bones to heal. And if there is any pain, it's got to be soft tissue? Maybe doesn't have to be soft tissue, but in my experience it has to be. But ya never know. I told her that I was experienced at helping people out of pain and with her permission I would check her low back out( promising not to press deeply). She told me that it doesn't hurt as bad as it use to, but she still has to be careful as to how she moves.
While assessing her low back we found out that it was painful( sore) when I pressed down with a light to moderate pressure using the palm of my hand on her right low back, but not the left. But when I specifically palpated the low back with my thumb, looking for trigger points, I found none? I palpated the lateral spinous of the lumbar, the muscles in the groove right next to the spinous, the bellly of the Longissimus, as well as the lateral Longissimus, and found no pain or trigger points anywhere in her lumbar area. Her vertebrae was fine. There was no pain on palpating what so ever, on her L5 vertebrae. That bone was healed as I suspected. So we are talking referred pain now. And that could mean trigger points in the right hip. And sure enough there was a big bad trigger point in her Gluteus Medius. I deactivated that in about twenty seconds. Went back and pressed her right low back with the palm of my hand, and there was no pain. She got up off the table pain free. She will need a follow up to make sure that trigger point stays gone. But I'm very confident that her broken L5 vertebrae back pain is gone. In the attachment is a diagram of the Gluteus Medius trigger point referred pain pattern. That was cool.
Attachments:
Permalink Reply by Gary W Addis, LMT on February 11, 2017 at 4:09pm

I had a client the other day with pain pattern jsut as the first image showed.  I did find and eliminate several trigger points elsewhere, but didn't check the glute medius.  Thanks I will when see her in a couple of days.

Permalink Reply by Gordon J. Wallis on February 12, 2017 at 12:50am
A young women came in with the complaint of mid back pain and frontal headaches. She was in an auto accident a few months ago and her complaints have been getting worse. Her mother got her the massage with a senior therapist( me) in hopes of getting her daughter some relief. She has been complaining more lately. Also the mid back pain sometimes hurts more when she breaths in deeply. The headache centers on the forehead above the eyes.
With general palpation using the palms of my hands , she felt pain when I pressed down ,with medium pressure, on the left paraspinal area at about the L1 level. The same area when pressed on the right elicited no pain what so ever. On detailed palpation of the lumbar and lower T spine, and I mean detailed( spinouses, spinalis, longissimus, and illiocostalis, and everywhere else), I found one trigger point on the right, at the most lateral aspect of the paraspinals at about the L1 level. I eliminated that tender point in about 26 seconds. Went back and pressed on her left L1 area that hurt initially when pressed, and that pain was no longer there. As far as her frontal headaches go.... I found one tender point on her neck in the occipital area right in the center at the upper most spot of C1. I eliminated that one in a few seconds. It was interesting. Those two trigger points were causing her all that discomfort. She will need a follow up. But she is fit young and healthy. Her problem is over. That was cool. I can't find any of the standard trigger point diagrams that match up with the two she came in with.
Permalink Reply by Therese Schwartz on February 14, 2017 at 9:35am

Lynn, your first comment (which I was interested in and wanted to read the links) showed up.  But then this one showed up and appears to have replaced it, without any of your post in it.  Please re-post the original comment if you can.  Or, send me a friend request and I'll accept it; then you can email them to me.  Whichever is better for you.

Permalink Reply by Therese Schwartz on February 14, 2017 at 9:42am

I would love it if you would re-post the entire thing, if you don't mind.  It may leave you open to negative comments from others, but IMO different voices (on just about everything) are needed, and refreshing.


Lynne Brown said:

Hi -

Not sure what happened. Huh. Is it the links you can't access and want me to repost? My comments are the same.

Therese Schwartz said:

Lynn, your first comment (which I was interested in and wanted to read the links) showed up.  But then this one showed up and appears to have replaced it, without any of your post in it.  Please re-post the original comment if you can.  Or, send me a friend request and I'll accept it; then you can email them to me.  Whichever is better for you.

Permalink Reply by Gordon J. Wallis on February 14, 2017 at 12:05pm

Lynne Brown said:



Gordon J. Wallis said:

A young women came in with the complaint of mid back pain and frontal headaches. She was in an auto accident a few months ago and her complaints have been getting worse. Her mother got her the massage with a senior therapist( me) in hopes of getting her daughter some relief. She has been complaining more lately. Also the mid back pain sometimes hurts more when she breaths in deeply. The headache centers on the forehead above the eyes.
With general palpation using the palms of my hands , she felt pain when I pressed down ,with medium pressure, on the left paraspinal area at about the L1 level. The same area when pressed on the right elicited no pain what so ever. On detailed palpation of the lumbar and lower T spine, and I mean detailed( spinouses, spinalis, longissimus, and illiocostalis, and everywhere else), I found one trigger point on the right, at the most lateral aspect of the paraspinals at about the L1 level. I eliminated that tender point in about 26 seconds. Went back and pressed on her left L1 area that hurt initially when pressed, and that pain was no longer there. As far as her frontal headaches go.... I found one tender point on her neck in the occipital area right in the center at the upper most spot of C1. I eliminated that one in a few seconds. It was interesting. Those two trigger points were causing her all that discomfort. She will need a follow up. But she is fit young and healthy. Her problem is over. That was cool. 

"I can't find any of the standard trigger point diagrams that match up with the two she came in with".

That's because we are humans and not car parts. ;-)

 "I eliminated that tender point in about 26 seconds".

Welcomed, safe, focused touch always brings about change, via the cns. 

There are many flaws and faulty premises with TrP data/charts, mostly based on outcomes, which are a poor correlate. Palpatory paredoilia and confirmation bias are strong in manual therapy, including massage.

Great paper that successfully challenges the many implausible, dubious claims made by the TrP folks, including Travell and Simons.

http://www.pain-education.com/referred-pain.html

 

And this article from another credible source, very insightful and worth a read.

http://www.bodyinmind.org/trigger-point-evaluation/

If we as a profession don't look for current data and use that data to leave old, outdated povs behind, how does one grow as a therapist and give clients the most recent, information?




The people that wrote those articles , don't really no about trigger points. They certainly don't know what I know. Especially that Quintner guy. I'm the most current guy on trigger points there is. Trigger points are so real it's a joke. I can find and eliminate them drunken in the dark blindfolded falling over backwards. And on top of that. When I make the trigger points go away. I make their pain problem go away. Most of the time anyway. I'm going to guess , 95% of the time. I don't get the doubt? People can think what they want. But that baffles me? I have helped so very many people out of needless chronic pain, simply by eliminating trigger points. Call them pain points if you want. But they are very real.
Permalink Reply by Gordon J. Wallis on February 14, 2017 at 10:13pm
Lynne, I'm sorry you feel that way. I've been looking for an excuse to stop writing in here. I don't know how many people in here feel as you do. I think this will be my exit. Lol.
Anyway, this is not about my ego. I know it sounds like it at times. And maybe some of it is my ego? But it's certainly not my intention to make this thread about me. My intention is to help our profession. We are the lowest paid of all health care practitioners and providers. Many therapists are struggling financially despite the fact that they are nationally certified and taking continiuing education classes. Our profession is no where's close to its maximum potential when it comes to helping others out of pain.
The pain industry is a Six hundred Billion dollar industry. What percentage of that money goes to massage therapists? The percentage is so small, there is not enough room on this thread to write down all the zeros. Then when you consider the fact that 85% of all pain comes directly from trigger points, and that trigger points are involved in 90% of all pain syndromes, and that trigger points are in muscles, which fall directly into the parameters of our license. That's a huge huge void that our profession,or any profession for that matter, is not filling. That's a lot of money. But more importantly, that's a lot of suffering. Needless suffering. That's why I write in here. I try to back up what I'm saying with comments and quotations from highly educated leaders in the pain field, like Melzack and Wall( the worlds leading reachers of pain). They are well aware of trigger points.
Never the less, there is this unbelievable resistance, passively, or aggressively in your case, about the existence or importance of trigger points? They are very real, and very important.
In the two articles that you posted that people can't find trigger points? I don't know who they picked in their studies to find trigger points? All I can say is those people don't know what they are doing. Trigger points are very easy to find. I could teach an 8 year old to find trigger points easy.
And when I said that those people that wrote those articles that you posted, don't know anything about trigger points, I ment it. Anybody that's in pain, and they have trigger points, pain points, tender points, or whatever you want to call them. You make the trigger points go away. 95% of the time you make their pain go away.
In the videos below. There's three of them. You will see me find and eliminate trigger points on a young lady that was suffering greatly from dysmenorrhea ( painfu peiods ). She was hurting so bad that she called a friend to take her to the emergency room. I intervened and told her that I could probably help her and save her medical costs. I just need 15 minutes. She agreed. I never touched or worked on her before. This was filmed live on the spot. Listen to her, hear and see her response. Look how easy it is to find trigger points. Hear her pain when I touch particularly painful ones. I assure you they are real pain points.. Distict from the surrounding tissue. And after I eliminate those trigger points, look at the clinical results. Before I load the videos here is a quotation I like.
"Every truth passes through three stages before it is recognized. In the first, it is ridiculed, in the second it is opposed, in the third it is regarded as self-evident."-- Arthur Schopenhauer 1788--1860
https://www.youtube.com/watch?v=jscqmQemQT0&sns=em
https://www.youtube.com/watch?v=i9j3O69Dy5A&sns=em
https://www.youtube.com/watch?v=O2kpk4QfwbE&sns=em
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Permalink Reply by Gary W Addis, LMT on February 14, 2017 at 10:37pm

Gordon, the willfully ignorant cannot be educated, for they know everything already.  They know trigger points are not real because, well, they can't find one.   

Permalink Reply by Gordon J. Wallis on February 15, 2017 at 2:34pm
Hmm, the nasty comements about me aren't there anymore? Too bad, for they validated my entire thread, and added context to my last comment. Anyway, I'm ending this thread now. I said my point. No use saying the same thing over and over again to infinitum. I'm going to spend my time doing other things.
Permalink Reply by Gordon J. Wallis on February 16, 2017 at 8:59pm

I keep trying to end this thread, but I have such great passion for my work and our profession that I'm finding it difficult to do. The two articles that Lynne Brown posted about the so called latest research disavowing the validity of trigger points authored by this guy Quintner is just plain wrong. False News.
Anyway, It turns out this Quintner guy doesn't have a very good opinion about the validity of our profession as well. He is basically saying massage and trigger point work are worthless when it comes to helping people out of pain. I'm going to post his comments that he made regarding our profession on another website in the attachment below. I'm also going to post one of my testimonials, not to prove how great I am, but to show how wrong he is. Massage therapy/trigger point work is a highly effective modality when it comes to helping people out of chronic pain. Quintner is wrong. Anybody that believes him is wrong as well. Just ask the lady in that testimonial. Gordon J. Wallis said:

Lynne Brown said:



Gordon J. Wallis said:

A young women came in with the complaint of mid back pain and frontal headaches. She was in an auto accident a few months ago and her complaints have been getting worse. Her mother got her the massage with a senior therapist( me) in hopes of getting her daughter some relief. She has been complaining more lately. Also the mid back pain sometimes hurts more when she breaths in deeply. The headache centers on the forehead above the eyes.
With general palpation using the palms of my hands , she felt pain when I pressed down ,with medium pressure, on the left paraspinal area at about the L1 level. The same area when pressed on the right elicited no pain what so ever. On detailed palpation of the lumbar and lower T spine, and I mean detailed( spinouses, spinalis, longissimus, and illiocostalis, and everywhere else), I found one trigger point on the right, at the most lateral aspect of the paraspinals at about the L1 level. I eliminated that tender point in about 26 seconds. Went back and pressed on her left L1 area that hurt initially when pressed, and that pain was no longer there. As far as her frontal headaches go.... I found one tender point on her neck in the occipital area right in the center at the upper most spot of C1. I eliminated that one in a few seconds. It was interesting. Those two trigger points were causing her all that discomfort. She will need a follow up. But she is fit young and healthy. Her problem is over. That was cool. 

"I can't find any of the standard trigger point diagrams that match up with the two she came in with".

That's because we are humans and not car parts. ;-)

 "I eliminated that tender point in about 26 seconds".

Welcomed, safe, focused touch always brings about change, via the cns. 

There are many flaws and faulty premises with TrP data/charts, mostly based on outcomes, which are a poor correlate. Palpatory paredoilia and confirmation bias are strong in manual therapy, including massage.

Great paper that successfully challenges the many implausible, dubious claims made by the TrP folks, including Travell and Simons.

http://www.pain-education.com/referred-pain.html

 

And this article from another credible source, very insightful and worth a read.

http://www.bodyinmind.org/trigger-point-evaluation/

If we as a profession don't look for current data and use that data to leave old, outdated povs behind, how does one grow as a therapist and give clients the most recent, information?




The people that wrote those articles , don't really no about trigger points. They certainly don't know what I know. Especially that Quintner guy. I'm the most current guy on trigger points there is. Trigger points are so real it's a joke. I can find and eliminate them drunken in the dark blindfolded falling over backwards. And on top of that. When I make the trigger points go away. I make their pain problem go away. Most of the time anyway. I'm going to guess , 95% of the time. I don't get the doubt? People can think what they want. But that baffles me? I have helped so very many people out of needless chronic pain, simply by eliminating trigger points. Call them pain points if you want. But they are very real.
Attachments:
Permalink Reply by Gary W Addis, LMT on February 16, 2017 at 9:55pm

a wonderful testimony.

Permalink Reply by Gordon J. Wallis on February 19, 2017 at 12:31am
Ive said this before. I'm writing in here because iive been doing this kind of work for thirty years. And I thought some of you might find it interesting as to how I think, or my particular approach to our work, especially or specifically when working on people in pain, both minor or severe, acute or chronic. And also to let people know about trigger points. Not to tell anybody how to do things or how great I am. I've screwed up and failed with patients/ clients on more then one occasion. And I've nearly been fired several times in my career. So dispite what it may sound like, it's not about me. It's about how powerful our license is, and what it can do for people that are hurting, both emotionally and physically. We all knew that when we first got out of massage school. But now for me, it's even more so. I'm helping people now that I could not have helped ten years ago. And at that point I'd been a practicing massage therapist for twenty years.
Anyway I've seen this client twice now. She had taken a bad fall a year or so ago. She fell right on her back. Main impact was mid back. So she had pain there. But also had developed pain in her lower Glutes and upper hamstrings. Although I think that pain developed not from her fall, but from the intense spin classes she was taking. The pain in her upper hamstrings was so bad she walked with a limp. The word hobble comes to mind. She has been seeing a chiropractor for a few months mainly do to her difficulty walking, but also her mid back which constantly aches. I asked her if the chiropractic was helping her? Her answer was not really.. The chiropractor recommended that she get a deep tissue massage. Apparently he doesn't have a therapist in his clinic. Well anyway she came to the spa and accidentally got me.
Her main complaint to me was her upper hamstrings that were making her walking difficult. Then second, the mid back. The first thing I told her was that she needs to stop going to the spinning classes until we get her pain under control. That Quintner guy that wrote those articles that rigger points don't exist or whatever, says that the best thing for chronic pain sufferers is exercise therapy. Well maybe for some, but I've found that often times it's the exercise itself that's perpetuating and even creating the pain. So it's not just a simple go out and exercise yourself out of pain and you will be fine. That's not always the case. And if I have a pain client with major trigger point activity, if they don't stop exercising during their trigger point therapy, I won't even work on them. Well I will work on them. But I will let them know that it's probably not going to help them out of their pain.
Ok back to the client. The first time I worked on her I didn't find any hamstring trigger points. I found a fair amount of Glute ones and Piriformis ones on bothe sides. They were substantial ones. But her mid back from about T11 to about T5 had several really bad trigger points. She also had several lateral spinous trigger points scattered throughout her spine. They all deactivated during her therapy though. But after the session was over, she was still limping. And that was her initial complaint, and why the chiropractor told her to get a deep tissue massage. After the massage I was all excited because all the trigger points I found all deactivated, but here she is still limping. I had a few minutes before my next client. So I quickly determined that her left Glute was the one mostly causing her limp when she pressed down with that leg. As she was standing in her robe I found the hamstring trigger point as she moved her leg, applied a release for the hamstring as she moved ,and the pain vanished as she moved while I was holding the release. I had her repeat the movement that was now pain free( because I was holding the release ) six or seven times. Then had her move without me holding the release, and her limp vanished.
The second time I saw her, she said that she stopped taking the spin classes and that she was feeling noticibly better. This time on palpation I found the hamstring trigger points. Wow they were big bad ones. I don't know how I missed them the first time? But no matter. I found em now. I was able to deactivate them on both legs. The lateral hamstring, I believe it was the Biceps Femoris. Right under the buttock. And of course she had the mid T spine trigger points to deactivate. But I got to thinking she took a fall. That means she probably got the wind knocked out of her. Trigger points in the lateral ribs often indicates Diaphragm involvement as well as pain in the Sternum. Sure enough she had a big trigger point in her right rib cage and a smaller one on the left. Her Sternum, on the right upper side had a really painful trigger point. They all deactivated. This time she didn't hobble when she got off the table. I really felt like this second time was a really successful treatment. That was cool.

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