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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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I forgot to mention he had another very painful PSIS on the effected side.  I added a couple attachments. One shows hamstring pain patterns and the other is a coment on trigger points by the co auther of Myofacial Pain and Dysfunction .The Trigger point Manual.

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I don't know why muscles are so ignored!  Other than to prescribe muscle relaxants, which for the vast majority of my clients who have used them haven't helped much at all.

One of my clients has an adult son who is having very bad back pain as a result of a car accident 20 years ago.  She tried last week to get him to come to me; I had my calendar pulled up ready to get him in.  But he says he has 2 herniated discs and wants the name of a good back surgeon.  You can't help everyone. 

Therese, I can't tell you how many people I've worked on that thought they were doomed because of some diagnosis, herniated disc or whatever. Just because someone had a herniated disc doesn't mean thats the cause of their pain. I have a herniated disc and I have no pain. The vast majority of the pain that people run to doctors or chiropractors for is nocioseptive(muscle pain)pain. And that for the most part means trigger points. Trigger point pain often times mimics neuropathic pain. A good example is pain radiating down the leg.  Its most likely a trigger point in the gluteus medius or hamstrings insted of nerve pain(neuropathic pain).  Read the two attachments.

Therese Schwartz said:

I don't know why muscles are so ignored!  Other than to prescribe muscle relaxants, which for the vast majority of my clients who have used them haven't helped much at all.

One of my clients has an adult son who is having very bad back pain as a result of a car accident 20 years ago.  She tried last week to get him to come to me; I had my calendar pulled up ready to get him in.  But he says he has 2 herniated discs and wants the name of a good back surgeon.  You can't help everyone. 

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People seem to define themselves by their diagnoses; we make up names for everything that people have "wrong" with them.  Once people have a label for something they are experiencing, they don't seem to be able to see a bigger picture. It's a big psychological problem, one that entire industries are built on.

I like those attachments. What a great review for you!  And it's a good thing to remember that pain issues don't have to be complicated to remedy.  Find the sore spots, make them un-sore!

I don't work like you do, but I'm getting better all the time at tracking down the source of a problem and getting rid of the tension where I find it.  It's very skilled work, and takes years to develop!  It's also intuitive, and that takes years to develop too.

Uhm, what I do is not very intuitive.  And tracking down the problem, or the part of the problem that I can effect, is relatively easy. Find the sore spots. And the client helps me find them.  There is no intuitive guessing on my part. If the clent does not flinch or groan when I touch a sore spot, I wont know its sore unless they tell me.  I don't try to assess the tissues. I listen to the client. Its a lot easier and way more accurate.  So lets say someone comes in complaining of shoulder pain.  I palpate the entire shoulder area and instruct the client to tell me if I touch a tender area. Often they will flinch and jump and tell me its sore. Often times they just tell me its sore.  Eventually I may end up palpating the entier body for sore spots, but initially I palpate  the area of complaint.  I take note of all the sore spots and tender areas. Go for the worst ones first. I know that if Im able to eliminate of down grade those tender spots.  We will be able to down grade or eliminate their pain problem.  And I also have someting to measure my progress with. Lets say I palpated 6 trigger points(painful spots) on the first visit. The next time they come in we re check and find they have only 4 trigger points. And like I said once those tender areas are gone, their problem is usually gone.  I dont really intuit anything.

Therese Schwartz said:

People seem to define themselves by their diagnoses; we make up names for everything that people have "wrong" with them.  Once people have a label for something they are experiencing, they don't seem to be able to see a bigger picture. It's a big psychological problem, one that entire industries are built on.

I like those attachments. What a great review for you!  And it's a good thing to remember that pain issues don't have to be complicated to remedy.  Find the sore spots, make them un-sore!

I don't work like you do, but I'm getting better all the time at tracking down the source of a problem and getting rid of the tension where I find it.  It's very skilled work, and takes years to develop!  It's also intuitive, and that takes years to develop too.

Truth remains hidden.  Most people, including massage therapists don't know about trigger points.  MDs and Physical therapists also.  70% to 85% of all pain comes directly from trigger points.  Within our license we should have the skill set and traing to address all that pain.  The pain industry is a Sixhundred billion dollar a year industry.   Massage therapists should be trained to help at least a couple billiion of that.  But instead, for a lot of therapists its almost like a slave job or working for minimum wage.  But the truth is.. Once any underlying pathology is ruled out  Like bone in the way or infection.  Its soft tissue work all the way. Ive been doing this work for a long time now.  So Im real confident with what I can do.  However what I do is simple and can be easily taught.  But it is not.  Truth remains hidden.  I add attachments to back up what Im saying.  So its not just me.  But I see it every day in my work.   As a side note.. I was stuck in an airport a few years ago when I met a chiropractor.  He told me he was an expert on curing carpal tunnel.  I asked him what he was doing.  He showed me.. He called it Active Release.   It was massage on the forearms..  Soft Tissue Release came out in the earlly 90s I think.  It was invented by a British massage thrapist... It was so effective that the chiropractors formilized it and copied it and called it Active Release... But its the same thing..   We should be dominating the ache and pain industry.. the go to guys..  But nope, we arn't..  I read in a massage text book not too long ago that said if you think you might have carpal tunnel, go get it checked out by a doctor... And they know nothing about trigger points.. What?, run to a chirpractor that does Active Release?   There is no real leadership in our industry.   Truth remains hidden.   PS- a couple of those attachments came out of a book Im reading on Fibromyalgia and Trigger points.  Pretty much thats what Fibromyalgia is... tons of trigger points.  The auther  of that book knows what I keep saying in here.  But Truth Remains Hidden...  

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Just wanted to add another attachment.  It fits along the same thing Ive been saying.  Massage therapy is most excellent for relaxation.  But the part nobody knows is.. Its also most excellent for pain removal.  That part is not being taught.

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I had a new client Monday; 66 years old, just started having bad headaches earlier this year.  They start in her neck and end in her left eye.  She's been thoroughly checked out by two eye doctors, had a CAT scan and an MRI and been to a neurologist (who prescribed Neurontin for her.  What?!?  She didn't take it for very long - it made her feel terrible).  So as much as possible, any underlying pathology has been ruled out.  I asked her to tell me about any accidents; she had a cheerleading accident in high school where she landed on her head/neck, and then a couple of years later a bad car accident. She's managed to compensate in some way until recently, when she retired from decades of stressful jobs.

I started working on her neck and she could feel the tension in her eye (which I expected).  By the time I was done, I could work on her neck with no tension/pain in her eye.  She was very pleased and has rebooked for every week until we can get things under control (she has other things going on too).

I love my job!  :)

Thanks for the continued posts and education.  My clients and I are most definitely benefiting from what you have to say.

Check her left SCM for trigger points.  I had a client the other day with pain in the left front of her neck and left ear and eye.  She had a very tender SCM on that side.   That muscle to palpate, you do a pincher movement. That is lightly squeeze the muscle between your index finger and thumb along the entire length of the muscle. If there is a tender spot, thats what you need to eliminate.  You can compare to the other SCM...  SCM is worth checking out is all Im saying.  Palpate her entire neck for tender spots.  

Therese Schwartz said:

I had a new client Monday; 66 years old, just started having bad headaches earlier this year.  They start in her neck and end in her left eye.  She's been thoroughly checked out by two eye doctors, had a CAT scan and an MRI and been to a neurologist (who prescribed Neurontin for her.  What?!?  She didn't take it for very long - it made her feel terrible).  So as much as possible, any underlying pathology has been ruled out.  I asked her to tell me about any accidents; she had a cheerleading accident in high school where she landed on her head/neck, and then a couple of years later a bad car accident. She's managed to compensate in some way until recently, when she retired from decades of stressful jobs.

I started working on her neck and she could feel the tension in her eye (which I expected).  By the time I was done, I could work on her neck with no tension/pain in her eye.  She was very pleased and has rebooked for every week until we can get things under control (she has other things going on too).

I love my job!  :)

Thanks for the continued posts and education.  My clients and I are most definitely benefiting from what you have to say.

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There are a lot of books out there. This is one Im reading now.   Ive read many books.  This one is well worth buying.

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Thank you for the suggestion for the SCM, and for the info about the book.  Much appreciated!  I don't read enough books any more - something I need to fix!

Therese, like you I have benefited much from Gordon's input.  But, like you, my way of working is different.  Due to my hearing problem (I'm legally deaf), I can't always effectively rely on the client's input.  Instead, I had to develop the ability to find trigger points by touch alone.  There's usually a palpable knot but not always--so, yes, I do sometimes fail to find a tp that Gordon will.  But if it is very tender, the tissue itself will react, and I can usually feel the slight flutter of the muscle. If it is milder tp, however, I may miss it. My skills are much much better thanks to Gordon.  

I thank you, buddy, and my clients thank you. 

Therese Schwartz said:

People seem to define themselves by their diagnoses; we make up names for everything that people have "wrong" with them.  Once people have a label for something they are experiencing, they don't seem to be able to see a bigger picture. It's a big psychological problem, one that entire industries are built on.

I like those attachments. What a great review for you!  And it's a good thing to remember that pain issues don't have to be complicated to remedy.  Find the sore spots, make them un-sore!

I don't work like you do, but I'm getting better all the time at tracking down the source of a problem and getting rid of the tension where I find it.  It's very skilled work, and takes years to develop!  It's also intuitive, and that takes years to develop too.

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