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I had a new client today.  She told me that her right shoulder always hurts...She had surgery on it last year, but it still hurts, and that nothing changed sense the surgery.   I said well  where does it hurt.. She said they operated on the front of her shoulder but she always felt it was coming from the back of her shoulder... I palpated her infraspinatus and she had a huge nocioceptive response..she jumped and let out a loud OUCH...I asked her if she had any type of therapy prior to the surgery last year... She said that she had four and a half months of chiropractic and massage with no results..same pain..nothing changed... I asked her if any of the massage therapists or the chiropractor that worked on her ever touched her there... She said NO. I asked her if the Medical doctor touched her there..She said No.  I asked her if after the surgery if she had any physical therapy..She said yes...I asked her if the physical therapist ever touched her on that spot...She said yes.  I asked her if she jumped and screamed like she did when I touched that spot..She said yes.  I said what did he do about it... She said he just gave her exercises to do.    I released that infraspinatus trigger point in 30 seconds.. On firm re palpation it wasnt there any more...she didnt jump or flinch.. She said I feel no pain.  Its gone.  I will see her again next week. But its gone.   

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I don't know what the implications are, but it's another awesome story!

Yup, had several similar last week. Insurance ran out on the PT & Chiropractors so they finally tried what should have been the first approach before surgery. One's doctor was now recommending a second surgery because the first two years ago didn't help. That wont be necessary now.

The implication is that it is satisfying to be of help but dissapointing that so many wrong attempts are made by those higher up the healthcare ladder.

Excellent statement of the implication!  Well put.

It's amazing to me that people consistently think "Well that didn't work so I'll do the same wrong thing again and see if it works this time".

Well what I see is that our profession should be dominating that entire aspect of the health care industry. We all should be making very good money.. Think about it....???  I mean that was a very simple problem..  She told me the massage therapists would gingerly massage around the area for four months !!...She felt like they were afraid to work on her...  I mean no one touched her where she hurt except the PT.????.. and then he didnt do anything about it???....And you know thats not an isolated case...Its rampant and across this nation.   But massage therapists are educated and conditioned to fit in.  Add more certification or whatever..It wont matter..  There is no way I could work in any of those offices or clinics that she went through.  Every body gets all this education...all kinds of certificates....and certified by this board and that board and   the washing board.  whatever...And it all means nothing...it was a knot in her muscle, a trigger point or whatever you want to call it, in the back of her shoulder where she thought it was.   And Daniel your right...It wont be necessary now.

What gets me is when I tell other people and therapists this...They say good job, well done.    I dont know, I guess they dont realize all those clinics that she went through are very very busy.  

Daniel Cohen said:

Yup, had several similar last week. Insurance ran out on the PT & Chiropractors so they finally tried what should have been the first approach before surgery. One's doctor was now recommending a second surgery because the first two years ago didn't help. That wont be necessary now.

The implication is that it is satisfying to be of help but dissapointing that so many wrong attempts are made by those higher up the healthcare ladder.

There are a lot of useless treatment plans going on as we speak. 

Daniel Cohen said:

Yup, had several similar last week. Insurance ran out on the PT & Chiropractors so they finally tried what should have been the first approach before surgery. One's doctor was now recommending a second surgery because the first two years ago didn't help. That wont be necessary now.

The implication is that it is satisfying to be of help but dissapointing that so many wrong attempts are made by those higher up the healthcare ladder.

Gordon, it's important to remember that in any given profession - any - there are only a small percentage who excel.  It's the standard bell curve.  I mean, I keep hoping that someone in my town will be really, really good but for the stories that I hear from people I think I'm the only one working to really solve problems for people.  I'm not bragging or being egotistical - it actually makes me sad because I need so much help and I have to go to great lengths and expense to get it.  My massage therapist is good but she only does massage, not a wide range of modalities.

I agree that more certification won't matter.  I keep thinking that the more training people get the better therapists they will be but I think inside the great therapists there's a spark, a part of them that's different.  Don't know how to explain it.  But purely doing the mechanics of the work isn't enough.

Well , her problem didnt require much in the way of skill or excellence.  We are talking about the most very basic of muscular skeletal problems. 

Therese Schwartz said:

Gordon, it's important to remember that in any given profession - any - there are only a small percentage who excel.  It's the standard bell curve.  I mean, I keep hoping that someone in my town will be really, really good but for the stories that I hear from people I think I'm the only one working to really solve problems for people.  I'm not bragging or being egotistical - it actually makes me sad because I need so much help and I have to go to great lengths and expense to get it.  My massage therapist is good but she only does massage, not a wide range of modalities.

I agree that more certification won't matter.  I keep thinking that the more training people get the better therapists they will be but I think inside the great therapists there's a spark, a part of them that's different.  Don't know how to explain it.  But purely doing the mechanics of the work isn't enough.

It does concern me how much is missed by so many.

Politically they are higher up on the ladder..but in actuality NOT.  Not even to the first rung.  

Daniel Cohen said:

Yup, had several similar last week. Insurance ran out on the PT & Chiropractors so they finally tried what should have been the first approach before surgery. One's doctor was now recommending a second surgery because the first two years ago didn't help. That wont be necessary now.

The implication is that it is satisfying to be of help but dissapointing that so many wrong attempts are made by those higher up the healthcare ladder.

Great story-- I think the implications are that people need to be educated about what massage really CAN Do-- what it is capable of doing... preventing years of pain and billions of dollars of surgery.  This will cause push back from the medical industry but it is for the good of the people. 

ALSO We need to learn to develop better reporting tools and research protocols in order to better document experiences like this.  WE know what we can do to help people but we often get into doing it and forget to document the before and after and exactly what was done.  Measurements of pain, movement etc is important... I for one, would love to learn more about how to do this... from the initial assessment to the documentation of the successes.

The media paints massage as a relaxing luxury but for many it is the difference between scars and surgeries and months of rehabilitation-- with limitations in ROM at the end of all that anyway!   Relaxation is a benefit too but ease from Pain is possibly the best aid to relaxation one can get!

Massage therapists need to be educated as to what massage can do.  Once any underlying pathology is ruled out..There is no one better to see then a knowledgeable massage therapist.No one..   The massage therapists that worked on her gingerly worked around the area so as not to cause any further damage... Before I work on someone...I do a quick one minute exam...I palpate specific areas on the body where trigger points are common...If I get a nocioceptive response or the client indicates she is sore there...I take note...and then my goal is to eliminate those sore areas.. If Im able to  do that, and often I can, more often then not all their presenting symptoms usually go away.... Its not rocket science...We work with muscles.. Trigger points or whatever you want to call them are involved in most peoples pain problems and often are solely responsible....So whatever approach you use, if the trigger point is still there, so is the problem.  No one in that clinic knows what a trigger point is, or how to handle a sore muscle.(what a joke)...  After the massage I re do that one minute exam..They notice the difference...Its measurable...you know if you are helping them or not by the results.  And if someone isnt noticeably better after four sessions...You cant help them , and need to refer them on.   Four or no more...Usually within two sessions you should know. Everyone can enjoy a good massage, but if you want to be specific for their problem.  You should know very soon.  In my opinion its our educational system.. Therapists are trained to fit in to a dysfunctional system.. In our text books is says to go to a medical doctor if you think you might have carpal tunnel... When in reality, massage is the best therapy possible for carpal tunnel... See what I mean?  Most of the people diagnosed with carpal tunnel have what I call fake carpal tunnel anyway...I dont know everything about this kind of work...But I shake my head in disbelief every day...

Teena Johnson said:

Great story-- I think the implications are that people need to be educated about what massage really CAN Do-- what it is capable of doing... preventing years of pain and billions of dollars of surgery.  This will cause push back from the medical industry but it is for the good of the people. 

ALSO We need to learn to develop better reporting tools and research protocols in order to better document experiences like this.  WE know what we can do to help people but we often get into doing it and forget to document the before and after and exactly what was done.  Measurements of pain, movement etc is important... I for one, would love to learn more about how to do this... from the initial assessment to the documentation of the successes.

The media paints massage as a relaxing luxury but for many it is the difference between scars and surgeries and months of rehabilitation-- with limitations in ROM at the end of all that anyway!   Relaxation is a benefit too but ease from Pain is possibly the best aid to relaxation one can get!

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