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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 Maryshka on May 21, 2014 at 5:13pm

Thank you Gordon, I really appreciate your posts. Please don't stop teaching us, esp. the newbies...

Gordon J. Wallis said:

When I first started this thread.  I was not sure what to title it.  I came up with A Typical Experience, because it is.  Because the reality is,  a huge percentage of the population that suffers mild, to medium, to severe pain, are mis diagnosed.  Now most people with pain issues run to their medical doctors,  chiropractors and or physical therapists..  Now I work in a spa.  So most of the people that run to me are having a birthday, or its a Christmass present, or maybe its mothers day.  But there is not one day that goes bye, that I don't have a Typical Experience.  Not too long ago a lady came in just to relax.  After showing her one of my testimonials.  She told me that she does have chronic low back pain , and has had it for years.  I didn't ask her how many years.  After some  time dealing with this pain she went to a medical clinic.   They diagnosed her with a Compressed Lumbar Spine and Dysfunctional Sacroiliac Joint.  Like thats suppose to help?.. Eventually they sent her to physical therapy.   I asked her how long she went to physical therapy and if it helped her..  In her words she said.. A long time.  And it didnt help.  She quit on her own.   I palpated her low back and hips.  I found an L5 TP on the left side of her spine, and two Gluteus maximus TPs on the right hip.   I asked her if any of the medical doctors or physical therapists touched her low back and hips... She said no.  I asked her what the physical therapists were trying to do.  She said re-align her spine? Any way.  I was able to deactivate those three trigger points and that mysteriously eliminated her low back pain for the first time in years.  This is a typical experience. .. Obviously those people she went to, know nothing about Myofacial pain.   And if you have read this entire thread.. You know I'm not the only one saying this.  But for some mysterious reason.  Truth Remains Hidden.  Even though the information has been out there for decades. The attachemts below were her compressed lumbar spine and dysfunctional sacroiliac joint that she had delt with for years.  No one palpated her area of complaint except me. They just use diagnostic imaging or something? . Well she had gotten massages, but she was just rubbed and her complaint was never addressed.   Reality is. Most of the pain that people run to the doctors for is Myofacial pain.  Which is seldom recognized or understood by the medical comunity.   There are many medical texts and books on the subject. .  However, its still not common knowledge for the Medical comunity or the general public or even for massage therapists.

Permalink Reply by Maryshka on May 21, 2014 at 5:40pm

Hi Gordon,

When you mention paraspinal locations, are you referring to specific deeper muscle groups (multifidus, longissmus, rotatores, etc.) or more superficial muscles that could harbor TrPs (lower Traps, medial area of Lats, serratus posterior obliques for example)? Trying to get a visual on what you're describing.

Thanks!

Gordon J. Wallis said:

Not everybody I work on thinks they are on the edge of surgery or has fibromyalgia.   Most people have just a few aches and pains.  Not enough to make them run to a doctor or even get a massage for.  But its always trigger points.  The other day a lady came in for a massage.  Id never seen her before.  I asked her what she needed from the massage, and I got the usual answer.  Just to relax.  Then I showed her a testimonial like the ones I posted on this thread.  Then she said.  Well I do have a back problem.  I asked her if she saw anyone for her back problem.  She said oh no, its not that serious.  Every once in a while I might have to take an Alieve or something, and that takes care of it.  My back did hurt this morning, but it feels fine now.   I told her I would take two or three minutes before the massage to examin her back for any tender areas. She said ok.  I found two tender spots on the  para spinals on each side of L5.  And a tender spot on the paraspinals at T10 left side, and another at T9 right side para spinals.   She had four latent trigger points.  They were un noticed until palpation and had no radiation patterns.  I took a few moments to eliminate those sore spots, then carried on with the massage.  Before the end of the massage I re palpated to see if those trigger points were still there.  They were not.   Of course everyone feels good after a massage.  But I have a real observable way to gage the success of my massage work.  And the client notices too.  I dont think I helped her.  I know I helped her.  And the client knows too.   

Permalink Reply by Maryshka on May 21, 2014 at 5:44pm

What are some examples of what can damage sarcoplasmic recticulum?

Gordon J. Wallis said:

Another follow up.  I saw her again today.  It was her fourth visit.  When she came in she told me she has been pain free sense her last session.  And when I palpated her.  There were no more tender spots.  The last session only the sacrum trigger point was left.  Now its gone along with her low back pain.  This big medical clinic she went to told her she needed surgery. Give me a break!  I wonder how many people they have told that too?  She is going to write a testimonial about her experience with her back pain.   And I will be able to show that to other clients.  But Truth Remains Hidden.   And I think it always will.   In the attachment below is a diagram of a muscle cell.  It shows the sarcoplasmic recticulum that controles calcium flow within the muscle cell.  When the sarcoplasmic recticulum is damaged, a trigger point forms.

Gordon J. Wallis said:

Just as a follow up.  I saw this client the other day for the 3rd time.  Three of the trigger points are now gone.  The two L5 TPs, and the QL TP.  Only the upper sacrum one remained.  And I was able to greatly down grade that TP this last session.  They are short 15 minute sessions.  Usually if I'm able to eliminate all the TPs, the clients symptomatic complaint goes away too.  In her case, low back pain.  And I have a real good way to gauge the success or lack of success by the number of TPs each session.  She started with four, now she has only one, after three sessions.  After this last sessin she says she can feel the difference and it feels good.  If I can't eliminate the TPs and or symptoms after a few sessions I tell them I can always massage them but I won't be able to help them with their pain problem.. Im not going to rip anyone off with endless sessions with no improvement.  There should be noticeable improvement after four to six sessions in order to justify additional appointments in my opinion.  

Gordon J. Wallis said:

Here is another experience that fits into this thread.  A new client. Initially she told me she just needed to relax.. After I showed her a testimonial from a client that I was able to help out of pain, she told me that she does have chronic lower back and hip pain.  I asked her how long she has had this pain she said, three years.  Ever sense the birth of her last child.  She said the pain is constant.  But she can live with it.  Her doctor told her that it might be from a uterus problem..  She went to an orthopedic clinic and they told her she needed surgery.. But she refused to sign all the paper work because nothing was guaranteed.   After she told me that.. I palpated her entire hip area( both hips) and back, all the way up to her neck.  What I found was a mild trigger point on her QL at the illiac crest border.. and a very painful trigger point on her upper sacrum just to the right of the sacral ridge.  And in addition two very painful trigger points on her spinal erector group on each side of her L4 L5 areas.  By the end of the session I had eliminated those trigger points as well as her chronic low back pain.  Most medical doctors do not understand muscle pain. Its more then obvious to me now.  Three years she sufferd, with the option of surgery? Uhm.  She was pain free when she left.. She told me..  Now she will need a couple of follow ups to make sure those TPs do not come back.. But her problem is over.  If you have followed this thread. You know that 80% of all pain comes from trigger points..  Anyway I will post a couple of attachments.. One is not very clear and does not show any pain pattern, but the QL one does.   Truth remains hidden.   So many are being ripped off and misdiagnosed.

Permalink Reply by Gordon J. Wallis on May 21, 2014 at 8:39pm

I'm only describing location. When I say paraspinals I'm talking any where lateral of the spinous process from maybe a half inch to three inches.  If I say lateral spinous , I mean right up on the spinous left or right side. Bucket loads of muscles attach to the spinous.  If I say upper trap, I mean top of the shoulder.  If I say rhomboids it could be the paraspinals, mid trap or whatever. For me, I dont really need to know exactly what muscle.

Maryshka said:

Hi Gordon,

When you mention paraspinal locations, are you referring to specific deeper muscle groups (multifidus, longissmus, rotatores, etc.) or more superficial muscles that could harbor TrPs (lower Traps, medial area of Lats, serratus posterior obliques for example)? Trying to get a visual on what you're describing.

Thanks!

Gordon J. Wallis said:

Not everybody I work on thinks they are on the edge of surgery or has fibromyalgia.   Most people have just a few aches and pains.  Not enough to make them run to a doctor or even get a massage for.  But its always trigger points.  The other day a lady came in for a massage.  Id never seen her before.  I asked her what she needed from the massage, and I got the usual answer.  Just to relax.  Then I showed her a testimonial like the ones I posted on this thread.  Then she said.  Well I do have a back problem.  I asked her if she saw anyone for her back problem.  She said oh no, its not that serious.  Every once in a while I might have to take an Alieve or something, and that takes care of it.  My back did hurt this morning, but it feels fine now.   I told her I would take two or three minutes before the massage to examin her back for any tender areas. She said ok.  I found two tender spots on the  para spinals on each side of L5.  And a tender spot on the paraspinals at T10 left side, and another at T9 right side para spinals.   She had four latent trigger points.  They were un noticed until palpation and had no radiation patterns.  I took a few moments to eliminate those sore spots, then carried on with the massage.  Before the end of the massage I re palpated to see if those trigger points were still there.  They were not.   Of course everyone feels good after a massage.  But I have a real observable way to gage the success of my massage work.  And the client notices too.  I dont think I helped her.  I know I helped her.  And the client knows too.   

Permalink Reply by Therese Schwartz on May 21, 2014 at 8:45pm

Glad to!  I'm glad it's helpful!  As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo.  I used a combo of mostly CST and a little MFR.

Maryshka said:

Thanks for this post. Helpful!

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.

Permalink Reply by Gordon J. Wallis on May 21, 2014 at 8:47pm

Some where in this thread I already answered your question.  But the big word is stress.  Emotional stress or physical stress.  Excessive worry, like grinding your teeth at night when you sleep.  Or repetitive movements over and over again.  One position too long.  A fall or a blow from an accident.  The muscle cell is a structure, and it can be broken or damaged like any structure.

Maryshka said:

What are some examples of what can damage sarcoplasmic recticulum?

Gordon J. Wallis said:

Another follow up.  I saw her again today.  It was her fourth visit.  When she came in she told me she has been pain free sense her last session.  And when I palpated her.  There were no more tender spots.  The last session only the sacrum trigger point was left.  Now its gone along with her low back pain.  This big medical clinic she went to told her she needed surgery. Give me a break!  I wonder how many people they have told that too?  She is going to write a testimonial about her experience with her back pain.   And I will be able to show that to other clients.  But Truth Remains Hidden.   And I think it always will.   In the attachment below is a diagram of a muscle cell.  It shows the sarcoplasmic recticulum that controles calcium flow within the muscle cell.  When the sarcoplasmic recticulum is damaged, a trigger point forms.

Gordon J. Wallis said:

Just as a follow up.  I saw this client the other day for the 3rd time.  Three of the trigger points are now gone.  The two L5 TPs, and the QL TP.  Only the upper sacrum one remained.  And I was able to greatly down grade that TP this last session.  They are short 15 minute sessions.  Usually if I'm able to eliminate all the TPs, the clients symptomatic complaint goes away too.  In her case, low back pain.  And I have a real good way to gauge the success or lack of success by the number of TPs each session.  She started with four, now she has only one, after three sessions.  After this last sessin she says she can feel the difference and it feels good.  If I can't eliminate the TPs and or symptoms after a few sessions I tell them I can always massage them but I won't be able to help them with their pain problem.. Im not going to rip anyone off with endless sessions with no improvement.  There should be noticeable improvement after four to six sessions in order to justify additional appointments in my opinion.  

Gordon J. Wallis said:

Here is another experience that fits into this thread.  A new client. Initially she told me she just needed to relax.. After I showed her a testimonial from a client that I was able to help out of pain, she told me that she does have chronic lower back and hip pain.  I asked her how long she has had this pain she said, three years.  Ever sense the birth of her last child.  She said the pain is constant.  But she can live with it.  Her doctor told her that it might be from a uterus problem..  She went to an orthopedic clinic and they told her she needed surgery.. But she refused to sign all the paper work because nothing was guaranteed.   After she told me that.. I palpated her entire hip area( both hips) and back, all the way up to her neck.  What I found was a mild trigger point on her QL at the illiac crest border.. and a very painful trigger point on her upper sacrum just to the right of the sacral ridge.  And in addition two very painful trigger points on her spinal erector group on each side of her L4 L5 areas.  By the end of the session I had eliminated those trigger points as well as her chronic low back pain.  Most medical doctors do not understand muscle pain. Its more then obvious to me now.  Three years she sufferd, with the option of surgery? Uhm.  She was pain free when she left.. She told me..  Now she will need a couple of follow ups to make sure those TPs do not come back.. But her problem is over.  If you have followed this thread. You know that 80% of all pain comes from trigger points..  Anyway I will post a couple of attachments.. One is not very clear and does not show any pain pattern, but the QL one does.   Truth remains hidden.   So many are being ripped off and misdiagnosed.

Permalink Reply by Gordon J. Wallis on May 21, 2014 at 8:50pm

Way to go Therese !!!!  

Therese Schwartz said:

Glad to!  I'm glad it's helpful!  As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo.  I used a combo of mostly CST and a little MFR.

Maryshka said:

Thanks for this post. Helpful!

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.

Permalink Reply by Gordon J. Wallis on May 21, 2014 at 9:27pm

Think about it Therese.  You helped her when highly educated medical doctors could not. Check the attachment.

Gordon J. Wallis said:

Way to go Therese !!!!  

Therese Schwartz said:

Glad to!  I'm glad it's helpful!  As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo.  I used a combo of mostly CST and a little MFR.

Maryshka said:

Thanks for this post. Helpful!

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.

Attachments:
Permalink Reply by Therese Schwartz on May 21, 2014 at 9:57pm

Thanks Gordon!!!  Yes, the medical community could not find anything "wrong" with her.  I knew I could help her; I can by no means help everyone.  She said I gave her her life back!  I'm not sure there's much else I can do better than that for people.

Gordon J. Wallis said:

Think about it Therese.  You helped her when highly educated medical doctors could not. Check the attachment.

Gordon J. Wallis said:

Way to go Therese !!!!  

Therese Schwartz said:

Glad to!  I'm glad it's helpful!  As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo.  I used a combo of mostly CST and a little MFR.

Maryshka said:

Thanks for this post. Helpful!

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.

Permalink Reply by Gordon J. Wallis on May 21, 2014 at 10:03pm

At the same time, you have to know when you can't help someone.  For me, if there is not a noticible improvement after four sessions.  I tell the client that I can always massage them.  But Im not going to be specific for their problem.  I mean after four sessions if they say.. I think I'm better.  You're not helping them.  My opinion only.. But for me, if the client cant say they are atleast 50% better.  I tell them I cant help them.  Gosh Ive had clients that have been seeing chiropractors for months with no improvement.   I'm never going to rip anyone off.   No need.

Gordon J. Wallis said:

Think about it Therese.  You helped her when highly educated medical doctors could not. Check the attachment.

Gordon J. Wallis said:

Way to go Therese !!!!  

Therese Schwartz said:

Glad to!  I'm glad it's helpful!  As a follow up, she only needed 3 or 4 sessions to have her symptoms eliminated - including vertigo.  I used a combo of mostly CST and a little MFR.

Maryshka said:

Thanks for this post. Helpful!

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.

Permalink Reply by Therese Schwartz on May 21, 2014 at 10:20pm

I'm with you Gordon - I don't ever want to take people's money and not make a difference.  I've been really concerned about a couple of clients - one said he was doing better than I thought he was doing, and the other I suggested that she wait until she was done with physical therapy and see where she was before she came back.  I did everything I know to do to help her (IT band syndrome, but with oddities I couldn't find), and most of what has worked with everyone else just made her worse.  I never want that for anyone!

Permalink Reply by Gordon J. Wallis on May 21, 2014 at 10:40pm

Well, now you have brought up another subject.  If I think I can help someone.  And after 30 years I pertty much know if I can or not.  I wont work on them if they continiue to see other people for their problem.   I had a client not too long ago that came in for a two hour massage..  Near the end of the session I found out he was seeing a physical therapist for a painful shoulder problem.  I asked him how he felt after the physical therapy treatments.. he said he felt worse.  He said its so sore he cant sleep at night.. and he had been seeing this guy three times a week for 8 weeks... I said  You want me to help you.  He said, if you can..  He had trigger points in the obvious shoulder muscles.. Afther the massage he was pain free.. I tolld him not to go back the that physical therapist. cause the guy is doing the exact opposite of what he needs.. Well he went back to the PT and told the guy that his massage therapist is doing the wrong kind of treatment.. the PT ignored him and made him do is weight strength training.. The guys pain was so bad that he came to me the next day.. and I released the trigger points again, and he felt wonderful after the session.. I asked him to compare how he felt after seeing me, and after seeing the Physical therapist.  He said he felt better after seeing me.  I said, well, if you want me to help you.  You cant see him anymore.  Because he is undoing what Im doing... So the client did no go back to the PT.  Saw me a couple more times.  And his shoulder pain was gone.  My client was a medical doctor.     Truth remains hidden.

Therese Schwartz said:

I'm with you Gordon - I don't ever want to take people's money and not make a difference.  I've been really concerned about a couple of clients - one said he was doing better than I thought he was doing, and the other I suggested that she wait until she was done with physical therapy and see where she was before she came back.  I did everything I know to do to help her (IT band syndrome, but with oddities I couldn't find), and most of what has worked with everyone else just made her worse.  I never want that for anyone!

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