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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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The last couple of days have been trigger point days.  At least 180 trigger points bit the dust.  One client, a referal from another client came in with years of chronic back pain.  I did not ask her how many years. But it was years.  She also suffered from Crohn's disease. So thats internal organ stress.  That often expresses itself in the related paraspinals as well as the abdominal area.  Gosh she had at least 80 trigger points on her body.  Mostly the back.  She also had three painful spots in her abdominal area( visceral somatic reflexes). All those trigger points were deactivated by the end of the session.  The only bummer of the whole thing is  that she lives out of state and was leaving the next day.  She told her friends that picked her up at the spa that it was the first time in years that her back did not hurt.  She was sort of freaked out in a good way.. She is coming back to Alaska in April and staying for a month.  She will come in every  few days during that period, and we will eliiminate her pain once and for all.  No one ever mentioned the word trigger point to her.  The misdiagnosis of pain continiues.   

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Out of my six hours work today, it was 5.5 hours of trigger point work.  One lady with a chronic shoulder problem is seeing a Rheumatologist.  She had at least 30 trigger points with most of them lacated in her right shoulder( all the shoulder muscles, even the upper biceps and triceps),  I was able to deactivate all of them.  After about six session, I dont think she will need to see a Rheumatologist again?  We will see anyway.  She had a lot of very active trigger points.  Of course I showed diagrams of her pain, let her read some of the same things I've posted on this thread..  It was kind of like shock and awe for her.   It was all trigger points today.  One lady had a very sore spot on her right errectors about the L2 level.  She had that tender spot for 20 years!!  She was freaked when it was no longer there on repalpation before she left the spa.   But Im sure it will come back, I think.  Everyone I saw today will come in on follow ups except one.  She lives out of state..  She had at least 80 trigger points.  Fibromyalgia, so they told her.  But it was really all trigger points.  Someone with 80 active trigger points feels pretty bad as you can imagine.   People are very often misdiagnosed.  And I know thats true because once Ive eliminated their trigger points.  Their pain symptoms are gone.   Most people after they have read a  testimonial begin telling me about their pain.  They may say something like well Ive had this pain for years, there is nothing you can do about it.  I have to see a Rheumatologist, Chiropractor or something like that. 90% of the time they are wrong.  

Had a new client come in today with five years of left lateral rib pain.   She can't hardly touch it herself, and the pain often wakes her up at night.  Her ribs were broken durring some kind of accident five years ago.  Now the bones have healed. So the pain had to be soft tissue from all the trauma.  And if its soft tissue, there are bound to be trigger points.   I found three very painful spots on her left lateral ribs.  I was able to down grade them substancially.  The painful spots were on the lateral left ribs.  Right on the lateral muscle chain or the Gall Bladder meridian.  So I needed to check that entire meridian or muscle chain out.  I see that as one big muscle in stead of a bunch of little ones.  One big muscle, the lateral side band.  So along the path of that muscle chain  i also found a painful TP on the illiac crest, glute medius, piriformis and a couple on the vastus lateralis.  As well as two trigger points on her left lateral neck.   I also found six painful left lateral spinus TPs along her spine.  All made sense considering her rib pain.   All those tender spots were gone when she left the spa today except for the three on her ribs, but they were greatly down graded( 50% better).  Unffortunately she lives two far out of town and can't come in on follow ups.  The attachments below show some of her trigger pointed areas.  Also a picture of the muscle chain or meridian.. However you wanna look at it.  

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Glute TP gone in a second.
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Nice work Gordon!!

Its been a while sense I last commented in here.  I've continiued to deactivate trigger point after trigger point.   And I've been able to help a lot of people dispite the fact that they have been seeing Chiropractors, Physical Therapists, and MDs for days, weeks, months and in some cases years.  Everybody seems to know trigger points when you ask them.  But when it comes to helping people with pain problems its like they are never considered?  So I will continiue to comment in here from time to time about that, sense we are muscle workers.     There is an area of the body that is often over looked durring any pain exam, and more often then not, never checked  by manual therapists and trigger point people.   I almost missed it the other day myslef.    A client came in complaining of back pain.  He had been dealing with it for years.  He said its not as bad as it use to be.  But his back still aches.  When I asked him where he feels the pain he started stretching around as he was sitting on the table and said I don'tknow?  I said well where is the worst part?  Upper, middle, or low back.   Again he sort of stretched around and this time said,  all over.   I started palpating from his hips to the top of his neck.  Front, back, and sides of his body.  Every lateral and dorsal muscle from the hips up to his head and found no painful spots. Nothing.  His whole reason for coming in was to get some releif for his back pain.  I found nothing.  I thought well,  here is one of the  few cases where trigger points are not involved.  I was kind of shocked.  Then I realized that I had not directly palpated the lateral spinous of his vertabrae.  When I did I found six very painful spots on his left lateral spinous.  From upper back to lower back.  They were painful enough to make hiim flinch and vocalize.   They were all on his left side right against the left lateral spinous.  I was able to deactivate all of them.  So dont forget to check the lateral spinous if you have a client with any kind of back pain.   Because thats a place that is most often not checked.   A lot of muscles connect to the spinous.  The couple attachments below will give  you an idea.  I dont know if vertabrae really go out as some say.  But muscles move bones, and if you can relax a triggered muscle, you relieve that stress on the vertabrae. That pull.   And each of those spinal segments (vertabrae)inervate certain areas of the skin, muscles, and internal organs.  So by relieving the tentions on those vertabrae you may be helping more then just relaxing a tight muscle.  

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thanks for the reminder.  May in fact apply to my wife this morning.  Today she's complaining of pain, right side, just below the rib cage...about the spot shown in the first photo, referral from L2.  But she says the pain extends throughout her abdomen.  Or would that be from a TP elsewhere?

I don't usually try to think too much when it comes to finding trigger points.  I would palpate everywhere from the hips up.  Front back and sides up to about T12.   I'm talking glutes, edges of sacrum, top  of sacrum, illiac crest, paraspinals(medial and lateral), each lateral spinous and the tops of the spinous.  All the lateral muscles of the body, and the entire abdominal area and all its attachments.   Then whatever major Tps you find,  you will want to check out the entire muscle chain that its on.  Thats what I would do.  

Gary W Addis, LMT said:

thanks for the reminder.  May in fact apply to my wife this morning.  Today she's complaining of pain, right side, just below the rib cage...about the spot shown in the first photo, referral from L2.  But she says the pain extends throughout her abdomen.  Or would that be from a TP elsewhere?

this is an excellent education about trigger points.

Gordon J. Wallis said:

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

Update to the post below: I released a tp just below bottom rib on right side, one in muscle of her side, and another at L2, inside the lamina groove, just like the picture you posted.  When I stopped she was still hurting, but 5 minutes later, the pain was all gone.

Gary W Addis, LMT said:

thanks for the reminder.  May in fact apply to my wife this morning.  Today she's complaining of pain, right side, just below the rib cage...about the spot shown in the first photo, referral from L2.  But she says the pain extends throughout her abdomen.  Or would that be from a TP elsewhere?

Gary, next time you work on a pain(trigger point)clinent, try using a Cross Body Distraction Technique( see file below) after the session. That will often times speed up or stop any delays in recovery. It"s way cool.
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makes sense!  Will do.

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