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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'm going to add to this thread. Not sure exactly what I'm going to talk about.. But I have been busy doeing bodywork sense my last comment in here. The whole reason for me writing and commenting in here is to empower Massage Therapists. A lot of my views are unorthodox and not mainstream. A few years ago when I first started commenting on this site I got accused of damaging the minds of young massage therapists. Well don't let me damage your minds. I'm only telling my truth after thirty years of doing this kind of work. And I don't know, but after I've done this for 35 years my truth may change? And my truth has changed a few times over the last 30 years. I can't work in a Chiropractic Clinic, or a Physical Therapy clinic. If you have read this thread, you will know why. I just don't fit into their treatment plans. So I'm in a spa. I love working where I work, but I sort of don't fit in there either. A new client came in not too long ago for an 80 minute massage. I asked her what she needed from this massage, and she said her back is killing her, and that she is going to see her Chiropractor right after the massage. Worst area by far is her low back.. My thinking right away is...You won't need to see a Chiropractor if you let me do my thing( TP work). But I really can't say that for obvious reasons. So I let her read a couple reviews and watch a clip of me doing my TP work. People have expectations on what they expect from a Massage Therapist. And in a spa environment there are different expectations then say a Chiropractic office. But then after she watched a video clip, she stated telling me about other areas on her body that are bothering her. And injured ankle and a knee that give her pain and problems from time to time. She gave me permission to do my TP work. Gosh she must of had 50 if not more Pain Points on her body. They covered her whole body. No need to list them all. But her low back pain came from Pain Points in her all her Glutes and Piriformis as L5 n L4 Pain points on her ParaSpinals.. And a few very tender Spinous Processes in her Lumbar spine. Also up near her arm pits on her Latissimus dorsi both sides. Most people don't think of that muscle for low back pain.. But it connects down there on the Lumbar spine.. Remember a Trigger Pointed muscle is a shortend muscle. Anyway she felt great after her 80 minute session. She knows that it will take more then one session to resolve her various pain issues. But she was very happy with the results. I have clients that are hurting, but they wont let me do my thing becasue they don't really understand what good soft tissue work can do for them. They will say something like.. Well I'm all ready getting Theraputic Massage at the clinic, and I'm under Doctors care.. I just want to relax. And they are paying good money in a nice Spa to get a massage. So....I massage them.. Other clients are sort of halfway into what I suggest. They will say, ok fix my low back, but I still want a relaxation massage. But what they don't realize is that pain in the low back can come from seveal different distal areas on their body. Like the Abdominal area or the Spinouses or the Glutes or the Neck or the Latissimus dorsi near the arm pit for example. Basically the whole body needs to be checked for Pain points. If you mis one of those remote places, their low back still hurts. They may love the massage and see you once a month because of it. But their pain issue is never resolved. And they continiue to see other people that never look in the right places or even think Trigger Points. I'm going to attach a really cool testimonial( not the same person I'm talking about now). You will notice she used the word DISAPOINTED in her testimonial. People just don't understand that Soft Tissue work is the best way to resolve most pain issues on this planet. Muscles Move Bones.. And you can't exercise an injured muscle and expect clinical results. Those are my two truths now that remain Hidden.
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That is a tremendous testimonial!!  I'm sure she was only disappointed because what you do doesn't feel at all like what she was used to, and it may not have felt like it could possibly work.

I'm glad the new client was willing to try your methods!  She probably thought she had fibromyalgia...because that's likely what she was told...

wow, that is a great testimonial.  i hope that one day i can get a testimonial like that.  i would love to be able to help take someone's pain away like that.   i think that is one of the greatest gifs you can give someone.  

i have been studying bodywork for 7 years and i have about 650 hours of study under my belt.  i can give a great relaxing massage  but i still feel like i haven't learned the tools to help people with their pain.  i did take a trigger point class many years ago, but i didn't follow up.  so i am rereading the clair davies trigger point therapy workbook and studying this trigger point stuff and i plan to start working on some friends that are in pain.  looking forward to hopefully learning some skills that can help people in a real way.  

one thing i like about trigger point stuff is that for me, it seems pretty simple and intuitive relative to other modalities which attempt to alleviate pain, like deep tissue and myofascial release.  and that makes me trust it more.  

It's a fact that Trigger Points are the cause of more pain then anything else. Dispite the fact that Trigger Points have been known about for a long long time, they are rarely considered or even thought about by all health care professionals, including Massage Therapists. There are a lot of reasons for that when I think about it. Might talk about that later? I met a fellow Massage Therapist a while back that had just finished a Deep Tissue Massage seminar for a few hundred dollars.. He said it was a great Seminar. I asked him if the Instructor mentioned the word Trigger Points.. He looked at me and said no. And that fact did not seem to bother him. The only reason I got a testimonial like that is because I made some Trigger Points go away. They( Trigger Points )are the major cause of pain on the planet. It seems like only a few scientist doctors know that. Like the ones I post on the attachments. And the ones that do understand the importance of Trigger Points teach it or go about it in such a complicated way that almost render the therapy ineffective. All the rave ,my pain is gone, testimonials I posted on this thread were because I made Trigger Points go away. Now the other types of health care providers could have done the same thing for these people. But they would have to have done good Trigger Point soft tissue work.. A lot of those other Professionals don't even palpate. For Massage Therapists the BIGGEEST hinderance, or lack of knowledge, about Trigger Points is because of the over riding emphasis on Structural Work, Posture, and Facia. I have nothing against Rolfers, they have their place and do good work for the right people. But that influence has burried the importance of Trigger Points in the Massage world. And if its true that Trigger Points cause 80% of all pain on the planet( it is true by the way ). You can see that its the wrong influence. When working on that lady in the above testimonial, all of the testimonials. There was not one time I thought about Structure, Posture, or Facia.
Had a client recently that told me about five years ago he accidently stepped on an electrical plug and injured his foot on the base of his left little toe. The 5th metararsal I think they call it. Initially it really hurt and the area was inflamed. But as time went by and the inflamation went down it still hurt to walk on it. Bad enough for him to go see a foot doctor. The foot doctor told him that do to the injury a callus was forming under the skin, and not really any thing you can do about it. When I palpated the spot he deffinataly let me know about it. The pain (his pain ) vanished by manipulating the tissues at Bladder 61 in a specific way. Now I'm sure it will come back and need a few sessions to clear it out once and for all, but becasue it vanished in the first place, it had to be soft tissue( trigger point ) and not some kind of weird internal callus. Not sure what muscle it would be sense there are a few that connect in that area.. Anyway, I guess that Foot Doctor didn't know anything about Trigger Points. I find that interesting. Hmm.................
http://www.sciencedaily.com/releases/2012/09/120911091100.htm#.VZL6...

The cost of pain in this country is in the Billions !!! In the above article, not one mention of soft tissue pain( Trigger Points ). It's just not even considered. The people with chronic pain that end up on my massage table always tell me that their pain is from Arthritis, bulging discs, pinched nerve, joint pain, and so on. The list is long, but rarely do I hear the word Trigger Points. Its always something else. That mindset permeates the country. It does not permiate me though. Travell was right. Much is misdiagnosed.
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You've seen this testimonial before. Think about it in the context of the above science article. Her shoulder problem was muscular, and never diagnosed or treated properly. The so called pinched nerve happened after her surgery. She was told that the nerve was accidently injured durring her surgery, and that another surgery was needed to correct it. Her shoulder had several Trigger Points, and the pinched nerve was only one Trigger Point in her upper Quads. Her muscle tissue was never palpated. In my experience I see a lot of misdiagnosis. Now its not that I diagnose. All I do, in the case of someone hurting, is check for the presents of Pain points on the body and deactivate them. Espesially the areas that cause vocalization or a withdrawal reflex. Gosh if you eliminate those pain reflexes you dramatically help the client, if not end their chronic pain forever. Now you wont be able to help everybody, just a whole bunch of em.
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This really angers me to even write about. A client today told me that she heard that I was the one to see if you have pain in your body. I said well maybe? She told me her elbow hurts. She has been in physical therapy three times a week ( hour and a half sessions ) for three months with no resolution to her pain. Her diagnosis was Tennis Elbow. After three months of three times a week of phsical therapy she asked the therapists why her elbow still hurts... They told her she needs surgery. She had one trigger point in the extensor muscles of her forearm( Don't even know the name of the muscle?). The whole thing was resolved in two minutes after I treated her. . She no longer hurts.. She was stuned and shocked to feel no pain what so ever in her elbow after her one minute session.. . Surgery??? I'm loosing respect for that profession. She will write a testimonial.

As I was reading this I was thinking extensor muscles in the forearm!  Can you imagine what surgery would do???  All that scar tissue and fascial adhesions on top of the trigger points...so totally unnecessary!

More good work, Gordon!


Stacey, I don't understand what you are saying? Goodness, The physical therapists she went too are the ones that need to research the new developments in pain science. Did I just accidently help her or what? Or would it be possible that I might actually know what I'm doing sometimes? What do you think happened in my two minute session with her? Please explain? The attachment below is the reason her physical therapy didn't work. Now as far as guessing the outcome of any surgery? You are right. And we will never really know now.
Stacey L Brown said:

"Can you imagine what surgery would do???  All that scar tissue and fascial adhesions on top of the trigger points.."

I'm interested to know how it is you can predict the outcome or assume an outcome of a surgery that has not yet happened? What are you basing your observations on? 

"Scar tissue" is a natural reaction to tissue damage and in-and-of itself is not a pathological situation. It sadly has become one due to many years of manual therapists projecting "scar tissue", "adhesions" and "myofascial TrP" as things to rid the body of.

Which creates quite the ethical conundrum of perpetuating a presumed problem where none exists. But it does keep us relevant and employed as manual therapists and it seems to satisfy patients who don't know any better and who depend on us for help with managing their pain.

Adhesions, trigger points, and slipped discs for that matter, have not been found to exist in the human body, in the way we understand them to be. (Via, MRI scans and postmortem observations)

I've said this ad nauseum before, until we as MT's are willing to be open to new developments in the field of pain science research and open to the idea that we don't know many things about what it is we *think* we are doing, we will not be taken too seriously in the healthcare field.


Therese Schwartz said:

As I was reading this I was thinking extensor muscles in the forearm!  Can you imagine what surgery would do???  All that scar tissue and fascial adhesions on top of the trigger points...so totally unnecessary!

More good work, Gordon!

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http://www.penguinrandomhouse.com/books/224038/healing-through-trig...

Stacey, this is what people don't know, and why this women was not helped sooner. And a lot of it is old information that people to this day ( like you ) refuse to acknowledge.

Brief reply? I have over forty pages of reply for you.
Stacey L Brown said:

Gordon -

Okay....

It's a textbook or reference guide.

"Old information" - when referring to human biology - especially pain science - IS out-dated and inaccurate information. Depending on what kind of clinician you are, "old information" could prove to be fatal for your patient. Seeing as we are manual therapists the biggest risk we run, is misleading and confusing our clients with "old information", by way of our anecdotal evidence and conjecture.

What is there to "acknowledge", accept that huge amounts of confirmation bias, exist in your brief reply.

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