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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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This guy came in today. He is totally pain free now. He went hiking yesterday( against my recommendation ) with no discomfort at all. When I checked him out today.. Only a couple of minor pain points on his spine, none of which referred pain or sensation to his knee like in the past. That ST36 area on his knee is fine.. So he is a happy camper. I hope he writes me a testimonial. My sciatica client is pain free as well. Uhm, another client with plantarfacitis is still troubled with it. Every time she comes in I eliminate the tender points, and it's gone for a day or two, then comes back.. I've seen her about 5 times for that...so? I'm going to see her one more time... For whatever reason, if I can't make the tender points stay away. I'm not going to take her money anymore.. She will be a regular massage client for sure, but as far as her problem goes, she is going to have to see someone else. She does do a lot of walking and standing on her feet.. I have a feeling that if she could just hang in bed and on the couch for a couple weeks, she may heal..But not many people can do that.
Gordon J. Wallis said:
Just to comment on this thread. This is interesting, at least to me. So I will comment on it. I've worked on this client twice. The first session was an hour. He was referred by another client that I had helped with a pain problem. The first session was an hour, because I need the time to do a full body scan for tender points. I don't think I'm going to call them trigger points anymore. The classic trigger point is in the belly of a muscle. I'm looking for pain points anywhere, not just in the bellies of muscles. They can be on boney prominences as well. Anyway the first session is an hour because I'm scanning the entire body for pain points.. He's second session was only 25 minutes. His complaint was left knee pain. He likes to hike and lift weights, and it's getting so painful that it's interfering with both of those two things. I found two very painful tender points, for location purposes, at ST35 and ST36 on and below his left knee. You can look it up on an acupuncture chart if you want. Those are pretty much the exact locations. I was able to deactivate those two painful spots the first session. I knew that the L4 spinal segment inervates the knee. So I wanted to check that area as well. Sense I'm going to do that I might as well check out his entire spine for pain points, which I did during that first initial scan session as well as the second session. This is where it was sort of weird. I figured the L4 lateral spinous could be tender to touch, and it was. And when I touched there, it also irritated his knee. I thought that made sense. But the weird part is. Several spots on his upper T spine when palpated( lateral spinous ) caused him discomfort in his knee as well. And that was on both sides of the upper T spine. And those spinous spots were not tender, they just caused his knee to ache and tingle when touched. I don't know what the relationship is between the upper T spine and his knee, but there obviously was one. I carried on like they were actually tender points and was able to eliminate those knee sensations. That was cool. The second time I saw him he was feeling much better. He said he was amazed. I kind of was too. The ST35 and ST36 pain points were still there, but at a much lower intensity. The weird upper T spinouses still reffered pain to his knee, and I eliminated those sensation a second time. When he got up off the table the second session he said that he felt even better. I'm guessing three more sessions and he should be doing good. So, any tender point needs to be eliminated or down graded as best you can. But also, any spot that causes pain or discomfort anywhere else in the body when palpated, also needs to be eliminated. I've been doing this for a long time.. It's advanced work. But, I first started palpating the lateral spinoouses gosh 20 years ago. I often times noticed they were tender and sore. Sometimes mildly, other times exquisitely so. I would go two or three or four times palpating each lateral spionous especially T1 to L5. Often after the fourth run, some if not all the spinoouses were no longer tender, and the client would feel better. Now, after thirty years, I eliminate those tender spots reall fast. But it's an area of the body that is rarely touched and is often a source of hidden pain. Chiropractors adjust the spine, why not massage the spine. Muscles move bones ya know..
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In the attachments below is a good book. If ya wanna read up on the more medically orientated side of soft tissue work. There is a history of or linage of Medical doctors, Osteopathes , Physical therapists, Scientists, and Chiropractors that do and research soft tissue work. 95% of which falls within our license as massage therapists. It's a cool read.
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I accidentally added my latest entry to this thread on the energy work thread that's been interacted with lately. Instead of re typing the whole thing again, I will post it as an attachment below.
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Gee.....Its the usual thing. I don't even know how to start this?? I had a young lady come in for a 50 minute deep tissue massage. She was in her twenties. When I asked her what she needed from the massage she said " Oh I just need to relax." I said ahh, stressed out huh? She said "Yes." And that makes sense.. She is young and could be burnt out because of a boyfriend or school or something. But then I always say something like this. I've been doing this kind of work for over 30 years. My regular massage is not any better then anyone elses. However if you are hurting anywhere, I have a very advanced skill set, if it's needed. Then she told me that she has an arthritic spine and neck, and also her ribs are dislocated and she has sciatica . And she gets painful muscles spasms in the low back. I asked her who told you that? She answered, a chiropractor. I'm looking at a young twenty something. There is no way she is suffering from arthritis.. Goodness. And if her ribs were dislocated, I think she would be in the emergency room.. Unbelievable. Ok, long story short. She had trigger points in all the right places. Lateral leg, hips, lateral Illiac crest, upper traps, neck, jaw, knee.. They all deactivated. She felt way better after the session, as you can imagine. I explained to her that there is no way I can make arthritis go away, and the reason she feels better now is because I got rid of , at least temporarily , a whole bunch of trigger points. And that her pain problem will soon be over. She told me that she quit going to the chiropractor because she was not getting any better. Well she is going to get better now.. Goodness... Another client, has been suffering hip pain for two years, I think she told me. She was told by medical doctors and physical therapists that she has arthritis and degenerative discs.. She was in physical therapy for 9 month! Didn't do a thing for her hip pain. Ok, she had trigger points in all the right places, and was shocked to feel no pain when she got up off the table. I could see her tearing up with happiness. I told her that her problem is over. I emailed them both information on trigger points , some of my testimonials along with video clips of me working on clients. I do this so they see that what I'm doing has worked on a lot of others, and will work on them as well. It was a good day. I got to save two more people from needless pain. Oh, they were also both working out, spinning classes, yogo, Pilates .. I told them both to stop working out until we get these trigger points under controle. Then they can start working out again. Gotta let those tissues heal first. They both had way too many trigger points. I feel very confident they will both heal quickly .
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amen, brother.  arthritis, all forms of it, cause visible "bumps", nodules like big, round dry (no pus, can't be palpated) swellings on the arthritic joints..  First to appear are usually the PIP joints of hands.  Arthritis is knees and shoulders are harder to recognize by sight alone-- but there is no mistaking its pain for tp pain. TP is in the muscles and their attachments.  Arthritis is deep within the joint where not even a chiropractor can reach it.  DCs, PTs, not even MTs can get inside the joint to clean out the damaged cartilage.

The client that was in physical therapy for 9 months emailed me last night. Said she is feeling way better. It's really sad if you think about it. It's so simple so simple simple. Yet nine months of useless therapy. The cost to the health care system. The stress for the patient. This lady actually thought she had a life long affliction. Travell and Simons placed great emphasis on the importance of eliminating perpetuating factors. Sadly, one of the biggest perpetuating factors for people's pain is the health care system itself. I forgot to mention they had her on a couple different kinds of medication for her perceived pain problem. I've seen them both advertised on TV for fibromyalgia and arthritis such. It's not like its one isolated case here and there. It's rampant .. If 85% of all pain is trigger point pain. And from my experience, I have no reason to doubt that. You can easily figure that at least 70% of all people going to any type of clinic, in this country or the world, both allopathic or holistic, for pain are either getting useless therapy or worse, therapy that's actually perpetuation their pain. When all they really need are a hand full of trigger point sessions. And to stop working out during their therapy.
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Just to follow along with the above entry. Knowing this secret information causes me a certain amount of stress during my work day. Like today.. I think I have five or six hours of massage scheduled. I can safely assume some of them have been or are curently seeing someone or in therapy for some kind of pain issue. And I can safely assume they are getting the wrong kind of treatment or therapy. But these clients are paying good money to relax in a nice spa.. And indeed almost all of them tell me they just want to relax. And they have no idea that I can actually help them. They don't want to hear me tell them that they are getting the wrong kind of therapy, or if they have been in pain for years, that I can help them. They have heard that so many times. And they don't want a quote THERAPUTIC massage because they don't want the pain.. They just want to relax.. They are stressed.. So, often times I have to give them that relaxing massage, and their pain cycle continiues. The clients I mention on this thread listened too me, because they see my sincerity. But a lot of them don't want to hear me talk. They just wanna get on that table get their massage they have been waitin for with no talking or interruptions. To zone out. Then I go home thinking. Gosh I could of helped that lady.
I had a couple of pain clients recently that are interesting. But I will just comment on one because she had seen an Osteopath prior to seeing me. When she first came into the room, I asked her what she needed from the massage today. She told me that for the last three weeks she has been feeling a lot of tension in her shoulders with difficulty turning her neck to the right. She went to an Osteopath that did, in her words, mofascial work. It was painful, and she was still bruised on the arm from the work. But reguardless of that, it didn't do anything for her shoulder and neck pain. I started to explain to her that a massage would feel good, but that she needed advanced trigger point work. Then she interrupted me and said.. Yea I know your skill set, you fixed me before a couple years ago. I didn't remember, but that was good because I did not have to try and explain things to her. She said just get me out of this.. That's why I'm here.. So I palpated from her hips up to the top of her head, front, back, and sides. I found four very noticible tender points on her upper T spine( two on each side ). One upper trap tender point on the left. Also what may have been a rhomboid tender point on the edge of the right scapula around T 5 level. On her neck I found only one tender point on the right lateral side of C1. That was the extent of her tender points. The anterior of her body was tender pint free. When she was on her back I tested the range of motion of her neck. I rotated her neck at first to the right. Got about 45 degrees and had to stop suddenly because of pain. When I rotated her neck to the left, she had pain free full range of motion. So what I did was preform what's called in chiropractic lingo a facet release( I think?). Then held her neck in sort of a modified cranial sacral technique that allows the muscles of the first two cervical vertabrae to relax. Held that position for about a minute and a half. Then I did what's called a lateral shift. It's not a rotation it's a shift of the neck. The nose keeps pointing to the ceiling as you slightly shift the head to the right, then the left.. Anyway it's too hard to describe by just typing. It's real easy, simple, and it does not hurt. I did a few more techniques along those same lines.. Only took like maybe a minute.. Then rotated her head to the right, and it went full range of motion pain free.. I then left the room while she got up and put her robe on.. Then came back in and asked her to turn her head both ways and see how it feels.. She turned her head left and right full range of motion.. No pain what so ever. All that took 15 minutes. I asked her if she wanted me to spend the rest of the time massaging her or if she wanted to go home. She elected for the massage. After the massage I again had her rotate her neck to make sure all was ok. . Her neck and shoulders were like new. Full range of motion both ways with no pain or tension what so ever. She was really happy. So was I. Pain on motion is often times different then palpatory pain. Sometimes you can eliminate all the palpatory pain you want, and the client still hurts when they turn their head or lift ther arm or whatever. Sometimes you can just eliminate the palpatory pain( trigger points ), and the pain on motion is eliminated too. But not in her case.
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The average income for a Massage therapist in the United States is $39,800.00. Now some of you may make more, some of you less. But that's the average yearly income. Now we all know that Physical therapists, Medical doctors, Osteopathes, and Chiropractors make way more money then the average Massage therapist. All those professions, including ours, deal with pain. The yearly money spent on pain in this country is $638,000,000,000.00. All the leading pain experts say that 70% to 85% of all pain comes directly from trigger points, and that trigger points are involved in virtually all pain syndromes. And I have to agree with that just based on my experience. I see it every day. And here is the deal. Eliminating trigger points falls well within our license, just like it does with all those other professions mentioned above. Well I forgot the Acupuncturists, but them too. But it definitely falls within our license. We touch muscles and tendons all the time. Those other professions hardly do if at all. Now think about this.. Wonder if all the Massage therapists were proficient at eliminating trigger points. And it was a major part of our training.. Then let's say that the 70% to 85% of all pain being trigger points is an exaggerated figure( it isn't though ). Let's say only 10% all all pain is directly from trigger points. A very easy figure to accept. 10% of $638,000,000,000.00 is $63,000,000,00.00. So that's $63,000,000,000.00 worth of trigger point pain. Now there are approximately 55,920 Massage therapists in the United States of America. If you divide 55,920 into that trigger point money, that comes to $1,140,915.15 a year for each Massage therapist in this country. Compare that to $39,800.00. For some reason, I'm the only one that realizes this? That's why I write in here. Within our license our profession has so much untapped potential. One has to ask the question. How come trigger points are not a major part of out curriculum, our education system?
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Such good points, Gordon!  And I'm glad you got the repeat client who remembered how much you helped her before.

The following are some of my thoughts that may or may not be accurate, but they are what I know as of this moment.

We live in a country that adds sugar to almost everything we eat; it's hidden so creatively that there are at least 40 different names for sugar.  Sugar is devastating to our bodies.  We tell kids that are over-sugared that they are "bad kids" and need drugs (yes, there is more going on there but cut out the sugar and see what happens).  We have rampant obesity and tell people to eat healthy food - much of which has hidden sugar in it.

We don't like the use of pesticides, so we change that by splicing the pesticides into the DNA of the grains we grow. Brilliant!  And we wonder why people start having trouble with wheat...

I'm sure I could rant about more stuff but I don't have much time - I really need to be doing stuff on my to-do list!  But the point of all this is that a society that is as messed up as ours is will certainly not have the clarity to understand trigger (or tender) points.


Yea you're right Therese. it's also obvious that the people that guide our profession don't know anything about trigger points. Clair Davies has a book. THE TRIGGER POINT THERAPY WORKBOOK. You can get it at Amazon. It's a $6.38 book.. I copied a review from that book. It's in the attachment below. Just read what this lady says. A lot to doctors couldn't help her. Think really hard on what that means?? She fixed herself. One of the problems with our profession is this over emphasis on fascia and structural alignment. They have their place, but it's a small one compared to all the real need that's out there, just waiting. Read that ladies review of Clair's book. Its implications are profound.
Therese Schwartz said:

Such good points, Gordon!  And I'm glad you got the repeat client who remembered how much you helped her before.

The following are some of my thoughts that may or may not be accurate, but they are what I know as of this moment.

We live in a country that adds sugar to almost everything we eat; it's hidden so creatively that there are at least 40 different names for sugar.  Sugar is devastating to our bodies.  We tell kids that are over-sugared that they are "bad kids" and need drugs (yes, there is more going on there but cut out the sugar and see what happens).  We have rampant obesity and tell people to eat healthy food - much of which has hidden sugar in it.

We don't like the use of pesticides, so we change that by splicing the pesticides into the DNA of the grains we grow. Brilliant!  And we wonder why people start having trouble with wheat...

I'm sure I could rant about more stuff but I don't have much time - I really need to be doing stuff on my to-do list!  But the point of all this is that a society that is as messed up as ours is will certainly not have the clarity to understand trigger (or tender) points.

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Yea the knowledge in Clair's $6.38 book was more then all the highly educated, highly paid physicians she went to for her foot pain. She went to more then two physcians from the sound of it. Unexplained pain. Another thought. How long does it take, and how much does it cost to be a massage therapist now? And all these national certification exams we do, or have to choose from.. All that education is doing is insuring an income of $38,000.00 a year. I remember gosh maybe 10 years ago giving a short lecture at a local massage school.. I had met the principle and lead instructor as an acquaintance and she invited me to give a little talk at her school.. Anyway, of course I mentioned trigger points.. Now all of these students were ready to graduate and take their certification exams. I asked then this question.. Can anybody here tell me what a trigger point is... I just got blank stares. Finally one of the students raised her hand and said. " Isn't it an engergy blockage?" I then turned to the instructor and asked her if she knew what a trigger point was.. She shook her head no. Anyway after my little talk the instructor pulled me over and asked if I wanted to be a teach at her school. I told her that I really didn't want to, but she insisted that I look over the curriculum and then make a decision. She left me alone for about a half hour as I looked over everything she wanted me to teach. When she came back, she asked me what I thought. I told her that I could not teach this stuff because I did not really know any of it. She looked puzzled and said. "But you're a professional massage therapist?" I said" Well, I guess you don't have to know any of this stuff to be a profession massage therapist." In the attachment below is a quotation that fits into how I think. Again I want to point out this entire thread is my truth. Not telling anybody how to think or what to do.
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