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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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In the attachment below are a few case histories of an acupuncturists experience with abdominal trigger points. Notice how long these people( Patients ) suffered before they were treated by this intelligent acupuncturist. Massage therapists, properly trained, could do the same thing.
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Trigger points in the abdominal area can indicate internal organ stress with symptoms such as nausea, bloating, gas, and so on, as indicated in the last paragraph or so in the attachment below.
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A while back, one of my regulars called and told me that she was thinking about cancelling her appointment because of gas and pain in her abdominal area. A very unusual experience for her. I told her she should come in anyway because there is a good chance that I could help her. If I remember correctly she had one tender point in the upper left quadrent, one in the middle of the lower left quadrent, and I think one more somewhere on one of the right quadrents. When palpated she made a noticible facial expression of discomfort. Immediately after deactivating those tender points, her symptoms vanished. Her testimonial is in the attachment below.
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One of my regulars came in today, not for her usual massage, but because she was hurting. All her friends told her that she needs to see a chiropractor. However I had helped her out before when she was hurting, so she came to me. She complained of pain in her mid low back, in her lower rib area on the right side. An area a little more lateral then where the main paraspinals would run. After palpating from her hips to occiput, I discovered a couple really painful tender points on her Seratus Posterior on the right side. Pretty much where she indicated she felt the pain. I also found right lateral spinous pain around the T2 level, which made sense, because of its relationship with T9 that inervates the area of her Seratus Posterior tender points. She has had a hard time sleeping the last two weeks. Last night was the worst. She could not find relief in any position. So she decided to see me today. I was able to find and deactivate those tender areas writhin 20 minutes, then carried on with the rest of her massage.. I was even able to massage over ther Seratus posterior area without causing any further discomfort. She left the spa pain free. She is coming in tomorrow or the next day for a short follow up session to make sure those tender points stay gone.. So that was cool. Actually my whole day was a pain relief day. Everyone I saw came in specifically because they were hurting. Luckily everyone got a profound and immediate relief.. It was cool. In the attachment below is a picture of a Serratus Posterior tender point and it's pain zone.
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It's a little agrivating that I can post only one attachemts at a time? Anyway, just for intellectual purposes I will show a dermatome chart that shows that T9 basically inervates that Serratus Posterior tender point area.
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Also for intellectual purposes, here is a chart that shows the T2-T9 relationship. I say for intellectual purposes only because it's not necessary to know in order to find a tender point( still fun to know though). A totally healthy body has no pain spots even with firm palpation. So where ever I find one, I want to down grade or eliminate it reguardless of any relationships. And indeed when I'm working, I'm usually not thinking on those things. I'm just palpateing for tender points. When I read all these neuromuscular technique trigger point books written by smart people.. I see them spending way too much time thinking on how to palpate and where to look for the trigger points, based on various relationships, symptoms and pain patterns. Unnecessarily complicating what would otherwise be a relatively simple process.
( TRUE REFINEMENT SEEKS SIMPLICITY--The height of cultivation runs to simplicity. Halfway coutivation ruins to ornamentation. - BRUCE LEE. ). Also, when I talk in here.. I don't measure things exactly when I'm palpating somebody( no time ). It might have been T1 or T2 or in-between? Also different Dermatome charts are different. And one spinal segment can inervate part of the area that the spinal segment above and below inervates, and so on. Just a general measurement. Not exactness. Also, maybe it wasn't the Seratus Posterior, maybe it was a Paraspinal, or a latissimus or a Trapezious or a Whatever.. The main thing is that the tender point is downgraded or eliminated and the client feels better.
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I had a client come in two weeks after a tumor was successfully removed from the anterior left of her neck. She told me that because of the surgery she can't turn her head yet , and because of that has developed a lot of tension on the top of her left shoulder. Before she got on the table I palpated very noticible ( to her ) trigger point in her upper trapezius ( GB 21 ). She had two tender points total. The upper trap one, along with a tender left spinous at T1. The vast majority of her session was spent massaging. After the massage her tension was gone. I would imagine it will come back because she has not fully recovered from her surgery. After she recovers, three months or so, any such tension can be eliminated on a more permanent basis. But you can see how maybe someone would not get or think about getting a massage after surgery, or the therapist would not know about trigger points.. This pain would continiue to develope. She would go back to the docs that most likely would not know about trigger points. They would perhaps send her to physical therapy that would have her exercising her neck.. You can see how something so simple can turn into a real expensive unnessisary ongoing pain problem. That would not be untypical. Then they would come into the spa on a gift certificate three years later and tell me they have bursitis or arthritis or a pinched nerve or a rotator cuff injury or who knows what. And I'd palpate more then two trigger points for sure. And it's possible I would have to spend considerable engergy ( time ) trying to convince her ( without pissing her off )that I can help her after maybe four to eight trigger point sessions. That would not be untypical. It's all part of that six hundred billion dollars.
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a few hours after surgeries, even serious back ,hip and leg surgeries, patients are encouraged to get moving.  So it's good that she came on to you.  Encourage her to move to the point of pain, but not really push through it. 

Just an additional short entry to this thread. A new client came with, in her words, pain all over. Low back, right hip, right foot,both legs( front, back and sides), right neck and shoulders... She has gone through the usual gauntlet of providers. The most recent being a major pain clinic here in town.. She got a cortisone shot in her hip and foot, at a cost of $4,000.00 that she is still paying for. It worked in her hip some, but not in her foot. Ok well, as you can imagine. She had pain points in all the right places. Just go to a trigger point chart. Anyway all the pain points vanished. She left the spa somewhat bewildered yet really happy. Bewildered as to why her pain vanished so quickly, happy because it did. She rescheduled for a follow up. When those tender points are totally gone, she should feel better. She showed me where her foot hurt, where the $4000.00 cortisone shot didn't work. They told her something about her bones spreading apart as the reason for her pain.. Well maybe , but she also had a really bad pain point there that initially made her wince when I touched it. But like all the other tender points it vanished. I'm just thinking out loud now. I don't really ever know if I can help someone for sure.. But I have a feeling if I'm able to, in time, to make those tender points stay away. She is going to feel pretty dang good. And the cost to her will be way way less then the cost of one cortisone injection. As a side note. I applied to work in that clinic, only to have my application ignored.
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I recently had an elderly client in her late 70s. She walked slowly, like she was in pain. When we got into the massage room, she began telling me about her various aches and pains. Pinched nerves, athritis, herniated discs, broken back, night cramps, heal pain, neck pain, head pain, hand pain, shoulder pain, on and on. She was very elderly, and I had no fantasies of getting her out of all her pain. Someone had paid for her 80 minute massage. As I left the room so she could get on the table I was thinking how I was going to work on her.. Should I go for trigger points, or just light soothing massage or some combination of? What would be best. She told me that the docs wanted to do surgery on her back and shoulders, but that they couldn't because she was allergic to the drugs that would be needed to preform the surgery. And the medication they gave her for her pinched nerve upset her stomach, so she can't take that either. Anyway, as I was standing outside the door waiting, for her to get on the table I heard her loudly moaning in pain. I went in the room only to see her in pain bent over the table.. She told me that she can't lay on her stomach or her back. So now I realize that there is no way for her to recieve an 80 minute massage. She had no clothes on.. So I got her robe on, and had her sit on the edge of the table. I figured I would work on her for a short while in the sitting position. She immediately began telling me about her pinched nerve in her left shoulder that sends pain up into her neck and head. She said the doctors told her she has a pinched nerve but the medicine they gave her it made her sick.. Ok, she is pretty fragile and old. But I hear this pinched nerve diagnosis almost every day. I'm telling you right now.. In my experience.. Maybe yours is different. Pinched nerves are rare. I can't even think of the last time I ever worked on anyone with a pinched nerve? Well there was one guy 15 years ago that I remember.. Must be more, but, really can't think of any now. It's always Trigger points. . Her shoulder pinched nerve that sent pain up her neck was a very nasty upper Trapezious trigger point at GB21. And the part that sent pain into her head was a very nasty trigger point in her Temporalis above her ear same side. She had several active trigger points in her upper T spine, her hand pain and arm pain were from very tender trigger points in her forearms.. Her foot pain was from trigger points on the bottom of her heals.. And I know they were trigger points, because they all vanished.. No way nerve or arthritis or disc pain is going to vanish from me working on her. I worked on her for a half hour.. And suggested she come back for a couple more short sessions instead of her sitting for 80 minutes. She agreed.. It's too bad I did not meet her 20 years ago. She has decades of trigger point accumulation. When that upper trap trigger point disappeared you should have heard her sigh of relief.. She said she could feel warmth in her shoulder.. That's the blood flowing in the tissues that were previously contracted... Anyway. I can help her a little bit.. It's kinda too late now though... Can you imagine being so hurting that you can't lay on your back or your stomach. In the attachment is the upper Trapezious trigger point that sent pain up inter her neck and head.. And that Trapezious pain pattern caused a Temporalis trigger point to form. I almost don't believe in pinched nerves.
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A few entries above this, I talked about the over six billion dollar pain industry that we, as massage therapist, should be taking a bigger part of. I totally blame our guru's and leadership in our field for this failure. I'm talking about all the massage organizations , exams writers, and schools that have anything to do with our profession. All these national certification exams are the ones keeping us at that average income of $39,000,00.00 a year. If the schools and exams focused on only one aspect of the pain industry.. We would all be making two to three times our current incomes. Case in point. CARPAL TUNNEL. It is among, if not the most, common surgery taking place in this country( USA ). It has a success rate of only 50%. If the surgeons cut that nerve, and the surgery is unsuccessful, that means they did not really have carpal tunnel in the first place. Because if they really had carpal tunnel, and they cut those nerves, the pain would be gone. And besides that, often times even real carpal tunnel can be eliviated via proper soft tissue techniques.. But not counting the real carpal tunnel, the pain that's not going away is trigger point pain, or as some put it, adhesion pain. Muscle pain. And eliminating that muscle pain is well within our license. And on top of that.. A relatively easy task. It's something we can do better then any other profession, unless that profession is doing soft tissue work themselves. I remember reading a text book at a local massage school.. When it mentioned carpal tunnel it said. If you suspect you have carpal tunnel. Go get it checked out by a medical doctor.. And indeed I have known massage therapists that were ready to run to their medical doctors because they thought they had carpal tunnel. Let's leave the serious life threaten problems to the medical doctors. Run to your friend that's a massage therapist, or fix it your self. We should be the go to guys when it comes to Carpal Tunnel. I can only attach one attachment at a time. Read the truth about carpal tunnel in the next two attachments. You will find it very educational. I personally feel confident in saying. That if 100 people came to me with that carpal tunnel diagnosis.. I could help 70 of them completely rid themselves of that pain in within 3 weeks. And a fair percentage of them could probubly fix themselves if someone showed them how.
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I'm not the only one that knows what I know. Check these websites out. Email them.. Call me on the phone.. Ask them how successful their therapy is for Carpal tunnel. Www.mrtherapy.com Www.softtissuerelease.com Www.softtissuerelease.ca. Be sure to check the attachment below because it's a continiuation of the attachment above. Again I ask the question. What if every massage therapist was properly trained and tested on Carpal tunnel therapy? And that it was taught in our schools, and tested in our licensing exams, and our organizations made it known to every General Practioner MD that we can eliminate their patients carpal tunnel quickly and efficiently. And if our organizations contacted large companies to let them know that massage therapists can help their employees rid them selves of carpal tunnel and dramatically cut down the cost of work comp claims. We are talking billions of dollars here folks. Or profession is not even close to its maximum potential. And you don't have to be medically trained, and it's not very hard to learn and do these therapies.. It's Easy Wheezy, Japanesey.
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