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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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Gordon, you've taught your fellow therapists a lot.  Detailing your treatments of clients is a chore, we know.  Maybe if you don't feel compelled to post to it regularly?  The thread won't die.  Even if you post to it infrequently-- or better yet, start a new thread, one in which all LMTs will feel welcome to outline their treatment of a troublesome case, inviting advice from others who have encountered similar problems with a client or clients.

I for one will continue to visit THIS thread regularly, whenever anyone posts to it. 

And, lastly, thank you, buddy, for making so many of us a better massage therapist.

Oh I will still be around. And if some interesting conversation comes up. I will put in my two cents. And I wanna keep making more videos.
I said I was going to end this thread, but here I am again. I added another video. It's a testimonial video. She is a new client I saw for the first time a couple days ago. She has been in pain basically her entire life, as you will hear on the video clip. . So I don't have any fantasies about totally curing her of all her pain problems. However, that being said, she has a trigger point every couple inches over her entire body. If I'm able to down grade or eliminate a certain percentage of those trigger points. She is going to feel noticeably better. Her entire body is covered with painful trigger points. Very challenging work. She went through several sessions of, in her words, very torturous painful physical therapy. When I asked her what was painful about it. She said they got out metal tools and dug inter her muscles. That's Gratston technique. Now that maybe appropriate for certain conditions but not for someone with such painful life long fibromyalgia. I just can't imagine what they were thinking? You just touch her with light to medium pressure and it hurts her. That's an intense therapy. It must have been truly torturous for her. Anyway, on the video is her coment after the first session. I really hope I can help her. https://m.youtube.com/channel/UC1nuuoTkJ4xqSulGQYJd7Ng

I think Graston is a slightly more humane version of a popular 17th Century medical practice.  It's the modern equivalent of opening a vein to let the little bugs swim out of the body in the blood.  Father of the Country George Washington died when three of the best doctors in America circa 1799 treated his laryngitis by draining more than five pints of his life's blood. 

Today, we all agree blooding to heal sickness was not only brutal but stupid in the extreme.  Today, some massage therapists, chiropractors and physical therapists let the little bugs out by scraping the skin with special (expensive) stainless steel tools till the skin reddens with inflammation.  Inflammation is a natural bodily reaction to injury.  Graston scraping bruises tissue; bruising = bleeding into the tissue from burst capillaries.  The claim by its practitioners is that only tissue containing toxins will redden from the scraping.  IMO, that is nonsensical, easily disproved.  Whether the therapist uses an official Graston stainless steel tool or plastic or the lid off a Tiger Balm tin, any area of the body subjected to "therapeutic" repetitious scraping will become inflamed-- indeed, scrape the spot long enough using even very light pressure, eventually droplets of "polluted: blood will magically seep through the skin.  As teenagers we used to get the same effect by sucking and biting the necks of our sweethearts till a hickey appeared that lasted for days.

Gordon, your treatments of her will succeed where nothing else has.  You're right: trigger points ignored and accumulated over time have created the systemic sensitivity labeled FMS.  But if she is patient with you and comes for therapy regularly, eventually she will become pain free.

Gordon J. Wallis said:

I said I was going to end this thread, but here I am again. I added another video. It's a testimonial video. She is a new client I saw for the first time a couple days ago. She has been in pain basically her entire life, as you will hear on the video clip. . So I don't have any fantasies about totally curing her of all her pain problems. However, that being said, she has a trigger point every couple inches over her entire body. If I'm able to down grade or eliminate a certain percentage of those trigger points. She is going to feel noticeably better. Her entire body is covered with painful trigger points. Very challenging work. She went through several sessions of, in her words, very torturous painful physical therapy. When I asked her what was painful about it. She said they got out metal tools and dug inter her muscles. That's Gratston technique. Now that maybe appropriate for certain conditions but not for someone with such painful life long fibromyalgia. I just can't imagine what they were thinking? You just touch her with light to medium pressure and it hurts her. That's an intense therapy. It must have been truly torturous for her. Anyway, on the video is her coment after the first session. I really hope I can help her. https://m.youtube.com/channel/UC1nuuoTkJ4xqSulGQYJd7Ng

Gary, that is a terrific description of Graston "therapy".  I can't imagine why anyone would think it's a good idea.

Gary W Addis, LMT said:

I think Graston is a slightly more humane version of a popular 17th Century medical practice.  It's the modern equivalent of opening a vein to let the little bugs swim out of the body in the blood.  Father of the Country George Washington died when three of the best doctors in America circa 1799 treated his laryngitis by draining more than five pints of his life's blood. 

Today, we all agree blooding to heal sickness was not only brutal but stupid in the extreme.  Today, some massage therapists, chiropractors and physical therapists let the little bugs out by scraping the skin with special (expensive) stainless steel tools till the skin reddens with inflammation.  Inflammation is a natural bodily reaction to injury.  Graston scraping bruises tissue; bruising = bleeding into the tissue from burst capillaries.  The claim by its practitioners is that only tissue containing toxins will redden from the scraping.  IMO, that is nonsensical, easily disproved.  Whether the therapist uses an official Graston stainless steel tool or plastic or the lid off a Tiger Balm tin, any area of the body subjected to "therapeutic" repetitious scraping will become inflamed-- indeed, scrape the spot long enough using even very light pressure, eventually droplets of "polluted: blood will magically seep through the skin.  As teenagers we used to get the same effect by sucking and biting the necks of our sweethearts till a hickey appeared that lasted for days.

Gordon, your treatments of her will succeed where nothing else has.  You're right: trigger points ignored and accumulated over time have created the systemic sensitivity labeled FMS.  But if she is patient with you and comes for therapy regularly, eventually she will become pain free.

Gordon J. Wallis said:

I said I was going to end this thread, but here I am again. I added another video. It's a testimonial video. She is a new client I saw for the first time a couple days ago. She has been in pain basically her entire life, as you will hear on the video clip. . So I don't have any fantasies about totally curing her of all her pain problems. However, that being said, she has a trigger point every couple inches over her entire body. If I'm able to down grade or eliminate a certain percentage of those trigger points. She is going to feel noticeably better. Her entire body is covered with painful trigger points. Very challenging work. She went through several sessions of, in her words, very torturous painful physical therapy. When I asked her what was painful about it. She said they got out metal tools and dug inter her muscles. That's Gratston technique. Now that maybe appropriate for certain conditions but not for someone with such painful life long fibromyalgia. I just can't imagine what they were thinking? You just touch her with light to medium pressure and it hurts her. That's an intense therapy. It must have been truly torturous for her. Anyway, on the video is her coment after the first session. I really hope I can help her. https://m.youtube.com/channel/UC1nuuoTkJ4xqSulGQYJd7Ng
https://m.youtube.com/watch?v=pneNFQiCJFs There are a lot of videos on YouTube about Gratston technique. Here is one. To me, it's totally inefficient, uncomfortable , and totally never needed. Because it can only be done by a physical therapist or chiropractor, and uncomfortable , the general public thinks it's an advanced level of treatment. Just like trigger point injections. My opinion, it's just one notch above medieval. But what do I know?

Thanks, Therese.  George Washington had a serious case of laryngitis, and there was no antibiotics then.  So the doctors were desperate.  Best thing they could've done for the man was feed him bouillon soups and keep him hydrated till the body healed itself.  But no.  The three expert doctors drained blood from him several times over three days, and, increasing desperate, they finished him off by draining five more pints (82 ounces) of his blood in less than twelve hours.  Ben Franklin probably would have stopped that if he could have gotten anyone to listen to him--but what did he know, eh?

Gordon, buddy, you know not to stick needles into people or feed them pills or abrade the skin till it bleeds.  In the video you linked to, the guy begins by admitting Graston is a massage therapy technique (legal in almost all states for us to do, actually). 

Notice the little tin of salve he rubs into the skin?  Betcha that's Tiger balm...a topical analgesic that heats the skin.  It heats the skin by bringing blood to the surface.  Icy Hot, Aspercreme or Bengay does the same thing.  So even if he hadn't scraped the hell out of the skin, the skin would have become inflamed.  The analgesic cream by itself would have lessened he client's pain without causing any damage to the tissue.  A TENS unit would have provided the same or superior relief.  However, Graston scraping of the skin does injure tissue; although the pain relief is temporary, the damaged tissue takes days to heal (an abrasion or cut in the skin requires 7-9 days to heal completely).

Chiropractors and physical therapists and massage therapists are well educated: without doubt they know that any beneficial effect provided by analgesic creams and TENS units is temporary.  Temporary relief is better than no relief when you're hurting, right?  Scraping the skin till capillaries bleed beneath the surface provides no additional benefit.  Yet, lots of well meaning manual therapists attend expensive seminars to learn the proper technique and buy expensive official Graston stainless steel tools, and schedule the client for 2-3 sessions per week. 

Oh, sure, intense scraping might accidentally release a trigger point, if the site chosen for the treatment is the location of the trigger point.  But as we know, as all massage therapists should know and as all DCs and PTs should have been taught in their four-to-six year degree programs, the active trigger point may be a very long distance from the muscle that aches when it is moved.  But, then, ain't a lot of money to be made if the source of the pain is located and taken out in a single one-hour session. 

Treating myofascial pain and the resultant movement restrictions without first locating and eliminating trigger points is surely gonna cost the client lots of money and unnecessarily prolong the client's pain.

 

I don't know? Good soft tissue work with the hands can do the job as good if not better. Soft tissue release, Active release breaks up adhesions. I just don't see the advantage of Graston technique?
http://www.grastontechnique.com/home
Here is their official site.

I didn't know that about George Washington and his unfortunate treatments until you posted here about it.

Graston technique I guess is supposed to unstick adhesions, blah blah blah.  As we are well aware, it's not necessary to use that degree of force to get the job done.  Not necessary, and counterproductive.  There can be no real justification for doing that to a person.


Gary W Addis, LMT said:

Thanks, Therese.  George Washington had a serious case of laryngitis, and there was no antibiotics then.  So the doctors were desperate.  Best thing they could've done for the man was feed him bouillon soups and keep him hydrated till the body healed itself.  But no.  The three expert doctors drained blood from him several times over three days, and, increasing desperate, they finished him off by draining five more pints (82 ounces) of his blood in less than twelve hours.  Ben Franklin probably would have stopped that if he could have gotten anyone to listen to him--but what did he know, eh?

Gordon, buddy, you know not to stick needles into people or feed them pills or abrade the skin till it bleeds.  In the video you linked to, the guy begins by admitting Graston is a massage therapy technique (legal in almost all states for us to do, actually). 

Notice the little tin of salve he rubs into the skin?  Betcha that's Tiger balm...a topical analgesic that heats the skin.  It heats the skin by bringing blood to the surface.  Icy Hot, Aspercreme or Bengay does the same thing.  So even if he hadn't scraped the hell out of the skin, the skin would have become inflamed.  The analgesic cream by itself would have lessened he client's pain without causing any damage to the tissue.  A TENS unit would have provided the same or superior relief.  However, Graston scraping of the skin does injure tissue; although the pain relief is temporary, the damaged tissue takes days to heal (an abrasion or cut in the skin requires 7-9 days to heal completely).

Chiropractors and physical therapists and massage therapists are well educated: without doubt they know that any beneficial effect provided by analgesic creams and TENS units is temporary.  Temporary relief is better than no relief when you're hurting, right?  Scraping the skin till capillaries bleed beneath the surface provides no additional benefit.  Yet, lots of well meaning manual therapists attend expensive seminars to learn the proper technique and buy expensive official Graston stainless steel tools, and schedule the client for 2-3 sessions per week. 

Oh, sure, intense scraping might accidentally release a trigger point, if the site chosen for the treatment is the location of the trigger point.  But as we know, as all massage therapists should know and as all DCs and PTs should have been taught in their four-to-six year degree programs, the active trigger point may be a very long distance from the muscle that aches when it is moved.  But, then, ain't a lot of money to be made if the source of the pain is located and taken out in a single one-hour session. 

Treating myofascial pain and the resultant movement restrictions without first locating and eliminating trigger points is surely gonna cost the client lots of money and unnecessarily prolong the client's pain.

 

Yep.  Brutal to the tissue.  BTW, while we were talking about Graston, I had forgotten that the actual name for it is Gua Sha.  Graston evidently has pretty much hijacked the technique and made his name, and patented tools the new name for gua sha.   Oh, in the video, when he's scraping the back, he says he is working subscapularis-- But through the scapula?????  Golly, Gordon, releasing trigger points through bone is a technique you haven't taught us yet!   

Therese, another meaningless factoid about our country.  Although George Washington was the first president of the US; he wasn't the first to hold that title: that distinction rightly belongs to John Hanson.  In 1781, Hanson was selected by the Continental Congress to fill the presidency.  As president, he was ceremonial leader of the Congress and of the United States; he presided only over the Continental Congress.  However, he was indeed addressed as Mr. President until George Washington was elected in 1788-1789 to be president and head of the newly established Executive Branch by unanimous vote of all 69 members of the first electoral college.  Washington was the only candidate proposed.  However, eleven candidates ran for the office of VP, which john Adams won.    The citizens of the new nation didn't have a say in that first election, but, yep, Washington would have won.

 

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