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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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Quintner would argue against what you're doing even if he got the successful treatment-- he has built a lucrative career tearing tp therapy down.


I found an email address for Dr. Quintner and sent him a link to one of my videos along with a couple of my testimonials and asked him what he thought. I probably won't get a response. But anyway all I know is this....If I eliminate those trigger points, regardless if they are in the muscle or not, what ever they are. I eliminate the clients/patients pain problem most of the time. And I mean the vast majority of the time. They are real and have an effect. I see it almost every day. Gosh I said I wasn't going to write in here, but here I am again.
A year ago a lady came in complaining of TMJ and migraine headaches. She had been seeing TMJ experts for her problem.. I saw her again recently. She was starting to tighten up in her right shoulder, and her headaches were coming back. She told me that a year ago I completely eliminated her headaches and TMJ. And that what I did was so different and successful she thought she had better get into see me before things got worse. I remember working on her and eliminating numerous upper T spine trigger points along with several cervical TPs, masseter and temporalis trigger points. Also a tender point in the lower right quadrant of her abdominal area( ileocecal valvue). It seems common for that area to be tender on people that suffer low back and migraines, for whatever reasons. Anyways, every thing held and she was pain free for a year. All I did was eliminate trigger points. I didn't need to go inside her mouth for the TMJ either.
Anyway her recent visit I found only rhomboid and paraspinal trigger points between her shoulder blades on the right side. As well as several painful cervical trigger points. Also her ileocical trigger point was back in a mild way. I found no trigger points in her jaw temples face or low back. They all deactivated. She left the spa happy.

Gary W Addis, LMT said:

Quintner would argue against what you're doing even if he got the successful treatment-- he has built a lucrative career tearing tp therapy down.

Here is a video of a very good trigger point Therapist at work. Watch how fast she takes this guys pain out. Anybody that deals with pain and doesn't check for the presents of trigger points, or think that trigger points don't matter that much, are dearly mistaken. I have gotten people out of pain in one or two short sessions( 30 minutes or less) ,that have been seeing other massage therapists, chiropractors, physical therapists and MDs for months and even years years. Just because I know trigger points. Some people don't believe me when I say what I do. But watch this lady work. You can believe me.
https://www.youtube.com/watch?v=m-Oe-kSXMTc&sns=em
Ask yourself this question... Would this guy do better getting Chiropractic adjustments? What do ya think?
Zero appointments today so far and it's nearly 4pm here, so I took the rest of the day off day off. I will spend some time brushing up on my anatomy because my new job is going to require me to write treatment notes. That will be challenging for me. Anyway I might as well write in here for a while.
A while back a client came in for a massage just to relax. He was in his late twenties and looked slim and fit. He told me he was a runner. I asked him if he had any aches and pains. He told me that when he runs his low back bothers him, and that his calves are always really sore sore. When he wakes up in the mornings his low back is always sore. And because he has a desk job and is hunched over a computer his neck is sore as well. I asked him if he sees anyone for his aches and pains, and he told me that he has seen a physical therapist that does active release on his calves and low back. He said it really helps. He said he never felt that he needed to see a medical doctor or chiropractor for his minor, yet nagging pain issues. I told him that I would give him his relaxing massage but would check his neck, low back and calves more specifically. He said sounds goood. I asked him if he has ever heard of trigger points. He said no.
When I started doing the trigger point work he got into it. He had maybe four trigger points in his lateral and posterior neck. He had very noticeable trigger points on the paraspinals on both sides around L3 and L4 as well as spinous tender points in the same areas. In addition he had gluteus medius trigger points on both sides and a vastus lateralis trigger point on the right. Both calves were very trigger pointed. All those trigger points deactivated. He lives way out of town so I won't be able to see him again, but that was cool. Some people come into the spa with various levels of aches and pains. But they tell me they are already getting thearaputic work and just want to relax. That has always bugged me. When I feel I can help somebody but they won't let me. But more so in the past then now.
The pain management clinic that I will soon be working in will be almost 100% trigger point work. My success rate won't be as high because because these patients will be in serious pain. I shadowed the doctor for a few days. It's going to be challenging. But there will be trigger points. And to the extent there are, I should be able to help. Oh forgot to mention he had tibialis posterior trigger points as well. In the attachment below is one way to see the connection between the calves to the low back to the neck.
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IMO people like Quintner are convinced of their own ignorance so rant and rave to convince the world of their brilliance.

Over the years I've had lots of clients that come in with low back pain... Some have been dealing with that pain for years. When I ask them to tell me about it , I often hear.. "Well I have Spinal Stenosis." That's a narrowing of the space between the disks. But they are surprised when they get off the table pain free. There is no way I can expand the openings of the disc space for them to be pain free after I work on them. They are pain free because I eliminated trigger points.
I'm now reading a book on pain written by a pain researcher. In the attachment below is an excerpt from the book.
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Reading that excerpt, my opinion of the guy is not very exalted.  Everyone who has ever experienced the un-funny pain caused by bumping the "funny bone" knows that nerve bruising, nerve compression does cause pain.

Compression of nerve isn't always an aching pain as the man suggests-- sometimes that pain can be quite sharp.  As the author apparently doesn't understand, a trigger pointed muscle (due to the muscle compressing a nerve) usually doesn't ache, usually no pain at all while it is immobile in an unstressed position.  A trigger pointed muscle causes its distinctive sharp pain upon movement-- Indeed, the physiological reason a TP forms is to limit what the body perceives (wrongly, usually) would be damaging to the muscle itself or to the joint or one of its ligaments that the muscle crosses.

By releasing the trigger point we help the CNS to understand that the perceived danger is passed (if this is not so, the tp will be reborn the moment the muscle is re-engaged, true?

Bumping the funny bone or anything else is picked up by the various pain sensors in the area and relayed to the brain. If I went to a medical doc or chiropractor complaining of low back pain( when I didn't really have any pain ), and they saw an X-ray of my low back. They would see a very narrowing of the disc space in the lumbar spine. It would be very easy to blame my pain on nerve compression. But I have no pain whatsoever in my low back. What he is saying, and it's true, is that often times these pathologies, like arthritis, disc compression and so on are blamed for the pain when actually they are just coincidental and really have nothing to do with the pain. I hear it all the time. Almost on a daily basis. Like, my back hurts because I have arthritis. Or my back hurts because I have a pinched nerve( I saw it on the X-ray ). But they get off my table pain free. Because their pain came from trigger points , not from those pathologies.
That's basically what my whole thread has been about. The misdiagnosis of pain. And how 70% to 85% of all pain comes directly from myofascial trigger points( soft tissue). And that trigger points are involved in 90% of all pain syndromes.
The pain industry is a 600 billion dollar a year industry in the USA. We have a license that allows us to eliminate myofascial trigger points. But our whole massage licensing education system stifles that potential. We should be playing a bigger part. Much bigger.
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Trying to answer your question. "By releasing the trigger point we help the CNS to understand that the perceived danger is passed( if this is not so, the TP will be reborn the moment the muscle is re-engaged, true?"
The trigger point is caused from a damaged sarcoplasmic recticulum which allows calcium ions to flow into the cell causing
contraction. By releasing the trigger point (by whatever the method) the blood can enter the area and start repairing the damaged tissue. If the muscle is allowed to heal,and not put to vigorous use right away, there is a good chance that it ( the trigger point)will not return. It may need to be released two or three times before it is permanently gone. My point, where I differ from others is that stretching after a trigger point session is taking a risk of re-injuring the sarcoplasmic reticulum. It's like a cut on your skin. You would not stretch your cut in order to make it heal faster. The trigger point is not formed to protect a joint for example. It's formed because of direct damage to the muscle cell it self. Now if there is disc or damage to the joint itself, it may cause a certain muscle to take on unnecessary work and strains it enough to cause a trigger point to form. If the joint problem never gets resolved. Then that trigger point might have to be released periodically in order to bring some relief for the injured person. But all that being said. I have released trigger points in many people, some that have been in pain for years. And the trigger points never came back. I don't know if I answered your question. I don't think the CNS is any more involved in the trigger point then it is with a cut on your skin. I don't know if I answered your question or not? If not. You might have to ask someone smarter then me. Lol.
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actually, I think I was pretty much agreeing with what you just said.  :-) 

I add this, however: A TP forms for several reasons.  Mechanical dysfunction within that muscle fiber as you described; CNS receiving feedback that causes it to assume the muscle has been injured or it or a ligament in the joint the muscle fiber is responsible for moving or stabilizing is about to be over-stressed; or it can form to help prevent injury to one of its agonists or even one of its antagonists.

Compression of a nerve by a muscle (not a vertebrae) is as we know almost always caused by a trigger point.  What the author of that book/article says, I supposes, is that compressions of nerves form, well, just because they do. 

Carpal tunnel the "experts" blame on compression of the medial nerve by the ligament that keeps the nerve and nine tendons in place.  Correct me if I'm wrong, but I don't think ligaments flex -- a ligaments job is to prevent over-extension...within a knee joint, an elbow joint, a shoulder joint, a hip joint.  Ligaments don't flex, to my knowledge.  Ligaments attach not to muscle but to two bones, correct? to stop them from being ripped apart by violent movement.  Therefore, as you and I and most intelligent manual therapists know (or should know) the compression known as carpal tunnel is due to a trigger pointed muscle clamping on the nerve or one of the (9?) tendons that pass through the carpal tunnel.  An analogy I use when explaining it to a client is that in mechanical devices several ropes or cables will be held in place by a guiding pipe; they slide freely through the pipe.  But if one of the gears a rope or cable is attached to hangs up for whatever reason, that rope will rise to the top of that roomy pipe and begin to fray as the pull on the other end continues.  The friction can prevent the entire machine from functioning.  Inside the carpal tunnel-- which is not roomy-- the "frozen" tendon or nerve will become inflamed, enlarged with blood which makes that tight space unbearably tight...and pain is the result when the sufferer attempts to use the affected fingers or wrist. 

In the attachment below you will see a list of possible treatment options for carpal tunnel and stats on the success rate of carpal tunnel surgery. Another interesting thing is the fact that trigger points or massage are not even mentioned. Which in reality is the best option for carpal tunnel period. And that not only goes for fake carpal tunnel (most often trigger points in the extensor muscles of the forearms), but also real carpal tunnel.
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I said that I wasn't going to write in here anymore, but here I am. Anyway, this was interesting and it fits into the above few paragraphs( the entire thread really).
When I went to greet my new client in the waiting room, she looked a little stunned when she saw me. I figured it's the male massage therapist thing. I've seen that look enough times to guess that's what it was. When I got here in the room she immediately told me that she has never done this before. I started to explain about what to expect during a massage session when she interrupted me and said. " Oh I've had massages before, but only in my chiropractors office, never in a spa." When she said that, I knew that she had some aches and pains. I asked her why she was going to a chiropractic clinic? She told me it was because of low back and neck pain. I asked her if she still hurt and she said yes. And then went on to tell me why. Her low back hurts because she has too much curve in her lumbar spine. And her neck hurts because of two herniated discs. All from a car accident years ago. I told her that my massage was good, but not any better than anyone else. As a matter of fact, there are people that I work with that probably give a better massage then me. Howerver, I have a very good skill set when it comes to helping people out of pain. I let her whatch one of my videos. She gave me permission to do whatever's I could if I really thought I could help her with her pain problem. I explained to her that it probably would take more the one session, but we would find out for sure if I could help her.
Neck and low back pain go together like hand in glove. Check the attachment out. I palpated two very tender trigger points on her right posterior neck( transverse processes ) C6 and C3. They made her flinch when palpated. As a matter of fact, almost all the trigger points I found on her made her flinch. I also found a very painful trigger point on her left at C3 as well as one of her occipital muscles on the right side. Her L3, L4, L5, were trigger pointed on the right. Her L3 on the left was trigger pointed. Her PSIS on both sides were very trigger pointed as well as the right Piriformis where it connects to the sacrum. She also had a couple trigger points on both sides of her spine around the T4 and T5 levels. She had a right lattissimus trigger point on the lateral shoulder blade( remember, that muscle runs down to the low back). Oh, I forgot to mention that she get migraines. A lot of people that are migrainers as well as low back pain people have a painful Ileocecal valve. That's a very tender spot in the right lower quadrant of the abdominal wall. A few paragraphs above I attached a video of a skilled trigger point Therapist that shows her releasing that valve. You might want to check it out. Near the end of the session she told me about a very painful spot on her left foot near her heal where her arch starts. When I found that spot she let me know. It was very tender. She said that she is always trying to rub it herself, but it never goes away. Anyway, long story short. All those painful spots deactivated. She felt really good after her session. She was amazed. She rescheduled for a 25 minute follow up. The other interesting thing is, she never heard of trigger points before. I told her about www.triggerpoints.net. And when or if she has time, she might want to look over that site. She said that she definitely would. Anyways, that was cool.
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