MASSAGE TODAY

Hooked on Shoulder Pain. Massage Today, January, 2015, Vol. 15, Issue 01 

By Whitney Lowe, LMT 

 

The article discusses the very important issue of anatomical arrangement of the shoulder joint and its association with various pains. The author deserves a lot of credit for bringing to therapists’ attention the presence of Type 3 of acromion, which is part of the acromio-clavicular joint. The fact that the patient has Type 3 shape of acromion that will be responsible for re-occurrence of the shoulder pain, despite that the therapist’s treatment was correct and efficient. This issue must be remembered by the therapist. 

 

The Body’s Load-Sharing Hub: The Thoracolumbar Fascia. Massage Today, January, 2015, Vol. 15, Issue 01 

By Leon Chaitow, ND, DO 

 

Great Article! There is nothing to add. 

 

The Aspiration to Prevent Hip, Knee and Shoulder Replacements, Part 2. Massage Today, January, 2015, Vol. 15, Issue 01 

By Dale G. Alexander, LMT, MA, PhD 

 

Here we go again! Mr. Alexander has created another masterpiece in all its misleading glory of unscientific claims! The readers of Massage Today again were enlightened by Mr. Alexander concerning his pioneering theory which explains how human shoulder and hip joints developed during evolution. In contrast to Darwin, who relied on such an outdated concept as hard scientific data, Mr. Alexander’s approach is much more modern. He relies on his own previous publications in Massage Today

 

Based on several of his articles, the author comfortably constructed the theory that our shoulder and hip joints developed as a result of our primate predecessors constantly falling from trees. We’ve already suggested the author visit his local zoo and observe other primates’ behavior and especially how frequently they fall from height. Unfortunately for the author and for Massage Today’s readers, Mr. Alexander didn’t follow our advice. 

 

To some degree we admire Mr. Alexander’s persistence in sticking to this ‘garbage science’ theory. However there is supposed to be some scientific explanation of how our major joints formed, assuming of course that readers are interested in real science, rather than Mr. Alexander’s para-scientific imagination. 

 

If one compares the modern pelvis with the hip joints and fossilized remains of the pelvis and hips of our predecessors, a couple of things will stand out (Ruff, 1996). First of all, our predecessors’ pelvises were much wider in medial/lateral direction and narrower in anterior/posterior direction. Only animals whose offsprings’ heads are positioned transversely in the womb have a similar shape of the pelvis. 

 

Secondly, the neck of the femur was longer and this was a critical factor in helping our predecessors enjoy a productive life in the trees. It gave the hip joint a larger range of motion, especially in abduction and that was a tremendous benefit for life in trees. Examination of the areas where adductor fibers of the gluteal group are inserted into the pelvic bones reveals that our earlier predecessors had weaker abduction since they compromised that for the larger ROM. 

Why did evolution change our pelvis and hip joints? Because moving from the trees to the plains required stable hip joints rather than extra flexible ones. This is why Mr. Alexander can run quicker on two compared to his predecessors. However, his modern hip joints will not support him in the trees anymore and indeed he will fall. 

 

According to science (Ruff, 1996) this dramatic change in the structure of hip joints happened in the Middle Pleistocene period between 781 and 126 thousand years BC when Homo Erectus (our direct ancestor) developed so called rotation birth. Before rotation birth, the fetus’ head was flexed forward to the degree that it was positioned transversely in the birth canal. Homo Erectus developed a new way of childbirth where the fetus’s head vertically enters the birth canal. To do that the anatomical structure of the pelvis had to be changed. Thus to successfully pass through the birth canal, the pelvis must be wider in anterior/posterior direction and narrower in lateral/medial direction. The great advantage of the rotation birth was the development of a larger brain in the fetus. 

 

Thus the reason our pelvis and hip joint have their modern shape was this new advanced way of childbirth. Rotation birth gave our predecessors two main advantages: 

1. The ability to develop more sophisticated CNS  

In Homo Erectus this process started earlier while the fetus was in the womb 

2. Extra stabilization of the hip joints during bi-pedal movement. 

That became possible because of the shorter femoral neck, which allowed the giving up of extra flexibility of the hip joints for the extra stability. 

 

As readers may see, these scientific data are directly contrary to Mr. Alexander’s wild unscientific imagination, which unfortunately found a stable presence in the pages of Massage Today

In the second part of the article Mr. Alexander continues to mislead readers. The author claims that posterior luxation of the femoral head inside of the hip joint is a direct cause for the development of avascular necrosis (AV) of the femoral head. AV is an indication for hip replacement surgery.  Here is a quote: 

 

“…the typical soft tissue compensations I have clinically experienced (notice fine personal touch to the incorrect data, by JMS). When the femoral head slips posterior (i.e. posterior subluxation), I propose it begins to ride the edge of the acetabulum, thus creating a hip joint instability. The most common compensation pattern involves the gluteus medius and minimus muscles, the tensor fascia lata and its iliotibial band all contracting around the femoral head to prevent its possible dislocation… yet, I propose that this (posterior luxation of the femoral head by JMS) fixes the femoral head against the lip of the acetabulum which over many years grooves a flat spot on the naturally spherical shape of the bone.” 

 

According to the author this flat spot is the beginning of AN. As usual, Mr. Alexander’s interpretation of the medicine is incorrect as is the majority of his misleading writings. First of all, excessive lateralization of the femoral head (i.e. the femoral head moves laterally inside of the joint) is the first stepping stone in avascular necrosis (AN). As a result of lateralization (not posterior subluxation which is groundlessly advocated by the author) the pressure is put on the medial circumflex artery and it decreases oxygenation of the bone with the subsequent formation of AN in the femoral head (Moberg et al., 2000). While scientists around the world see lateralization as the first stepping stone in the development of AN, Mr. Alexander uses Massage Therapy’s national platform to promote groundless ideas he cooks up by himself.  

 

The main force responsible for the lateralization of the femoral head is spasm in the gluteus minimus muscle (Beck et al., 2001). The gluteus medius and tensor fascia lata muscles as well as the iliotibial band which the author throws into the pot do not have anything to do with AN. 

 

REFERENCES

1. Beck M, Woo A, Leunig M, Ganz R. Gluteus minimus-induced femoral head deformation in dysplasia of the hip. Acta Orthop Scand 2001 Feb;72(1):13-7. 

2. Moberg A., Hanson G. Kaniklides C. Acetabulum-head index measured on arthrograms in children with Legg-Calvé-Perthes disease. J Pediatr Orthop B, 2000 Oct; 9(4):252-6. 

3. Ruff CB. Biomechanics of the hip and birth in early Homo. Am J Phys Anthropol 1996 Jan; 99(1):229.  

 

Comprehensive Manual Therapy for Breast Cancer Survivors. Massage Today, January, 2015, Vol. 15, Issue 01 

By Shea Shulman, LMT, CLT, Nancy Strand, LMT and Elaine Dohms, LMT, CLT-LANA 

 

Bravo! This is what clinical articles should be! It was especially refreshing to read it after the previous article by Mr. Alexander. 

 

Hands-On Learning in the Dissection Lab. Massage Today, January, 2015, Vol. 15, Issue 01 

By David Kent, LMT, NCTMB 

 

This article is very basic but it touches the important subject of the dissection lab and this is key knowledge for the therapist. There is no anatomy book or 3-D program which can substitute for the dissection lab. 

 

Reducing Hypertension with Massage Therapy. Massage Today, February, 2015, Vol. 15, Issue 02 

by MK Brennan, Beth Barberree, Renee Stenbjorn 

 

The article discusses the results of a study that was published in the International Journal of Preventive Medicine in 2013. In this study the effect of a Swedish Massage session on pre-hypertensive women was tested against general relaxation in the same environment. The authors detected a decrease of systolic and diastolic pressure up to 72 hours after the massage session versus no changes in the control group. 

 

First of all we would like to thank the authors who shared these data with therapists and showed them the larger benefits of massage therapy. We would like the readers to pay attention to the modality which was used in the study – Swedish Massage. If a basic massage therapy session was able to decrease arterial blood pressure, imagine what Medical Massage with its specially designed protocol does for the treatment of hypertension! 

 

Hands That Remember. Massage Today, February, 2015, Vol. 15, Issue 02 

By Marie-Christine Lochot, LMT 

 

A very interesting article about the power of touch. It will be especially interesting to those who work with terminally ill or overstressed clients. 

 

Treatment With No Clear Protocol. Massage Today, February, 2015, Vol. 15, Issue 02 

By Debbie Roberts, LMT 

 

An excellent piece! The author exhibits a lot of clinical skills but she also touches a critically important subject: the validity of treatment protocols from different sources which frequently contradict each other and are constantly showered onto therapists by educators. The author illustrates one important point: protocols are general guides which must be adjusted to each patient separately. If the educator promotes recommendations as 100% clinically effective when the therapist follows them to the letter, he or she simply doesn’t know what he or she is talking about. The clinical reality shouldn’t be adjusted to fit the system of personal beliefs. Instead the personal beliefs must be flexibly adjusted to the clinical reality to achieve quick and stable clinical results. 

 

When Cancer Involves the Liver. Massage Today, February, 2015, Vol. 15, Issue 02 

By Tracy Walton, LMT, MS 

 

This article discusses massage therapy for cancer patients using liver cancer as a main topic. The information in the article is very basic but has important practical potential for those who are not familiar with these patients. Here is an important quote as an example:  

 

“…the therapist should treat any new and unfamiliar pain as possible bone involvement and therefore possible instability of the bone tissue. Any time pain is new, unfamiliar or has not yet been reported to the client’s doctor, the massage therapist should refer the client to their physician for support.” 

 

 

Exploring Elusive Knee Pain. Massage Today, February, 2015, Vol. 15, Issue 02  

By Whitney Lowe, LMT 

 

A very good article on Medial Plica Syndrome which is felt by the patient as medial knee pain with or without clicking noise. We have only one addition. This is a extremely rare pathological condition and the therapist must rule out more common abnormalities first since they will exhibit exactly the same clinical picture as Medial Plica Syndrome. 

 

The Nature of Adhesions. Massage Today, February, 2015, Vol. 15, Issue 02 

By Linda LePelley, RN, NMT 

 

This article is complete craziness. Readers of JMS may remember Mrs. LePelley’s initial explanation of elevated tissue density developed in the soft tissue as a result of cholesterol deposit. After almost two years of our fight with such nonsense, Mrs. LePelley officially retracted her weird ideas and even promised to all readers she wouldn’t speculate about the theory of soft tissue tension anymore. Here is her quote from Massage Today Vol 11, issue 14, 2014: 

 

“I resolved to refrain from further open speculation about the cause of elevated TD”. 

 

The author promised to all of us in print that from now on she would refrain from further open speculation! And now another blow to science is delivered by Mrs. LePelley.

 

Actually, we wish Mrs. LePelley had stayed with her cholesterol theory since her new theory is odder if this is even possible. We are ‘delighted’ that Mrs. LePelley returned to open speculation and discovered an even more absurd cause for elevated soft tissue density. Pause for a second before you will read this: 

 

“The nature of the adhesions in the soft tissues of the human body is similar to the properties of hide glue (i.e., glue made from the mammal skin! by JMS).” 

 

We ask readers to Google “How to make hide glue” and read the basic requirements. The main one is temperature. The water where a mammal’s tissues are placed must be boiled to 212F and after that the temperature decreased to simmer for some period of time. Mrs. LePelley needed somehow to avoid boiling temperatures since they are killing her theory that soft tissue adhesions are similar to hide glue. Here is her genius quote:  

 

“Back to my initial concern that the heat required to render glue from hides would make it impossible to create it in the human body. I realized that there is no need for our bodies to extract the proteins, they already exist in a useable form within our tissues. All that is needed to cause adhesive glue formation within our bodies is to reach the right temperature under the right conditions.” 

 

First of all, as we previously proved to the readers and Mrs. LePelley that soft tissue adhesions start as glycoproteins – not proteins – and there is not any correlation between increased local temperature and the formation of collagen fibers in the areas of the initial glycoproteins’ deposit. For example, in the area of chronic trigger points there is a decrease in blood circulation and thus there is no increased body temperature (this is the glycoproteins deposit stage). Eventually, constant reactivation of trigger points will activate collagen fiber deposit (this is the protein deposit stage). 

 

Mrs. LePelley has another problem in her theory – the temperature needed to activate hide glue so that it becomes liquid before it hardens. To prove her weird theory Mrs. LePelley informed readers that she consulted professional sources in hide glue manufacturing and application, or more precisely, furniture restorers. Here is the quote: 

 

“I’ve read several articles about the use of hide glue, the temperature of glue activation can range between the low 100s up to 145 degrees, and will depend on the grade of glue.” 

 

As everyone knows, normal body temperature is 98.6 F, and 100.4F is considered to be fever and 104F is life threatening fever. Thus the author tries to convince readers that formation of the adhesions in the soft tissues after, let’s say, scarification of fascia happens when the affected area is in acute fever while the rest of the body is not. 

 

However, knowing the low standards of Mrs. LePelley’ articles (despite that she is a RN), there is something fishy about activation of hide glue by a low 100s temperature. So we decided to follow the pathway Mrs. LePelley already took. We consulted the Professional Restorers International Journal and an article written by the Senior Furniture Conservator of the Smithsonian Institution (Williams, 2008). Here is a quote from his article: 

“… hide glue can then be heated to a usable liquid form. This is accomplished in a double boiler or a glue pot at a temperature warm enough to liquify the glue but not hot enough to break down the collagen too rapidly. For most uses glue is heated to and used at approximately 140 degrees F” (bold by JMS). 

 

So Mrs. LePelley misled readers to fit data into her ridiculous theory. This article approaches the absurd and it is unfortunate. 

 

REFERENCES

Williams D.C. Adhesives For Wood Restoration. Professional Restorers International. 2008 

 

Rational Treatment for Scoliosis. Massage Today, February, 2015, Vol. 15, Issue 02 

By Don McCann, MA, LMT, LMHC, CSETT 

This article is about treatment of Scoliosis by the author’s method which is actually kinesiology. The author is correct that addressing misalignment of the pelvis is an important part of Scoliosis therapy. As a matter of fact, the therapist should use the pelvis as a leverage tool to decrease pressure within the curvature. However as usual, Mr. McCann fails to understand that changes in the pelvis are secondary to the curvature and curvatures themselves are main target of the therapy. 

 

 

MASSAGE&BODYWORK MAGAZINE

 

Defect or Defense. Massage&Bodywork Magazine, 2015, Jan-Feb: 6-27. 

By Douglas Nelson 

 

This is an excellent article which in a very simple form illustrates a critically important issue which many educators and therapists are missing. Using a clinical case as an example, the author illustrates the fact that structural abnormalities which the therapist sees in patients in a majority of cases is the body’s defense reaction in the form of protective muscle tension or as the author correctly calls antialgic positions. 

From article to article and from seminar to seminar we hear the same thing: the therapist must detect and correct structural abnormalities to eliminate the pain the patient feels. Mr. D. McCann is a main proponent of this misleading concept. 

In clinical reality as it correctly is put by the author of this article, the structural abnormalities are the body’s response to the pain and chasing them is the same as chasing the pain which is in a sense chasing a ghost. The therapist who practices clinical applications of massage must find and eliminate the source of the pain rather than its consequences. In many cases removing the source of pain brings back normal body mechanics and symmetry. Thank you for this excellent article with very important content! 

 

Reflections on Mirror Therapy. Massage&Bodywork Magazine, 2015, Jan-Feb: 36-39. 

By Ruth Werner 

 

The subject of this article is the healing effect of Mirror Therapy, which is a very interesting psychological phenomenon. It is very educational for the therapist to read and the article illustrates how important the role of the brain is in the formation of pain perception. We also discussed mirror therapy in our article about the Neuromatrix Theory of Pain in the #1 Issue of JMS

 

Pectoralis Major. Massage&Bodywork Magazine, 2015, Jan-Feb: 41-42 

By Christy Cael 

 

An informative article on the anatomy, function and palpation of the pectoralis major muscle. 

 

Massage Therapy Reduces the Blood Pressure. Massage&Bodywork Magazine, 2015, Jan-Feb: 44-47 

By Jerrilyn Cambron 

 

This article reviews the meta-analysis of studies examining the antihypertensive effect of massage therapy. There was an average 6.9 mm Hg reduction in systolic pressure and 3.6 mmHg reduction in diastolic pressure. 

 

As we mentioned above, the antihypertensive effect of regular massage therapy is nothing compared to the clinical effectiveness of Medical Massage protocols. In a pilot study conducted by B. Prilutsky for Back and Limb Institute in Los Angeles he showed that Medical Massage therapy is able to completely control blood pressure in cases of Essential Hypertension when all anti-hypertensive medications have failed. 

 

Six Short Stories About Biomechanics of Movement. Massage&Bodywork Magazine, 2015, Jan-Feb: 74-85 

By Andrew Biel 

 

An excellent educational article which is greatly written and fun to read! 

 

Helping Dustin Play. Massage&Bodywork Magazine, 2015, Jan-Feb: 94-97 

By Whitney Lowe 

 

This is a very good article on focal dystonia as a result of repetitive motions and chronic overload of motor pat of the nervous system. The only missing part of the article is massage therapy itself as a treatment option.

A informative description of symptoms and evaluation requires solid clinical recommendations and they are completely absent in this article, which greatly diminishes its practical value. In reality Medical Massage therapy can be an essential tool to eliminate dystonia. We illustrated the effect of Medical Massage on dystonia in one case from our clinic (see JMS, Issue #2, 2010 ‘Medical Massage Vs. Medical Mystery’). 

 

Clicking Jaw Syndrome. Massage&Bodywork Magazine, 2015, Jan-Feb: 99-100 

By Erik Dalton 

 

A very good and informative article. 

 

Working with Diaphragm. Massage&Bodywork Magazine, 2015, Jan-Feb: 106-109 

 By Til Luchau 

 

A very good article on working with the diaphragm. There is, however, one issue that we greatly disagree with. Quoting the author;

“Instead of digging under the ribs for the diaphragm you can safely use the bone edge of the costal arch to open the umbrella of the diaphragm in a very effective way…” 

 

This suggests you should address the diaphragm from the outside only and basically denies the necessity of working on the fibers of the diaphragm itself. To be clinically effective the therapist must combine work along the costal arch (which the article suggests) and under the arch (which the article denies). There is no way that only working under the costal arch or only working along the costal arch can be clinically efficient. These two approaches are two sides of the same coin and the author unfortunately fails to understand that. 

 

Another issue is “digging under the ribs.” We would like to inform the author and readers that the correct application of the Diaphragm Technique from the Medical Massage arsenal does not require “digging,” but uses the patient’s active abdominal respiration to work on the diaphragm directly. 

 

Always On. Massage&Bodywork Magazine, 2015, Mar-Apr: 26-27 

By Douglas Nelson 

 

A good article using the author’s case as an example which emphasizes the relationship between an affected muscle and the neighboring ones. 

 

Platysma. Massage&Bodywork Magazine, 2015, Mar-Apr: 42-44 

By Christy Cael 

 

An informative article on the platysma muscle, its anatomy, function and palpation. 

 

Massage Therapy Eases Fibromyalgia. Massage&Bodywork Magazine, 2015, Mar-Apr: 46-49 

By Jerrylin Cambron 

 

It would be trivial to say that Fibromyalgia is a serious problem since everyone knows about it, but discussion about the treatment options is a completely different story. This article informs readers that massage therapy helps to ease symptoms associated with Fibromyalgia. It is based on meta-analysis of several studies which examined the effect of massage on Fibromyalgia patients. Unfortunately, the article doesn’t mention what type of massage was used by researchers.  

Even basic Swedish massage is beneficial for patients. However, Medical Massage has much better clinical outcomes and more stable results. Recently K. Mooney, who is our Person of the Month for this issue of JMS, illustrated this clinical observation with her PhD research. 

 

Groin Pulls. Adductor Longus Strain and Iliopsoas. Massage&Bodywork Magazine, 2015, Mar-Apr: 90-95 

By Whitney Lowe 

 

A very good article on the subject of groin pain due to the adductors and iliopsoas strain. This is a very positive change compared to previous articles by the same author. Almost in every Good Apples/Bad Apples section of the JMS we’ve emphasized the important component Mr. Lowe missed in his clinical recommendations – application of muscle energy techniques. This is an integrative part of every clinical application of massage therapy and we are glad Mr. Lowe finally recognizes that. 

 

Text Neck and Desktop Neck. Massage&Bodywork Magazine, 2015, Mar-Apr: 97-98 

By Erik Dalton 

 

In this era of computers and sitting jobs, neck pain and disbalance have become a frequent pathology. This article explains the chain of pathological events associated with forcing the position of the head and neck. 

 

Working With Mesentery. Massage&Bodywork Magazine, 2015, Mar-Apr: 106-109 

By Til Luchau 

 

A great article! 

 

MASSAGE MAGAZINE

Whiplash. Massage Magazine, 2015, Issue 225, Feb.: 46-49 

By Douglas Nelson, LMT 

 

A very good article on the mechanisms of whiplash and its impact on the function of musculoskeletal and central nervous systems. Unfortunately, Massage Magazine’s journalistic format didn’t allow the author to fully discuss massage treatment options, but he did well to cover the topic. 

 

Pediatric Massage. Massage Magazine, 2015, Issue 225, Feb.: 46-49 

By Tina Allen, LMT, CPMMT, CPMT, CIMT 

 

The topic of this article is very important while article itself is a very poor source of clinical information. There is nothing to learn from the article other than pediatric massage is good and it helps children in a hospital setting.  

 

Diabetic Client. Massage Magazine, 2015, Issue 226, Mar.: 36-40 

By Jimmy Gialelis, LMT, BCTMB 

 

A good review of very basic information on diabetes and massage therapy’s role in its management. 

 

Myofascial Techniques. Massage Magazine, 2015, Issue 226, Mar.: 42-45 

By Til Luchau 

 

There are good parts to this article. The author tries to explain the difference between migraine and tension type headaches. However, there are a lot of misrepresentations and repetition of unscientific claims previously advanced by the author.  

 

For example, an illustration of migraine headache points to the brainstem as a place where the pain center is located. There is no one pain center in the brain and the author who publishes his articles nationally must know or at least research this basic fact. Pain is a product of very complex interactions of different parts of the brain – thalamus, amygdala, nucleus accumbens and so on. Their combined work gives the brain the ability to synthesize the pain sensation. 

 

In the treatment part of the article Mr. Luchau again suggests treating migraines by working inside the patient’s mouth on the hard palate. We already reviewed this absurd recommendation in Good Apples/Bad Apples section of  Nov/Dec issue 2010, where we caught Mr. Luchau manipulating medical sources and intentionally misleading therapists. It is simply wrong since it puts patients on the losing side. 

 

Body Mechanics Makeover. Massage Magazine, 2015, Issue 226, Mar.: 64-66 

By Mirra Greenway, LMT 

 

A very informative article on the necessity of correct body mechanics for therapists while they are working with clients. 

 

Hospital Massage. Massage Magazine, 2015, Issue 227, Apr.: 36-44 

By Laura Koch, LMT 

 

This article is about application of therapeutic massage in a hospital setting. The article gives a general review of the subject. It also tries to answer the question of why massage isn’t in every hospital. Unfortunately, the article fails to find the correct answer since according to the author, the major reason is the need for correct or additional marketing. The real reason why massage isn’t in every American hospital is very simple – the lack of medically trained therapists. This article reflects a much bigger issue which we have observed in the profession. 

 

Here’s a simple example:  The front cover of issue 227 of Massage Magazine mentioned this article under a different name – Medical Massage. We don’t think the massage community clearly understands the difference between Therapeutic Massage and Medical Massage. 

Swedish Massage is an important tool of preventive medicine, but it doesn’t have anything to do with Medical Massage. In other words, the concept of Medical Massage constitutes a special medical procedure rather than a place of treatment (i.e., Swedish Massage conducted in a hospital setting). There are specially designed and clinically tested Medical Massage protocols for every inner organ abnormality from rehabilitation after heart attack to psoriasis. Thus as long as massage therapists continue to see Medical Massage as a place of therapy, rather than special method the massage will never be fully incorporated into the hospital setting. Additional marketing will never help. The therapist must deliver results and do so quickly and efficiently! 

 

 

MASSAGE THERAPY JOURNAL

 

Body Mechanics. The Price Of Smart Phone. MTJ, 2015, 54(1): 17-24 

By Joseph E. Muscolino 

 

As usual with this author, it is a very good article. The author discusses the biomechanical price we pay for extensive use of Smart Phones and how it affects the health of our musculoskeletal system. We suggest readers pay attention to the diagram illustrating Upper Crossed Syndrome proposed by Dr. Janda.

 

 

Massage + Trigger Points. MTJ, 2015, 54(1):46-51 

By Christian Bond 

 

This article reviews trigger points and the role massage therapy plays in their treatment. The author identifies the cause for trigger point formation as acute, sustained and repetitive muscle overload. It is correct but it is only 50% correct since the medical community no longer sees the formation of trigger points solely as a result of muscle overload. 

 

The original theory that explained the nature of trigger points was developed by Dr. Mackenzie and Dr. Shade and emphasized the neurological origin of trigger points. Both authors pointed to trigger points as an early sign of reflex zones formation in the skeletal muscle. Work by Dr. Travel and Dr. Simmons shifted the cause of formation of trigger points to acute or chronic muscle overload. However, more and more authors recommended reconsidering this shift and bringing back the neurological origin of trigger points as an equally important mechanism of trigger point’s development. 

 

Why is it so important for practitioners to keep in mind both origins of trigger points – muscle overload and mild irritation of the nerve supplying the muscle which harbors trigger points? 

This understanding is crucial since it completely changes the treatment protocol. If trigger points develop as a result of muscle overload the local Trigger Point Therapy described in the article would be the correct treatment choice. However, if the trigger point is a sign of reflex zones formation, local Trigger Point Therapy is completely useless. Yes, it will bring temporary relief since it will decrease the activity of the trigger point, but it will never eliminate it since local Trigger Point Therapy only patches the problem. If trigger points develop secondarily to the irritation of the peripheral nerve, the only correct solution is freeing the nerve, decreasing its inflammation and only after that using local Trigger Point Therapy (if needed) to finish the job. 

From experience in our clinics in Arizona, California and Texas we can say with certainty that in the majority of our patients the trigger points have neurological origin. To read more on this subject, see our four-part article about trigger points and Trigger Point Therapy in issues  #2; #3; #4; #5 2009 of JMS

 

 

Treating Myofascial Trigger Points For Relieving Chronic Shoulder Pain: What Research Tells Us. MTJ, 2015, 54(1):52-53 

By Martha Brown Menard, PhD, LMT 

 

This article is a great source for the latest scientific data on trigger points and their treatment using massage therapy. 

 

 

 


Category: Good Apples, Bad Apples

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