Trigger Points in muscle and other soft tissue are one of the most common causes of a wide variety of pain and dysfunction, including (but not limited to):
• Achy persistent pain
• Severe local pain
• Arm / leg pain
• Back pain
• Radiating pain
• Weakness
• Stiffness
• Pain resulting from a medical condition, such as
– Migraines
– Sciatica
– TMJ dysfunctions
– Arthritis
– Fibromyalgia
– Carpal tunnel syndrome
– Soft tissue injuries
– And more…
The levator scapula is a muscle located in your neck. It originates on the transverse processes of C1-C4 vertebrae. It inserts on the superior part of the medial border of the scapula. This muscle acts to elevate the scapula and rotate the glenoid fossa downward. At the cervical attachment it acts to rotate the neck to the same side and assists extension. Trigger points will refer pain into the angle of the neck with spillover into the scapula. When this muscle is tight due to trigger points it will restrict neck rotation causing the classic stiff neck. With a forward head position this muscle often becomes stretched and over worked.
It’s that time of year again. Those colorful leaves falling from the trees will soon leave you with a big mess on the lawn and a new chore to add to your to-do list. Before grabbing the rake, take these tips into consideration to avoid the soreness and injury that commonly accompany leaf raking.
1. Stretch
It may not seem like a workout, but leaf raking can be a very strenuous activity, especially if you’re not regularly active already. Be sure to do a quick warm-up to get your muscles ready and stretch to limit soreness in your neck, shoulders, and back.
2. Use the Right Equipment
Make sure you’re using a rake that’s the correct size for your height. A rake that’s too small will cause you to bend over more often and put more stress on your back. Wear gloves to protect your palms.
3. Use Correct Posture
Keep your back straight and upright. You’ll want to bend at the knees – not the waist – when picking up your piles and always avoid twisting your torso.
4. Switch Arms Often
Avoid an overuse injury with your dominant arm by switching sides frequently.
5. Take Breaks
Remember to give yourself a little recovery time now and then and stay hydrated. Taking frequent breaks will help you avoid exhaustion and strain.
As with any form of physical activity, listen to your body. Any sudden, sharp, or persistent pain is not normal. Stay safe by following these tips and be sure to give our office a call if you experience any neck, shoulder, or back pain this fall.
Session Description
A treatment with Bryan is very user friendly. And, no, you don’t have to remove any clothing. However, bringing a t-shirt and a pair of shorts or sweats is recommended.
The first time you come for a treatment you will be asked to fill out a Client History form. Bryan will go over the information you provide, asking for more detail and discussing the type of pain you are having and its location.
The treatment itself involves locating the Trigger Points in the muscle or soft tissue and applying a deep focused pressure to the Point. This will reproduce the pain and the referral pattern that is characteristic of that pain.
The treatment will be uncomfortable at first, but as the Trigger Points release, the pain will decrease. The pressure will always be adjusted to your tolerance level. If, at any time, you feel too uncomfortable you can ask Bryan to ease off a bit.
Depending on your specific problem, Bryan may also use some stretching and / or range-of-motion techniques, as needed.
After treatment, it is usually recommended that the client apply moist heat to the area treated.
What the Heck Is a Trigger Point?
By Bryan Cobb, Advanced Remedial Massage Therapist
What is a Trigger Point?
Trigger Points (TP’s) are defined as a “hyper-irritable spot within a taut band of skeletal muscle. The spot is painful on compression and can evoke characteristic referred pain and autonomic phenomena.”1
Put into plain language, a TP is a painful knot in muscle tissue that can refer pain to other areas of the body. You have probably felt the characteristic achy pain and stiffness that TP’s produce, at some time in your life.
TP’s were first brought to the attention of the medical world by Dr. Janet G. Travell. Dr. Travell, physician to President John F. Kennedy, is the acknowledged Mother of Myofascial Trigger Points. In fact, “Trigger Point massage, the most effective modality used by massage therapists for the relief of pain, is based almost entirely on Dr. Travell’s insights.”2 Dr. Travell’s partner in her research was Dr. David G. Simons, a research scientist and aerospace physician.
Trigger Points are very common. In fact, Travell and Simons state that TP’s are responsible for, or associated with, 75% of pain complaints or conditions.1 With this kind of prevalence, it’s no wonder that TP’s are often referred to as the “scourge of mankind”.
Trigger Points can produce a wide variety of pain complaints. Some of the most common are migraine headaches, back pain, and pain and tingling into the extremities. They are usually responsible for most cases of achy deep pain that is hard to localize.
A TP will refer pain in a predictable pattern, based on its location in a given muscle. Also, since these spots are bundles of contracted muscle fibres, they can cause stiffness and a decreased range of motion. Chronic conditions with many TP’s can also cause general fatigue and malaise, as well as muscle weakness.
Trigger Points are remarkably easy to get, but the most common causes are
•
TP’s (black dots) can refer pain to other areas (red)
Sudden overload of a muscle
• Poor posture
• Chronic frozen posture (e.g., from a desk job), and
• Repetitive strain
Once in place, a TP can remain there for the remainder of your life unless an intervention takes place.
Trigger Points Not Well Known
With thousands of people dealing with chronic pain, and with TP’s being responsible for — or associated with — a high percentage of chronic pain, it is very disappointing to find that a large portion of doctors and other health care practitioners don’t know about TP’s and their symptoms.
Scientific research on TP’s dates back to the 1700’s. There are numerous medical texts and papers written on the subject.
But, it still has been largely overlooked by the health care field. This has led to needless frustration and suffering, as well as thousands of lost work hours and a poorer quality of life.
How Are Trigger Points Treated?
As nasty and troublesome as TP’s are, the treatment for them is surely straight-forward. A skilled practitioner will assess the individual’s pain complaint to determine the most likely location of the TP’s and then apply one of several therapeutic modalities, the most effective of which is a massage technique called “ischemic compression”.
Basically, the therapist will apply a firm, steady pressure to the TP, strong enough to reproduce the symptoms. The pressure will remain until the tissue softens and then the pressure will increase appropriately until the next barrier is felt. This pressure is continued until the referral pain has subsided and the TP is released. (Note: a full release of TP’s could take several sessions.)
Other effective modalities include dry needling (needle placed into the belly of the TP) or wet needling (injection into the TP). The use of moist heat and stretching prove effective, as well. The best practitioners for TP release are Massage Therapists, Physiotherapists, and Athletic Therapists. An educated individual can also apply ischemic compression to themselves, but should start out seeing one of the above therapists to become familiar with
the modality and how to apply pressure safely.
1 Simons, D.G., Travell, D.G., & Simons, L.S. Travell and Simons’ Myofascial Pain and Dysfunction: the Trigger Point Manual.
Vol. 1. 2nd ed. Lippincott, Williams, and Wilkins, 1999.
2http://www.muscletherapyworks.com/MTW%20Biography%20T%20&%20S%2001.htm
“A new study in Spine Journal found that immobilization of a joint leads to rapid degeneration and arthritis. Chiropractors are uniquely trained to identify and resolve joint restrictions via safe and effective manipulation. Click here to watch how it works.”
Low back pain during pregnancy is quite common. In fact, between 50-75% of all pregnant women will experience low back pain. The pain is usually caused from rapid changes in weight, posture, gait and hormones.
The average woman gains between 20-40 pounds throughout pregnancy. This weight gain moves your center of gravity forward, causing your pelvis to tilt and your lower back to sway – placing excessive stress on the ligaments, discs, and joints of your spine.
Pregnancy-related low back pain typically starts between the fifth and seventh month of pregnancy, although a significant portion of women experience pain sooner. Symptoms often begin at the base of your spine and may radiate into your buttock or thigh. Discomfort is often aggravated by prolonged standing, sitting, coughing, or sneezing. Your symptoms may increase throughout the day, and some patients report nighttime pain that disturbs their sleep. The extremes of activity seem to contribute to pregnancy-related low back pain – with increased risk for both “sedentary” and “physically demanding” lifestyles. Patients who have suffered with back pain prior to pregnancy are more than twice as likely to re-develop back pain during pregnancy.
Be sure to tell your doctor if your symptoms include fever, chills, bleeding, spotting, unusual discharge, cramping, sudden onset pelvis pain, light-headedness, shortness of breath, chest pain, headache, calf pain or swelling, decreased fetal movement, or symptoms that radiate beyond your knee.
Unfortunately, pregnancy related low back pain occurs at a time when your medical treatment options are limited. Not surprisingly, over 90% of prenatal health care providers would recommend drug-free treatment, including the type of alternative therapy provided in this office. Studies have shown that chiropractic manipulation provides significant relief of pregnancy-related low back pain. Almost 75% of women undergoing chiropractic care report significant pain reduction with improved ability to function.
Most patients will also benefit from continuing aerobic exercise throughout pregnancy. The US Department of Health and Human Services advises that healthy pregnant women may begin or continue moderate intensity aerobic exercise for at least 150 minutes per week. Women should not begin “vigorous” exercise during pregnancy, but those who were preconditioned to vigorous exercise may continue. Be sure to check with your doctor prior to initiating or increasing any exercise program while you are pregnant.
Be sure to take frequent breaks from prolonged sitting or standing. You may find benefit by using a small foot stool to alternate feet while standing. Sleeping with a pillow between the knees in a side lying posture may help you to rest more comfortably. You should wear shoes with good arch supports. In some cases, your chiropractor may recommend a sacroiliac belt or pelvic support belt to help relieve your pregnancy-related low back pain.
According to the European Spine Journal, Chiropractic care was proven to be an effective treatment for acute back pain (pain that occurs suddenly and is often more sharp and severe).
“The European Spine Journal published guidelines for treating acute LBP and Radiculopathy:
o Employ: Manual therapy, exercise, and patient education about prognosis, warning signs, and advice to remain active.
o Avoid: routine use of imaging, extra-foraminal steroid injections, acetaminophen, NSAIDs, and opioids.
If you or someone you know suffers from back pain, follow the proven advice and call our office today.”
Resisted Shoulder Retraction
*This exercise may also be performed using a cable row machine or by looping a piece of elastic resistance band over your feet while sitting on the floor with your legs directly in front of you.
Your nervous system is basically a big electrical circuit. Your spinal cord transmits all of the electrical nerve impulses between your brain and lower back. From there, individual nerves emerge from your spine then travel to supply sensation and movement to a specific area of your buttock, legs and/or feet. This allows you to move and feel sensations like touch, heat, cold and pain. Anything that
interferes with this transmission can cause problems.
You have been diagnosed with a “Lumbar Radiculopathy”. This means that one or more of the nerves emerging from your lower back has become irritated or possibly pinched. This often results in pain, numbness or tingling in the specific area of your leg that is supplied by the irritated nerve. The term “Sciatica” is often used to describe this condition, because most (but not all) “lumbar radiculopathies” involve the sciatic nerve which supplies the back & outside of your thigh and calf. Symptoms of a lumbar radiculopathy may vary from a dull ache to a constant severe sharp shooting pain. Your symptoms are likely aggravated by certain positions or movements.
To solve this problem, we will treat the source of your nerve irritation. It is important for you to follow your treatment plan closely and be sure to tell us immediately if you experience any progression of your leg pain, numbness or weakness.
Summer is winding down, and families across America are gearing up for the beginning of a new school year. Help your kids (or yourself) start the year off right by considering some of our healthy back-to-school tips.
Although backpacks are practical, carrying around heavy books and supplies every day can cause discomfort and injury over time.
Be sure to do a quick backpack check:
Encourage your child to practice good posture when sitting in the classroom. Hunching over the desk for hours every day is sure to cause discomfort.
To sit at a desk correctly, they should:
forward head posture, which will strain the neck. Consider purchasing a desktop bookstand to help prop the book up to eye-level.
Back-to-school also means back-to-sports for many kids. Remember that if your child was inactive in their sport for a couple of months, they might need to ease back into it. Always encourage them to warm-up beforehand, stretch afterward, and keep their workouts reasonable for their conditioning level and age.
By being proactive in your child’s health, you can help prevent problems. If your child does experience back, neck, head, or joint pain this school year, please give us a call.
