the glute medius is a major pelvic stablizer. It is often overworked in runners and hockey players. trigger points in this muscle will cause pain to be felt in the hip and down the back of the leg.
Pain
Trigger points.
Trigger points are knots of contracted muscle or connective tissue that form as a result of overload stress. Once formed these points will produce pain, refered pain, weakness, and stiffness. Trigger points can also mimic other conditions such as Carple tunnel syndrome and sciatica. Trigger points will on go away on their own, they must be manually released.
Trigger points in the sternocleidomastoid muscle
The sternocleidomastoid muscles are two strap like muscles located in the front of you neck. They often become overworked from poor sitting posture. Trigger points in these muscles will cause referral pain into the head and around the eye, causing migraine type pain.
Trigger points in the trapezius muscle.
The trapezius muscle is a large diamond shaped muscle located in your back. This muscle is often overloaded due to poor sitting posture or excessive exercise. When this occurs trigger points will form. These points can cause back, neck, and shoulder pain. Trigger points in the upper traps are a leading cause of headache.
Fibromyalgia and Sleep
Is there a connection between fibromyalgia (FM) and sleep disturbance? Let’s take a look!
FM is a condition that causes widespread pain and stiffness in muscles and joints. Patients with FM often experience chronic daytime fatigue and some type of sleep problems like getting to sleep, staying asleep, and/or feeling restored in the morning upon waking. The National Institutes of Health estimates between 80-90% of those diagnosed with FM are middle-aged women, although it can affect men and happen at any age. As little as 10-20 years ago, it was hard to find a doctor who “believed” in FM, and it was common for the patient to be told that their pain “was all in their head.” FM has now been studied to the point that we know it is a real condition, and it affects between 2-6% of the general population around the world.
It is well established that sleep disturbance frequently occurs after surgery, which usually normalizes as time passes. One study used a group of healthy women who were deprived of sleep (particularly slow wave sleep) for three days to see if there was a link between sleep disturbance and pain. Results confirmed that the women experienced a decrease in pain tolerance and increased levels of discomfort and fatigue after three days—the same symptoms found among FM sufferers!
Fibromyalgia may have NO known cause, or it can be triggered by other conditions such as repetitive stress injuries, car crash injuries, and other forms of trauma. FM also appears to run in families though it’s still NOT clear if this is a true genetic link or caused by shared environmental factors. Some feel FM is a rheumatoid condition, and though FM is NOT a true form of arthritis, it has been found that people with arthritis are more likely to have FM.
FM sufferers frequently suffer from conditions such as irritable bowel syndrome, chronic fatigue syndrome, migraine headaches, arthritis, lupus, and major depressive disorders. Approximately 20% of FM patients have depression and/or anxiety disorders, and a link between chronic pain and depression exists and seems to play a role in people’s perception of pain.
Because conditions such as sleep apnea can result in symptoms similar to FM, it’s recommended that patients suspected of FM keep a sleep/sleepiness diary in order to rule out sleep apnea as a cause for their condition.
There are many “tips” for improving sleep quality, which we will dive into next month, as these may prove VERY HELPFUL in the management of FM!
If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!
Trigger points in the gluteus Maximus muscle.
The gluteus Maximus muscle makes up your buttock. It’s is a powerful hip extensor and thus used heavily during activities such as walking, running, and climbing up stairs. Most atheletes abuse this muscle. When overworked trigger points will form, and these points will cause pain to be felt in the hip, sacrum and the as well as deep in the gluteal area. Litterally a pain in the butt!! Trigger points won’t release on their own and require interventions like trigger point massage.
MRI Truths & Myths
Low back pain is a very common complaint. In fact, it’s the #1 reason for doctor visits in the United States! The economic burden of LBP on the working class is astronomical. Most people can’t afford to be off work for one day, much less a week, month, or more! Because of the popularity of hospital-based TV dramas over the past two decades, many people think getting an MRI of their back can help their doctor fix their lower back problem. Is this a good idea? Let’s take a look!
Patients will often bring in a CD that has an MRI of their lower back to a doctor of chiropractic and ask the ultimate question, “….can you fix me?” Or, worse, “…I think I need surgery.” Sure, it’s quite amazing how an MRI can “slice” through the spine and show bone, soft tissues, disks, muscles, nerves, the spinal cord, and more! Since the low back bears approximately 2/3 of our body’s weight, you can frequently find MANY ABNORMALITIES in a person over 40-50 years old. In fact, it would be quite odd NOT to see things like disk degeneration, disk bulges, joint arthritis, spur formation, etc.!
Hence, the “downside” of having ALL this information is the struggle to determine which finding on the MRI has clinical significance. In other words, where is the LBP coming from? Is it that degenerative disk, bulged disk, herniated disk, or the narrowed canal where the nerve travels? Interestingly, in a recent review of more than 3,200 cases of acute low back pain, those who had an MRI scan performed earlier in their care had a WORSE outcome, more surgery, and higher costs compared with those who didn’t succumb to the temptation of requesting an MRI!
This is not to say MRI, CT scans, and x-rays are not important, as they effectively show conditions like subtle fractures and dangerous conditions like cancer. But for LBP, MRI is often misleading. This is because the primary cause of LBP is “functional” NOT “structural,” so it’s EASY to get railroaded into thinking whatever shows up on that MRI has to be the problem.
Here is how we know this, when we take 1,000 people WITHOUT low back pain between ages 30 and 60 (male or female) and perform an MRI on their lower back, we will find up to 53% will have PAINLESS disk bulges in one or more lumbar disks. Moreover, we will find up to 30% will have partial disk herniations, and up to 18% will have an extruded disk (one that has herniated ALL the way out). Yet, these people are PAIN FREE and never knew they had disk “derangement” (since they have no LBP). When combining all of these possible disk problems together, several studies report that between 57% and 64% of the general population has some type of disk problem without ANY BACK PAIN!
Hence, when a patient with a simple sprain/strain and localized LBP presents with an MRI showing a disk problem, it usually ONLY CONFUSES the patient (and frequently the doctor), as that disk problem is usually not the problem causing the pain! So DON’T have an MRI UNLESS a surgical treatment decision depends on its findings. That is weakness, numbness, and non-resolving LBP in spite of 4-6 weeks of non-surgical care or unless there is weakness in bowel or bladder control. Remember, the majority of back pain sufferers DO NOT need surgery!
We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for back pain, we would be honored to render our services.
Trigger point massage
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.
Is my Shoulder Pain a SITS Tear?
One of the most common causes of shoulder pain is a rotator cuff (RC) tear. To determine just how common this is, one study looked at a population of 683 people regardless of whether or not they had shoulder complaints. There were 229 males and 454 females for a total of 1,366 shoulders. (The participants’ average age was 58 years, ranging from 22 to 87 years old.)
The research team found 20.7% had full thickness rotator cuff tears. Of those with shoulder pain, only 36% had tears found on ultrasound. Of those without shoulder pain, 17% also had tears! Risk factors for an increased for tearing of the rotator cuff include a history of trauma, the dominant arm (ie your right arm if you’re right handed), and increasing age.
In a review of radiologic studies of 2,553 shoulders, researchers found full-thickness rotator cuff tears in 11.75% and partial thickness tears in 18.49% of the subjects for a total of 30.24% having some degree of tearing. In this group, about 40% of tears were found in pain-free shoulders. The researchers concluded that rotator cuff tears are common and frequently asymptomatic.
Both of these studies support the necessity to FIRST consider the patient’s clinical presentation and then correlate that with the imaging results. In other words, the presence of a RC tear on an image (usually MRI or ultrasound) does NOT necessarily mean there is pain (and vise versa)!
So what other things could be causing the shoulder pain? There are many: impingement, tendonitis, bursitis, muscle strain, capsular (and other ligament) sprain, frozen shoulder, and osteoarthritis (the “wearing out” type). Also, rheumatoid arthritis, lupus, polymyalgia rheumatica and other autoimmune types of “arthropathies,” fibromyalgia, a herniated cervical disk, shoulder dislocations, whiplash injuries, and more!
Most importantly, we must NOT forget to include referred pain to the shoulder from an impaired heart (such as coronary heart disease or heart attack), lung, liver, or gall bladder as these problems commonly refer pain to the shoulder and may represent a MEDICAL EMERGENCY!
Meditation and Chiropractic
With growing evidence that meditation has significant health benefits, a 2016 study by a team of researchers from the United States, Spain, and France sought to explain how and why meditation actually works.
The study investigated the difference between “mindful meditation” in a group of experienced meditators vs. “quiet non-meditative activity” in a group of untrained control subjects. After eight hours of mindfulness practice, the meditation group showed a range of genetic and molecular differences, which in turn correlated with faster physical recovery from a stressful situation.
According to researchers, this is the first time a study has documented a rapid alteration in gene expression within meditating subjects. Interestingly, the researchers observed these changes in the SAME genes that anti-inflammatory and pain-killing drugs target! Thus, they speculate that mindful-based training may benefit patients with inflammatory conditions! This and prior studies have prompted the American Heart Association to endorse meditation as an effective cardiac preventative intervention.
Meditation has been found to be helpful for many conditions including stress management, lowering high blood pressure, heart disease, and depression. You can incorporate meditation into your life with three simple meditation exercises! The initial advice is “…go slow and be compassionate and gentle with yourself.” Your mind will try to wander (called our “default mode”) which consumes about half of our day, so try to focus (called “focus mode”)!
1) WALKING MEDITATION: At a slow to medium pace, focus on your feet. Notice how your heel hits the ground and then feel the roll of your foot followed by the big toe pushing off prior to the swing phase. Feel for stones under the foot and other interesting sensations. If your mind starts to wander (default mode), gently bring your attention back to your foot (focus mode). You WILL get better with practice, and you’ll soon find it much easier to “focus” during stressful situations!
2) NOVEL EXPERIENCES: It’s much easier to lose focus on the people you see everyday vs. those seen only one time a month. The next time you arrive home from work, pretend you haven’t seen your spouse/friend in 30 days. Give them your undivided attention. Then, try this on co-workers and other people you see every day. Believe me, they WILL notice a difference!
3) GRATITUDE EXERCISES: When you’re not in their presence, focus on a person’s face and send them a “silent gratitude” for being in your life. Try this on family members, friends, co-workers, and others!
Aberdeen Chiropractic 