I bought the Trigger Point Therapy Workbook, 2nd ed, by Clair Davies after reading a thread on DD about it. The book was $20 at a local bookstore, and is available for a cheaper price at Amazon. I also purchased one of the products the book recommended: a TheraCane, available at Relax the Back stores, which was $45.
The book about relieving soft tissue pain from soft tissue strains and injuries. It deals with three aspects of the pain: where the pain is; where the source is; and how to treat it. The trigger points (where the pain is caused) are clearly illustrated in the book (the illustrations, of a balding middle-aged man in his underwear, are a little disturbing). The area where the pain occurs is also illustrated well. The treatment options, including the Theracane, and other devices (which can be as simple as a hard rubber ball) are also discussed. Generally there are several options for treatment. The treatment advice is a lot like GTG. Do some treatment at various times throughout the day.
I have used the books advice for two main problem areas so far: my feet and my traps/neck. On my left foot, I was had problems with a bruised heel. The pain was referred from the middle of my foot, and after following the treatment, it went away after about a week. I used a rubber ball for most of the treatment. I also used the side of the Theracane for myofascial treatment on my shins. A dowel or broomstick would also work here.
On my traps/neck, I was having pain in my neck, but stretching the neck was not helping, and neither was self massage. The book explained the the pain was referred from trigger points in my traps. I used the Theracane for this.
The Theracane is basically a hard plastic cane with knobs sticking out on both sides- two longer ones on one side, and two short ones on the other. Each knob is useful for different treatments, as well as for leverage.
Apparently the traps are hard to self massage, especially when the knots in the muscles are deep. I was able to use the cane to get pressure on the knot and relieve the tension. The pain in my neck has decreased.
I am not suggesting that this treatment combination is a substitute for massage therapy or chiropractic work. But self treatment is often appropriate, and I think it can complement existing work that you may need to have done.
The book covers other areas of the body as well, including: low back pain; arthritis; headaches; sore knees; accident trauma; tennis elbow; and carpel tunnels syndrome. The book will not solve all trigger point problems, but it helps with many, and is one of the best purchases I have made. The Theracane is a good purchase too, but I wouldn't recommend it unless you have the book first. The book covers myofascial pain as well, but a foam roller is more appropriate in most cases IMO.
For more information, see the following DD threads:
http://www.forum.dragondoor.com/trainin ... ge/320978/
http://www.forum.dragondoor.com/trainin ... ge/319861/
Good stuff
Trigger Point Therapy Wkbk & Theracane
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Turdacious
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Jehoshaphat
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The Book Is Excellent!
I can't say enough about this book, everyone should have a copy. I have had long term pains in both elbows which seemed to be tendonitis. I tried ice treatments, etc. and nothing helped. After obtaining the book I discovered that the pains were the result of trigger points and the pains were gone after only a few days of working out the trigger points.
Stretching.com has some excellent products in addition to the theracane for working out trigger points.
http://www.stretching.com/products/bodytools.asp
Stretching.com has some excellent products in addition to the theracane for working out trigger points.
http://www.stretching.com/products/bodytools.asp
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Turdacious
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Turdacious
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Maza: If you are being serious (which I doubt), the theracane is not essential equipment to get the most out of this book. You can do many of the massages, if not all, with a hard rubber ball (which I use for my foot). For the muscles in the mid back, you can put the ball in a long sock, or a pair of pantyhose (you have the dildos, you probably have the hose), to get to. The Theracane is a tool which makes doing the massages easier. Especially since most of them should be done PTP style- for a few seconds, multiple times a day. You don't have to lay down, or lean against a wall, to use the theracane. The book is worthwile even if you don't buy anything else but a small, hard, rubber ball.
It is worth browsing through at your local bookstore.
It is worth browsing through at your local bookstore.
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Abandoned by Wolves
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Clair Davies performed a HUGE public service by putting this book together, and we bodyworkers all owe him a debt of thanks. TPTWB is a great starting place to learn about trigger point work, and is all the resource that most people will need.
Bonnie Prudden has also been writing educational material about trigger points for laymen and beginners for decades - her two most relevant books are "Pain Free" and "Myotherapy". Bonnie's approach is slightly less accessible, but has a lot in common with Davies, and is a valuable supplement to his material.
Another place to learn LOTs more, in depth, is Sean Riehls' two volume video set (now available on DVD) on Neuromuscular Therapy and Deep tissue massage. (http://www.deeptissue.com) These videos are more about treating trigger points on others, but is worth getting for yourself. Sean has a real gift for making complex material accessible to the average person, and presents simple, straightforward protocols that work like magic at least 70-80% of the time. I've cleared up or greatly improved chronic/long standing wrist pain, headaches, rotator cuff pain for clients and friends in 20-30 minutes or less using this approach. I even self treated a strained wrist tendon (flexor pollici longus) and solved the problem with 2 7-8 minute sessions on myself, using the edge of my other forearm and my fingertips.
Bonnie Prudden has also been writing educational material about trigger points for laymen and beginners for decades - her two most relevant books are "Pain Free" and "Myotherapy". Bonnie's approach is slightly less accessible, but has a lot in common with Davies, and is a valuable supplement to his material.
Another place to learn LOTs more, in depth, is Sean Riehls' two volume video set (now available on DVD) on Neuromuscular Therapy and Deep tissue massage. (http://www.deeptissue.com) These videos are more about treating trigger points on others, but is worth getting for yourself. Sean has a real gift for making complex material accessible to the average person, and presents simple, straightforward protocols that work like magic at least 70-80% of the time. I've cleared up or greatly improved chronic/long standing wrist pain, headaches, rotator cuff pain for clients and friends in 20-30 minutes or less using this approach. I even self treated a strained wrist tendon (flexor pollici longus) and solved the problem with 2 7-8 minute sessions on myself, using the edge of my other forearm and my fingertips.
"I also think training like a Navy S.E.A.L. is stupid for the average person. I would say PT like an infantry unit, run, body weight stuff, hump a little, a little weights and enjoy life if you are not training for specifics." -tough old man
Lemon,
I'd appreciate a point in the right direction.
I have some symptoms that crop up when I begin any program of increased KB jerks & snatches. Intuitively, I know it's a biomechanical problem. While I have an x-ray confirmed spondylolisthesis, ( and I'd wager some lumbar buldges and/or herniations that have never been confirmed by MRI because I figure, WTF, I wouldn't have surgery so where am I going with that info anyway ? ) the pain really kicks in when I start building volume in the KB lifts mentioned.
( I've read Sarno, it's helped with some things, but not this, which REALLY creates -not too- suppressed rage.)
Ultimately, I think I need a 2 pronged approach. Excellent KB form analysis, which I expect to get at a Steve Cotter seminar this summer, and some high quality bodywork.
The trigger point stuff feels good while I'm doing it, and leads me to believe it could be very helpful, but I am inadequatly skilled to self-administer what I really need.
How can I find someone on Long Island, NY who is doing the kind of work you describe in this thead ? ( I've gone to various practitioners, sports med docs., chiros, etc., who have advised forget the KBs. Not the route I want to take.)
Thanks.
Eddie
I'd appreciate a point in the right direction.
I have some symptoms that crop up when I begin any program of increased KB jerks & snatches. Intuitively, I know it's a biomechanical problem. While I have an x-ray confirmed spondylolisthesis, ( and I'd wager some lumbar buldges and/or herniations that have never been confirmed by MRI because I figure, WTF, I wouldn't have surgery so where am I going with that info anyway ? ) the pain really kicks in when I start building volume in the KB lifts mentioned.
( I've read Sarno, it's helped with some things, but not this, which REALLY creates -not too- suppressed rage.)
Ultimately, I think I need a 2 pronged approach. Excellent KB form analysis, which I expect to get at a Steve Cotter seminar this summer, and some high quality bodywork.
The trigger point stuff feels good while I'm doing it, and leads me to believe it could be very helpful, but I am inadequatly skilled to self-administer what I really need.
How can I find someone on Long Island, NY who is doing the kind of work you describe in this thead ? ( I've gone to various practitioners, sports med docs., chiros, etc., who have advised forget the KBs. Not the route I want to take.)
Thanks.
Eddie
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Jehoshaphat
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Eddie:
Give Dr. Joseph Debe a call. I went to him several years ago when I had some neck problems. At that time he had his office at Ken Leistner's Iron Island Gym. He has now moved his practice to Great Neck. He's a former olympic style lifter, very knowledgeable and a real gentlemen. I haven't needed a chiropractor since then. If I ever do again, he's the man. I wouldn't trust anyone else.
(By the way, at the time he was treating my neck, I had also had some hip pain from doing barbell power cleans that he corrected using what I realize now is trigger point therapy.)
Here's his link:
http://www.drdebe.com/
Give Dr. Joseph Debe a call. I went to him several years ago when I had some neck problems. At that time he had his office at Ken Leistner's Iron Island Gym. He has now moved his practice to Great Neck. He's a former olympic style lifter, very knowledgeable and a real gentlemen. I haven't needed a chiropractor since then. If I ever do again, he's the man. I wouldn't trust anyone else.
(By the way, at the time he was treating my neck, I had also had some hip pain from doing barbell power cleans that he corrected using what I realize now is trigger point therapy.)
Here's his link:
http://www.drdebe.com/
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Jehoshaphat
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Abandoned by Wolves
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Eddie, sorry I didn't reply sooner. Don't have the time to look at the Internet very much, except on the weekends.
You can't beat word of mouth recommendations, and if an Irongarm member says good things about this guy, he's probably worth checking out.
The following is by way of education.Keep in mind that I am only in my first year of doing this professionally, and there is lots I still don't know: but if the therapist you go to doesn't know this stuff either, they probably aren't going to be much help to you.
Pure 'trigger point' work can be very helpful - you find the real source of the pain, work it fairly intensely with direct pressure (ischemic compression), cross fiber strokes, and short 'stripping' one-directional strokes (about an inch or less) over the area. Often that is enough.
Sometimes it isn't enough or it's only a temporary fix. So the next step is to take a more sophisticated 'myofascial release' approach. Most of the bodywork approaches out there that aren't based on 'energy work' seem to take one or more of the following approaches:
1) Facilitate lengthening. You work the adhesion in the direction of the stretch as you lengthen the area (ie, you'd 'strip' the bicep muscle in the direction of the elbow as you 'uncurl' your arm.
2) Facilitate shortening: Sometimes the little 'bridges' in the muscle fibers catch and rachet as the muscle shortens rather than lengthens. So in this case, you'd 'strip' the bicep towards the shoulder as you 'curled' the arm.
3) Skin rolling. You'd literally pinch the area between your thumb and fingers and roll it back and forth, working up and down the bicep. You are trying to both unstick the adhesion from the skin and from the tissues underneath, and 'unstick' the fibers in the adhesion from each other.
4) Separating muscle compartments from each other and from the bones and tissue they slide over. This is a lot like 3), but working over the entire muscle belly. You'd 'pick up' the bicep with your thumb and fingers and try to 'unstick' it from the tricep and deltoids by pushing, pulling, rolling and sliding it to its limit in all directions. Sometimes you will also put stripping pressure on the borders between two muscle compartments to break up adhesions between them.
5) Anchor and stretch (sometimes called 'pin and stretch'). You put pressure on the adhesion with a fist, thumb, knuckle, elbow, etc to hold it still. Then you lengthen the tissue (or someone lengthens for you). This has the effect of focusing all of the stretch in the tissue on the spot where you've put the pressure. This is a very powerful and effective technique, I use it a lot, but it can be intense. A milder version of this is to hold with one hand below the adhesion and strip or lengthen the muscle belly with the other hand.
6) Positional release (counterstrain): sometimes the best way to take soft tissue out of a painful spasm is to put it in a position of 'relaxed contraction' instead of trying to stretch it. For instance, if your lower back is killing you, you'd go into 'extension' (ie a 'floppy pushup' position as described by McKenzie) instead of a toe touch. When the muscle is placed in a 'passively shortened' positioned (it's short, but not doing any work), the reflex arc that keeps it in spasm often stops with 30 seconds or so.
Support systems like the bodyCushion work well to set the client up in a position where many muscle groups are well presented and passively shortened or passively lengthened which is why I have one and use it for my private clients - the tissues are already relaxed when I start to work.
7) Muscle energy technique: You know this as PNF stretching, reciprocal inhibition, CRAC etc.
The vast majority of 'real' deep tissue therapists employ variations of one or more of the above techniques, informed by various theories of the most effective places to work on and whether the client passively receives the work or actively moves against the therapist's resistance. This doesn't include work on nerve roots in the spine or work on releasing facet restrictions in the vertebrae, which is incredibly cool but I don't feel qualified to discuss or practice those techniques (yet). I am also not 100% sure about how much of the above is covered in the concept of 'directed myofascial unwinding', but I am sure there is a fair amount in common.
If the doc doesn't work out and you feel the need to seek out a manual/soft tissue therapist, be sure they know some or all of the above ideas (even if they don't use them), and aren't just going to do REALLY HARD SWEDISH on you.
BTW, Shiatsu/Acupressure is a great therapeutic modality (I prefer to give Shiatsu instead of Swedish massage whenever I can), but it's aimed at enhancing health and balancing energy flow, not trigger point work. Lots of times Shiatsu will release tight muscles and alleviate tension and stress, but sometimes it doesn't work as you hope it will for muscle spasms and adhesions because it's not 'aimed' at the muscles, it's aimed at the chi. Same thing with acupuncture.
Hope that helps.
You can't beat word of mouth recommendations, and if an Irongarm member says good things about this guy, he's probably worth checking out.
The following is by way of education.Keep in mind that I am only in my first year of doing this professionally, and there is lots I still don't know: but if the therapist you go to doesn't know this stuff either, they probably aren't going to be much help to you.
Pure 'trigger point' work can be very helpful - you find the real source of the pain, work it fairly intensely with direct pressure (ischemic compression), cross fiber strokes, and short 'stripping' one-directional strokes (about an inch or less) over the area. Often that is enough.
Sometimes it isn't enough or it's only a temporary fix. So the next step is to take a more sophisticated 'myofascial release' approach. Most of the bodywork approaches out there that aren't based on 'energy work' seem to take one or more of the following approaches:
1) Facilitate lengthening. You work the adhesion in the direction of the stretch as you lengthen the area (ie, you'd 'strip' the bicep muscle in the direction of the elbow as you 'uncurl' your arm.
2) Facilitate shortening: Sometimes the little 'bridges' in the muscle fibers catch and rachet as the muscle shortens rather than lengthens. So in this case, you'd 'strip' the bicep towards the shoulder as you 'curled' the arm.
3) Skin rolling. You'd literally pinch the area between your thumb and fingers and roll it back and forth, working up and down the bicep. You are trying to both unstick the adhesion from the skin and from the tissues underneath, and 'unstick' the fibers in the adhesion from each other.
4) Separating muscle compartments from each other and from the bones and tissue they slide over. This is a lot like 3), but working over the entire muscle belly. You'd 'pick up' the bicep with your thumb and fingers and try to 'unstick' it from the tricep and deltoids by pushing, pulling, rolling and sliding it to its limit in all directions. Sometimes you will also put stripping pressure on the borders between two muscle compartments to break up adhesions between them.
5) Anchor and stretch (sometimes called 'pin and stretch'). You put pressure on the adhesion with a fist, thumb, knuckle, elbow, etc to hold it still. Then you lengthen the tissue (or someone lengthens for you). This has the effect of focusing all of the stretch in the tissue on the spot where you've put the pressure. This is a very powerful and effective technique, I use it a lot, but it can be intense. A milder version of this is to hold with one hand below the adhesion and strip or lengthen the muscle belly with the other hand.
6) Positional release (counterstrain): sometimes the best way to take soft tissue out of a painful spasm is to put it in a position of 'relaxed contraction' instead of trying to stretch it. For instance, if your lower back is killing you, you'd go into 'extension' (ie a 'floppy pushup' position as described by McKenzie) instead of a toe touch. When the muscle is placed in a 'passively shortened' positioned (it's short, but not doing any work), the reflex arc that keeps it in spasm often stops with 30 seconds or so.
Support systems like the bodyCushion work well to set the client up in a position where many muscle groups are well presented and passively shortened or passively lengthened which is why I have one and use it for my private clients - the tissues are already relaxed when I start to work.
7) Muscle energy technique: You know this as PNF stretching, reciprocal inhibition, CRAC etc.
The vast majority of 'real' deep tissue therapists employ variations of one or more of the above techniques, informed by various theories of the most effective places to work on and whether the client passively receives the work or actively moves against the therapist's resistance. This doesn't include work on nerve roots in the spine or work on releasing facet restrictions in the vertebrae, which is incredibly cool but I don't feel qualified to discuss or practice those techniques (yet). I am also not 100% sure about how much of the above is covered in the concept of 'directed myofascial unwinding', but I am sure there is a fair amount in common.
If the doc doesn't work out and you feel the need to seek out a manual/soft tissue therapist, be sure they know some or all of the above ideas (even if they don't use them), and aren't just going to do REALLY HARD SWEDISH on you.
BTW, Shiatsu/Acupressure is a great therapeutic modality (I prefer to give Shiatsu instead of Swedish massage whenever I can), but it's aimed at enhancing health and balancing energy flow, not trigger point work. Lots of times Shiatsu will release tight muscles and alleviate tension and stress, but sometimes it doesn't work as you hope it will for muscle spasms and adhesions because it's not 'aimed' at the muscles, it's aimed at the chi. Same thing with acupuncture.
Hope that helps.
"I also think training like a Navy S.E.A.L. is stupid for the average person. I would say PT like an infantry unit, run, body weight stuff, hump a little, a little weights and enjoy life if you are not training for specifics." -tough old man
Lemon,
Your post is not a mere reply, but an education. Thanks ! Especially in light of your limited online time.
BTW, I've enjoyed your posts here and at DD. While you may be "new" to the profession, you obviously bring a long history of ( to borrow a term a friend of mine coined,) "mentilating" about "all this stuff", and I'd wager heavilly, a talent for it as well, to the "table" ( bad pun intended.)
Eddie
Your post is not a mere reply, but an education. Thanks ! Especially in light of your limited online time.
BTW, I've enjoyed your posts here and at DD. While you may be "new" to the profession, you obviously bring a long history of ( to borrow a term a friend of mine coined,) "mentilating" about "all this stuff", and I'd wager heavilly, a talent for it as well, to the "table" ( bad pun intended.)
Eddie
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buckethead
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Freaking Great book!! This and Sarno are absolute musts.
I've been using a golf ball or rubber bouncing ball or fingers/knuckles/etc.. for about two weeks on various areas of my right leg and upper back. Great results.
Most amazingly, is doing some specific trigger points for a few minutes before exercising is night/day better than most warm ups.
Graci Turd.
I've been using a golf ball or rubber bouncing ball or fingers/knuckles/etc.. for about two weeks on various areas of my right leg and upper back. Great results.
Most amazingly, is doing some specific trigger points for a few minutes before exercising is night/day better than most warm ups.
Graci Turd.
Re: Trigger Point Therapy Wkbk & Theracane
This is a Theracane on steroids. Sturdier, with better knobby things. And the same price as the Theracane.
And triple Kudos to the Trigger Point book - a tough sparring session put my wrists in such pain that I thought my grappling days were about to end. Three quick sessions on the trigger points, and I'm ready for more punishment.
The best lack all conviction, while the worst
Are full of passionate intensity.
W.B. Yeats
Are full of passionate intensity.
W.B. Yeats