I would not interfere with nor advise a patient to alter their prescribed treatment. However, when circumstances such as described below present, I will work within my scope to get to the root of the problem.
Becky, a young lady, 20 yrs. old, came in for treatment for her back pain. During intake she reported that she had recently been diagnosed with a dysfunctional gall bladder and ovary that needed surgery.
That excited me as I have seen the abdominals refer to the back, the gallbladder and the ovaries too many times. See picture for trigger point referral chart. The X is where the trigger point is located. The red indicates the location of pain.
I performed Myofascial Release on her hip and abdominals to lengthen the tissue. I worked deeper and found trigger points that mimicked the identical pain patterns of both her gall bladder and ovary. She got off of the treatment table with NO pain.
She reported her pain free status to her doctor who replied, “I don’t know what he’s doing, but if it works keep doing it.”
She did not require surgery for either.
Her back pain was gone as well.
A team of therapists and I were working on several teachers at a local high school for Teacher Appreciation Day. A football coach, Mike, took a seat in front of me. I asked him if he had any trouble spots or pain. Mike admitted to significant shoulder pain.
“”But you can’t fix it. It’s been going on for three years. I haven’t been able to throw a football since then”.” Mike was quick to tell me.
I love a challenge. I immediately put my thumb on a specific rotator cuff muscle.
“Is this your pain”?” I asked, but his reaction was extreme enough that he didn’t need to use words.
“”YES! You’re on a nerve or something”!”
“No, Coach, that’s a trigger point in your lateral rotators. It’s the muscle that puts the breaks on when you follow through throwing a football”.”
He was skeptical. “I still don’t think you can fix it, but go ahead”.”
Five minutes later he sat up and showed me how far he could raise his arm, as if to throw a football.
“”I can only reach this high”.” Coach lifted his arm just so.
““I can’t take it this high”, he started to demonstrate. His arm floated on up as if there was never a problem. “
“Hey, wait a minute! I can… Look at this… and it doesn’t hurt”!” he practically sputtered.
I smiled knowing this was one of the reasons I do what I do. Giving a football coach back the ability to throw a football again is what it’s all about.
Coach comes to the clinic now. We release his shoulder pain so that he can continue to do what he loves.
“Now, if you can fix my back pain, I’ll give you a million dollars”!” he said on one of his visits, still sure that he had me stumped.
Thirty minutes later, after I released trigger points in the muscles of his low back and glutes, a sheepish coach asked, “”Will you settle for a steak dinner”?”
I love what I do.
Penny had undergone surgery for an aneurysm nine years earlier. Post surgery, she developed a constant cough. Every 30 seconds to a minute she had to cough. Her surgeon was inclined to believe that the surgery caused nerve damage. Penny did not want to undergo another surgery.
She spent the following years coughing every minute of the day. This interrupted all aspects of her life, sleep, work, home.
When she entered my clinic, and before we were introduced, I could actually see the tightness in her neck muscles. She explained her history and chief complaint. We started work promptly.
Without delay we found trigger points in several muscles of her neck that caused the feeling of needing to cough. Her cough was not productive, it was just a tickle in her throat that made it feel like she needed to cough. We determined that the position that she had to be in on the operation table was the weightiest factor in the shortening of these neck muscles as well as the consequent development of trigger points.
We never completely got rid of her cough but did reduce the intensity and frequency by 90%. Her happiest report was that she was able to eat Doritos again without having to cough.
I cannot say enough of what Neuromuscular Therapy has done for me in the short time I have been in this treatment.I had surgery in 1997 due to an aneurysm in the back of my left eye. I had some kind of trauma to my throat or a slight stroke about three months after. Since, and for nine years now, I have been enduring a constant need to cough.Over the years the cough had become so severe that my physical health was affected. The nerves and muscles were so tight in my neck and in so much stress that I often felt like I would probably have a major stroke in my throat. I felt I was a hopeless case. It is amazing how much my cough has improved with this therapy. The stress I had in my neck and throat is at a level that has given me a new positive outlook. I have also learned therapy I can do at home that helps in maintaining my cough and the stress in my throat.I have been impressed how knowledgeable the Director and the therapist are in dealing with my particular situation. They listen to me, change the type of therapy as needed or indicated and it is working. I know I will have to continue these treatments to keep me from regressing back to where I was. I just wished more people knew about this kind of therapy so they could see positive results as I have. It has certainly changed my life.
Case Study #1: A mechanic, John, is scheduled for carpal tunnel surgery in a few weeks. I found trigger points in lats, back muscle, and subscapularis, rotator cuff, that refers the identical pain to his wrist. The supervising physician agreed that I had found the source of pain, but also believed that John had suffered with the symptoms for so long that surgery was still a must. This does happen. Still, carpal tunnel surgery, more often than not, only treats the symptoms.
Case Study #2: A teacher, Mandy, is scheduled for surgery in a few weeks. I found trigger points in her upper traps, shoulder, that refers the identical pain to her wrist. Mandy wrote on an overhead white board in her classroom. I treated her three times. The pain left! Mandy’s doctor cancelled the surgery.
Case Study #3 A massage therapist, Autumn, had carpal tunnel surgery 4 months prior to seeing me. The searing pain had returned with the same intensity. Working as a massage therapist contributed to the strain in her neck and schoulders.I found trigger points in her shoulder and neck that sent the identical pain to her wrist. I treated her twice. The pain disappeared.
Case Study #4: A Typist, Beth, was scheduled for surgery in a few weeks. I found trigger points in her neck that sent the identical pain to her wrist. I treated her twice. The Dr. cancelled the surgery.
Case Study #5: A Sonographer , Jessi, has pain in her wrist. She was told by her family doctor to see a specialist. When she came to see me, I found trigger points in her neck, shoulder and back that sent the identical pain to her wrist. Her pain disappeared. I am still waiting to hear the end of the story.
Headaches are very common among a significant percentage of people. Most treatments include medication. Most treatments attack the symptom and not the cause.
I developed an expertise in headaches early in my pain management practice. I truly believe that if I cannot get rid of a headache that there is something a little more serious that may be wrong, and I will refer to your doctor quickly. Honestly, 99%, meaning there was 1 out of 100 that stumped me, was caused by muscle tension. This muscle tension was caused by bad posture, prolonged shortening or overuse/misuse at work, play, sleep, ……etc.
Typically, my line of questioning consists of:
1. Where does it hurt?
2. What type of work do you do?
3. What position do you sleep in?
4. How do you sit at your desk, couch, car…, …etc.
5. What do you spend most of your time doing?
The following Case Study is a good example of finding a simple cure for a headache.
A Kindergarten Teacher, Linda, who was in her early 20’s came in for treatment for debilitating daily headaches. She appeared to be stressed. (No kidding.) Fidgety. Pacing. Linda had been trying different medications for several months. The meds would take the edge off of debilitating pain, but did not keep the headaches away.
We designed a treatment plan to target the nervous system and promote relaxation so that she could sleep better. The plan also included targeting specific muscles that are generally associated with her typical headache. During treatment, we discovered trigger points in her neck and shoulders that mimicked the headache pain.
Figuring out why the muscles had shortened in the first place was a mystery. My never-fail questions failed. Driving posture? Sleeping position? Work activities? So far, we were hitting a dead-end.
Linda is a teacher, and not just any teacher, she’s a Kindergarten teacher. What could Linda be doing teaching kindergarteners that would shorten neck and shoulder muscles? Is there anything unusual that Linda would do during her day that other teachers might not do? One of my greatest joys is finding out the root cause of pain. It’s almost a euphoric feeling to know that I’’m on the right track, as ideas begin to take shape.
“When you talk to your children one-on-one and you want to look them in the eye, do you kneel on the floor or do you bend forward with your hand on your knees and look up at their face?”” I asked.
Her answer, “I bend forward and move my head so that I am looking up”?”
The ah-ha moment!
We lengthened the muscles, which had shortened with the awkward position. Linda started taking a knee when she talked to her kids. The headaches disappeared. No more need for medication. And Linda did not have to come back to see me.
Sometimes it is a quick fix.
I met with Brandon, a college student, who had been diagnosed with TMD, Tempora Mandibular Disorder, which was believed to be the cause of jaw pain and headaches. The medical recommendation was TMJ surgery. Brandon’s mother brought him to me “just to see if there’s something else that could be done.” His mother was a student of mine and knew enough to ask for another opinion.
I put Brandon through several tests. I found numerous trigger points in his neck and shoulders that ALL referred pain to his jaw, which was his chief complaint. Working on those trigger points relieved pain. All of this was done without ever touching his jaw!
What was causing this particular set of symptoms and pain? The grouping of muscles with the trigger points seemed odd to me, so I did further investigating about ergonomics and posture. I decide to put each muscle that housed a trigger point into a shortened, contracted position.
- Right trapezius elevated shoulder and rotated head to opposite side
- Right cervical multifidus rotated cervical spine to opposite side
- Right pectoralis major medially rotated the right shoulder
- Left infraspinatus ands teres minor laterally rotated the left shoulder
- Right SCM rotated face downward and to the left
As I moved Brandon’s body into the position that was consistant with the trigger points that I found, his pose started taking shape into something familiar to me.
“Do you play guitar”?” I asked.
“”Yes, I teach it as well”,” Brandon said.
““Are you looking at your fret hand as you play”?” I asked.
“”Yes”,” he answered, beginning to understand.
“”Well, Brandon, quit looking at your hand when you play”!” I said.
We talked more about ergonomics and posture. Lengthend the short muscles. Stretching for homework. Momma and therapist , Cathy Trapp, LMT, will take it from here.
No more pain. Surgery was not needed.
“Brandon, what in your jaw were they going to cut on anyway”?
Interview with Krige Schabort
By Brooke Edwards
Krige Schabort was an avid surfer growing up in Cape Town, South Africa. He also enjoyed rugby and squash, and become active in the South African military as a young man. In 1987, during a Cold War battle with Angola, a bomb from a Russian fighter plane hit Schabort. He nearly died, and was saved by an adrenaline shot to his heart. When he woke up days later, he learned that both of his legs and one finger had been amputated.
As a disabled athlete, Schabort broke South African swim records and competed in wheelchair basketball. But it was in his first wheelchair race in 1988 that Schabort found his passion.
Schabort moved to Cedartown, Georgia, with his wife in 1997. Now sponsored by wheelchair manufacturer Invacare, Schabort has repeatedly won the Cleveland, LaSalle Bank Chicago, Pittsburgh, Detroit, and Columbus Marathons, among others. He placed third in the marathon at the 1992 Paralympic Games in Barcelona with a 1:30.23 and second in Sydney in 2000 with a 1:29.28. In 2004, he was accepted into the Honolulu Marathon’s Hall of Fame, after winning for the seventh year in a row.
Schabort has also racked up many 10K victories, and holds the world record for 10 miles with a time of 35:18. During the 2002 New York City Marathon, Schabort set a new course record with a time of 1:38.27. The next year, he won the race again and broke his own record with a 1:32.19 (since broken).
At 44, (2007) Schabort is still a top contender amongst a stacked class of racers…
Addendum by Bobby Lewis, LMT, Corrective Body Work
I met Krige when he first came to my clinic seeking help with his training and performance in the upcoming Paralympics Games. He was in training for the Paralympics Games. As a hand cycling athlete, he wanted to increase his ability to contract his abdominals as well as improve his range of motion with his shoulders. He had specific groin pain as well.
We designed a treatment plan to include myofascial release at the hip and through his abs in order to lengthen the muscles that had been shortened from repetitive use. On the first visit of several, we discovered trigger points in his abs that referred pain to his groin as well as to his foot! Yes, his foot! The trigger point referred to what is called a “phantom pain.” When these trigger points were released, his abdominal muscles lengthened. The range of motion in his shoulders increased so he would have great “reach and pull.” Krige reported greater strength during daily training. He went on to the Olympics and competed very well.
Two years later Krige returned to my clinic again for help in strengthening and training for an upcoming triathlon. He had limitations in his over-hand free-style stroke which limited his ability to turn his head to breathe during the swimming competition. He had pain in his neck on one side and headaches. The problem was rooted in the medial rotators of his shoulders. His lats had also shortened. With myofascial release, neuromuscular therapy and MET stretches, we lengthend his Lats. We did the same treatment on the neck muscles that rotated his head to the opposite side.
After his first visit, Krige went directly to the pool to train. He returned the same week for more treatment and was happy to report that he had taken a full minute off of his best time! Kriege attributed this to his ability to reach further with the one arm and the ability to turn his head without limitation or pain, in order to breathe. Each week thereafter he reported a continual drop off of his best time.
Krige is a determined human and a remarkable athlete. He knows firsthand the value of supplementing his training with manual therapy and giving himself the winning edge in competition. It has been an honor to be a part of this championship athlete’s journey.