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Re: Trigger Points
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Re: Trigger Points - February 4, 2005 3:10:00 PM
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PTupdate.com
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From: Pittsburgh, PA USA
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Hmmmmmmmmm...my knots are pretty edged up today...where are my rolling papers and that live Dead CD??? After all, it's FRIDAY!
Duffy
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John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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Re: Trigger Points - February 4, 2005 5:57:00 PM
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Jon Newman
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From: Amherst, WI
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What is the common denominator between manipulation, acupuncture, vigorous massage, exercise and smoking pot?
(Beside the fact that they all seem to relieve trigger points)
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Trigger Points - February 4, 2005 7:56:00 PM
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Synergy
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From: Texas
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Jon, my guess is that the common denominator would be a sense of euphoria coupled with a strong sense of hunger. :)
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Chris Adams, PT, MPT
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Re: Trigger Points - February 6, 2005 4:30:00 AM
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Diane
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http://websites.golden-orb.com/pain-education/100137.php
I found this ages ago while roaming around looking for info on TPs. It makes sense to me, that where there is pain there will be a stressed or impinged nerve or nervi nervorum at source, broadcasting pain maybe as a result of a taut band etc, but not a taut band etc sending pain about in and of itself.
Make sense?
Also, reading through that reference of Jon's, it was interesting to read that counterstrain etc is useful for TPs, which to me means (as I stated somewhere else here) that a sore spot is a sore spot is a sore spot, regardless of whose "system" they derive from.. in my experience they mostly all respond to an indirect approach, i.e. levering off of pressure rather than adding more. Was glad to see the article alluded to that very idea.
In my humble opinion it is impossible to address presumed TPs in rectus capitus without having to deal with the occipital nerves, which lie superficial to anything muscular. This is so obvious to me everywhere in any part of the body anymore, that I've started to focus on the nerves themselves (just below the skin, much more shallow focal length) as objects of treatment rather than any deeper structures.. results are at least equivalent if not improved. Eg: Jones point T12 anterior; that's the spot where the T12 cutaneous nerve surfaces over the iliac crest. Coincidence? I think not. That is exactly where it would logically hang up if it were to hang up, right where there is a bone and connective tissue to deal with, a change of neural tunnel material. Visualizing the stesses on nerves where their tunnels change direction or tissue type has helped me figure out where to treat and probably, more importantly, why. Not much has changed in my treatment, just in the inside of my head as all these "systems" and "theories" collapse into each other like a big pile o' compost.
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Re: Trigger Points - February 6, 2005 8:56:00 AM
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Synergy
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From: Texas
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Hi Diane! You brought up an interesting point on the nervi nervorum. My collegues and I did a study while in PT school regarding the effects a stretching protocol could have on neural tissue...specifically the median nerve (using the ULTT1). I don't have the capabilities to upload it so if you'd like to see it, I can email it to you.
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Chris Adams, PT, MPT
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Re: Trigger Points - February 6, 2005 9:19:00 AM
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Diane
Posts: 1507
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From: Vancouver, B.C., Canada
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Thanks Chris (I've written to you privately by now.)
If anyone would like to get their hands on a great anatomy text/atlas that depicts soft tissue layers/ nervous system/ individual nerve relays in astoundingly good detail, best I've ever seen, get the 5th edition(2002) of Rohen, Yokochi, and Lutjen-Drecoll's Color Atlas of Anatomy: A Photographic Study of the Human Body published by Lippencott.
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Re: Trigger Points - February 7, 2005 12:31:00 AM
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Lukey
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From: Australia
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Diane, thanks a million for posting that link. I'm starting to lean this way too.
Luke.
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Re: Trigger Points - February 7, 2005 3:11:00 AM
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PTupdate.com
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From: Pittsburgh, PA USA
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Want to hear a weird one? I treated an older woman years ago...the mother of a regular patient. She basically had headaches and head pain. Thorough exam was performed by physicians, and nothing found. Typical PT findings for a 60-something year old woman....limited cervical ROM, forward head, tautness/tenderness, stress in her life, and trigger points in the temporalis musculature.
Working on cervical ROM and TP therapy to the temporalis and supraorbital area, just under the brow, I was able to eliminate all the pain and discharge her.
When I ran into her son a year later, and asked how his Mom was doing, found out she had a brain tumor. Surgery did remove it and she didn't die, but weird to think that I was able to resolve the pain.
I have had similar things happen with levator and interscapular trigger points, where relief is given but they find out there is lung cancer.
John Duffy, PT OCS
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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Re: Trigger Points - February 7, 2005 4:00:00 AM
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Jon Newman
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From: Amherst, WI
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Hi Duffy,
I don't find that weird at all. I've had similar experiences. I'm guessing that these patients didn't remain completely painfree, although it could be. I say that because something had to bring them back to the MD to look more closely at the problem. Now it could have been because they began coughing up blood or were falling down all the time and were otherwise painfree.
If these cancers were the causal source of their pain, then I think it is evidence of how pain is a neurologic event that is subject to modulation. What the modulatory input looks or sounds like is how continuing education course providers make their money. What I look for is how much of the blue print is covered versus how much of the finished product is sold (blueprints not included). I prefer the blueprint. Now I'm off topic.
FlaOrtho put forth a hypothesis on why the MWM of the lateral malleolus/fibula works in a different thread. Personally, I think it works for the same reason your trigger point therapy worked for cancer related pain.
jon
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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