Trigger Points – Sinus Pain in the Face and Ear Congestion

referral - lateral pterygoid - cropped

 When asked, people trace their hands along your cheekbones around toward their here  and complain of sinus pressure. The pain in the cheek bones seems to be more constant, irritated and feels like pressure. The referral into the ear, when present, feels like earache or stuffiness. They may also complain about clicking when they open wide. They often complain of weather or seasonal changes that has made them stuffy. Often, they are surprised when the they get relief from bodywork. Unless they are familiar with the relief that can be had from this work, they seldom see the sinus congestion as a problem that the bodyworker can solve. The congestion is something that I see a lot of in my practice as I specialize in cranial work and clients are more likely to connect the two. This really is a TMJ problem. They may complain about the clicking and popping. The clicking and Continue reading Trigger Points – Sinus Pain in the Face and Ear Congestion

Trigger Points – Pain when Reaching Up or Back

referral - infraspinatus - medial border

People complain of pain along the inside of their shoulder-blade when reaching high above the head, to the back seat of the car or to adjust clothing behind the back.  They have usually adapted their movements to avoid taking that arm too far back. They will insert that arm first into a coat. They will avoid having to tuck in their shirt by putting the pants on over the shirt. They will fasten the bra in front, turn it around and then carefully insert the painful arm under the strap first. These same movements, which involve the infraspinatus muscle, may produce shoulder pain as described in this post. Those patterns of shoulder pain are more likely to bother people when sleeping on the shoulder than reaching over head. The tests to see if this muscle is the problem, involve those movements. The first one involves placing the forearm across the Continue reading Trigger Points – Pain when Reaching Up or Back

Do You Find Trigger Point Illustrations Confusing?

Do You Find Trigger Point Illustrations Confusing

Most books and sites on trigger points are usually focused on a the characteristics of a trigger point. They help you primarily understand its areas of referral, impaired functions, sensation, activities of onset, etc. If you’re a therapist that can be interesting for detailed assessment. Most people are overwhelmed by all that. I’d venture to say that many therapist are overwhelmed by that. It leads them to avoid talking about trigger point patterns. They often try to point out problems in the research, which is, by the way, amazingly solid and has been proven with many years of clinical success. My posts on trigger points are different; they focus on connecting a problem in typical activities with a trigger point. They offer some safe self-care and help you distinguish it from similar referral patterns. Those posts also point out when you should really be taking this problem to a therapist. For the average person Continue reading Do You Find Trigger Point Illustrations Confusing?

Trigger Points – Sharp Pain Between the Shoulder Blades

referral - thoracic multifidi

People complain of pain along the spine between the shoulder blades. This can vary a great deal in intensity. It can be nagging and achy or sharp during a deep breath. There are a number of patterns here between the shoulder blades but this one is right along the spine and described like a bone is out-of-place. People complain more about movement of the trunk and breathing than pain in their arms and neck. This illustration shows of a focus of pain along the thoracic spine where this often occurs. It may also occur above and below this spot along the spine and ribs. Cervical multifidi produce different referral patterns and are discussed in this post. When it is more severe, and creates a sharp pain on breathing it is often described as a rib head that is out. There is some truth to that. This pain is often associated to a vertebrae Continue reading Trigger Points – Sharp Pain Between the Shoulder Blades

Trigger Points – Radiating Pain Under the Base of the Shoulder-Blade

referral - iliocostalis thoracis - R6 - posterior

People complain of achy, nagging pain that is focused near the base of the shoulder-blade. It may radiate upward along the edge of the shoulder-blade and toward the spine. If there was some sort recent event that started this, it may be a sharper sensation. Pain in the middle or the left side of the chest can be cardiac related and should be cleared by a medical doctor before bodywork is sought as relief. They may also complain of pain that radiates through their rib cage to the front of their chest. It is often confused with heart related symptoms, even thought the focus of pain is in the back. When this is chronic, clients are usually not aware of the onset of symptoms. When it is acute, it is caused by some activity that unexpectedly twists the torso like a car accident, roller coaster ride or slipping on a slick floor. Continue reading Trigger Points – Radiating Pain Under the Base of the Shoulder-Blade

Why are the unfamiliar activities painful?

why do I have pain after

It’s a great question. I often state its counter part, “Other people do that and don’t have pain. Let’s work so that you can do that without pain, too.” Let’s briefly look at few things about trigger points that will answer this question: what they do, their levels of activity, what makes them more active, how we naturally avoid activating them,  as well as short and long-term answers for relief. What trigger points are: They are hyper-irritable spots in muscle with specific behaviors. I’m less interested in the actual spot than most trigger point specialists but here’s an illustration of a trigger point from the most respected researcher in the field. What trigger points do: They restrict contraction. In many cases, this is that fragile feeling of weakness connected to pain as when a knee buckles walking in stairs or you’re slow to get up or you loose your grip on your coffee cup. Here’s Continue reading Why are the unfamiliar activities painful?

Trigger Points – Sharp Pain in Front of Shoulder

lattissimus dorsi - lower ribs

People complain of pain in the shoulder that is sharp and sudden when reaching up and/or forward. This may occur during a tennis serve or when getting something off of a high shelf. This can also occur when a dog yanks them forward on a leash. This creates sharp pain in the shoulder at the end of the stretch created in exercises like pullovers and seated triceps extensions. These people may complain of pain in the shoulder while sleeping on that side, especially when the arm is pulled up and forward so that the border of the lat is pressed into the ribs. Some talk about the “only position” in which they can get comfortable to sleep as the low back pain may wake them as well. The referral in the low back is usually described as “stiffness” or some sort of restricted motion when bending to the opposite side. It is seldom described Continue reading Trigger Points – Sharp Pain in Front of Shoulder

Trigger Points – Hard to Resolve Forearm Pain

referral - pectoralis major - sternal

Pain across the chest and down the arm is similar to the sensations of heart attack. Most of my clients have already checked with their heart specialist and tests show that they are OK. People with these symptoms need to check with a medical doctor before getting bodywork that may mask important indicators. People usually complain of pain in the upper forearm.  They actually grab or trace the area indicated in the picture. They will search for an activity that stressed the forearm but usually can’t come up with one. Some of my regulars will have already tried massaging and stretching the forearm. Clients with this pattern of pain in the chest and arm usually find that is inconsistent but intense when it occurs. They have often adopted a slumped posture on that side that leaves slack in the sternal pectoral section.They may not have noticed that the pain pattern occurs when they roll that Continue reading Trigger Points – Hard to Resolve Forearm Pain

Trigger Points – Pain Along the Collar Bone and Down the Arm

referral - subclavius

People seldom have any part of this pattern as their primary complaint. When this is a problem, the entire pattern can usually be elicited by pressing up under the collar-bone near the sternum. It is surprisingly intense for a pattern that is seldom a part of their complaint. I usually find this by working the area based on other complaints related to pecs or thoracic outlet syndrome. A small percentage of people complain about pain along the collar-bone. They trace the pattern along the collar-bone just as shown in the illustration. If subclavius has pulled the collar-bone down onto the subclavian vein, there may be swelling and bluish color in the arm. The other parts of this pattern are more frequently caused by other trigger points, so this muscle is easy to overlook until the other patterns have been eliminated. Paget-Schroetter syndrome is a specific form of throacic outlet syndrome where Continue reading Trigger Points – Pain Along the Collar Bone and Down the Arm

Trigger Points – Pain in the Front of the Shoulder When Lifting Arm

referral - pectoralis minor

People complain of pain in the front of the shoulder when lifting the elbow above the shoulder or back at shoulder level. This pain is less distinct and focused unless the person has a specific activity that they need to do and cannot adapt their movement. For instance, one case was a weight lifting enthusiast who could not incline bench or do front dumbbell raises above shoulder level. Another case was a woman who could not reach up to get plates off of a high shelf that she could reach before. People may complain primarily of pain in the upper forearm. There aren’t many muscles that have a focus of pain in this area and when it occurs, it is often pectoralis minor or the sternal division of pectoralis major. These days, this problem is most common among students that carry a back pack. It can create some blunt trauma to Continue reading Trigger Points – Pain in the Front of the Shoulder When Lifting Arm