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Finding The Godfather of Organized Pain

Integrative bodywork is more than ferreting out trigger points, balancing pelvises and smoothing out the tissues. It focuses on finding the governing problems and addressing them first.


When I was growing up, we lived on a farm with 6 kids. My father’s brother, Gene, would say, “Y’all could tear up an anvil bare-footed.” Pop quoted him on many occasions. We often heard it as he was fixing whatever mess that we just created. There were a lot of us kids so my mother and father were busy putting out fires while working to rehabilitate this gang of little arsonists.

Sometimes, therapy can be that way.

In 1995, I was writing the neuromuscular manual for the ASHA School of Massage and studying craniostructural techniques with Dallas Hancock. I was working at a small practice with a chiropractor in a tiny north Georgia town. It was there that I had a watershed moment about putting out fires.

In Session

A client came in with a rotator cuff problem. Subscapularis trigger points were referring pain in the back of her shoulder. Also, they aggravated her wrist. This pattern can make people want to take off their watches.

It isn’t any fun for the client as you work in their armpit. But I worked there for a while, just like the protocols directed. The results that I wanted weren’t coming. I was stumped, so I brought Dr. Pruitt in to take a look. As I described the problem, he put his knee in the gal’s armpit and bumped the front of the shoulder. I ran my hands up in there after he did that and those trigger points were quick and easy to release. That really got my attention.

The First Layer of Restrictions

Later, I figured out how to release restrictions in that shoulder joint using gentle massage techniques, instead of popping it. The epiphany was that sometimes you cannot put out the fire when the arsonist is still at work. You just end up putting out the same fire over and over again. What I needed to do was hunt down the arsonist. In this case, the trigger points. The ultimate trigger points.

Eventually, I figured out that there were restrictions in the neck that perpetuate restrictions in the shoulder. And that those shoulder restrictions perpetuate the trigger points in subscapularis. Finding this was helpful. If I can address these little capos and their boss, all will be well, right?

Not entirely.

The Next Layer of Restrictions

Well, it turns out there are bosses and there are underbosses. That previous layer of restrictions was just the underboss. There are also restrictions in the cranium that perpetuate those restrictions in the neck that we had worked ourselves up to. And those follow suit by then restricting the shoulder and then perpetuating the trigger points in subscapularis.

Ughh.

The Godfather

However, when I fix those cranial restrictions, the client usually gets off the table with no shoulder pain. Often, trigger points release without ever having to actually dig in the armpit or mobilize the shoulder or even address the neck directly. Amazing. And, a lot less bothersome for both of us. Best of all, the problem seldom comes back. The body rehabilitates and becomes better at correcting itself.

I hadn’t just found the arsonist, I had found the kingpin – the Godfather of Organized Pain.

“Integrative” is an adjective that describes something that integrates itself.  Therefore, integrative bodywork changes your body so that your body is better at fixing itself. Yes, there are times that I still dig deep into the muscle. But not until I have addressed the other problems that govern and perpetuate that trigger point.

Integrative Craniosacral is the crowning approach in Integrative Bodywork. Integrative Bodywork is my therapy of choice because it gives us, the therapist and the client, choices about how to put out fires and hunt down arsonists. Or, better yet, take down the Godfather of Organized Pain.




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This patient had recovered from a frozen shoulder but developed shoulder pain at the end of his golf swing. More traditional neuromuscular techniques weren’t working. Chiropractic wasn’t working. Integrative Craniosacral was the right solution for lasting relief.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.

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