I am the type of person who really likes to learn, so after I read Claire Davies' book (The Trigger Point Therapy Workbook), I wanted to read the book where he got his information. This two-volume set is called, Myofascial Pain and Dysfunction: The Trigger Point Manual, and is written by Janet G. Travell and David G. Simons, et al. (Hereafter called the Red books...) It has more detailed information in it and if you have a bit of anatomy background as I have, it is readable. It also has great illustrations by Barbara D. Cummings.
One of the things that was emphasized in the Red books was to apply moist heat to the area after performing trigger point therapy.
I thought this was a good idea, but I hadn't used it much, mainly because it seemed difficult to do. I was picturing a fairly complicated scenario, in which I would take a hot bath, or at the very least, get a bucket of very hot water, dip a towel into it, squeeze out the excess water, and then apply to the affected site.
I wondered how to apply moist heat without all of the hassle. Then I remembered: Rice-filled, microwave-powered heat pads. They give off moist heat. I have some of those. (If you don't have these, they are very easy to make. Do a search on the Internet, and I'll bet you find some instructions. If you can't find any, leave a comment here, and I will get some for you.)
Several days ago, my back "went out," I used trigger point therapy on the most likely culprits: the psoas, my gluts, the muscles surrounding my spine, especially up by the bottom of my ribs. I would get temporary relief, but everything seemed to seize up again, pretty much immediately. I decided that I probably had pinched a nerve. I could not get my abdominal muscles to relax. The pain would start in my sacrum area (center back around and below the waistline), and I could feel it reach up the sides of my neck and down my thighs. It is really hard to maintain your cool when you can't get these muscles to relax.
I called to see if I could get in to the chiropractor, but knew it was not likely. They put me on the cancellation list, but I never got in.
Knowing that the long holiday weekend was ahead of me, I knew that I was going to have to tough it out. It was then that I remembered my rice-filled heating pads. I took my ibuprofen. Then I heated up three of my rice heating pads and sat in a comfy easy chair. I put one heating pad on my back behind my waist, another around one of my hips to help one of the trigger points in the gluts, and the other I put around my shoulders.
I was amazed at how fast my pain subsided. I could actually think! After a while, I was able to get up and do a few things, very carefully and slowly. Of course, after an hour or so, I began to feel pain again, but I was encouraged; at least I could manage the pain through the Thanksgiving holiday!
I decided to do an experiment (I am taking a statistics class right now, so I think like this...). In a few hours, I tried just the ibuprofen after using trigger point therapy, but I used no warm, moist heat. It lessened my pain somewhat, but it seemed hardly noticeable. A few hours later, I used just the moist heat after trigger point therapy, with no ibuprofen. Again, I felt that instant, soothing relief! Yay! I found that taking the ibuprofen every four to six hours, and doing the trigger point therapy and moist heat every hour was an ideal prescription for my pain.
Over several sessions, I was able to get my back to the point where it did not feel like a pinched nerve anymore, but it still had the residual soreness from the whole traumatic experience.
My upper back started to feel like it might go out though. This happens sometimes when one area of the body has been so tight that other areas are tightening to keep the balance. When the overly tight area finally releases, sometimes the second area seizes. (Think of the energy involved in a tug-of-war. Both sides are pulling very hard on the rope. If one side suddenly lets go, the other side will be exerting too much energy and fall down. It is a similar idea.)
I have been continuing to use trigger point therapy on all of these areas, and I am careful to not overdo my activities. At least I can walk somewhat smoothly today. And I can get up and down out of the chair without trouble.
I was able to get up this morning and roll out my "twisty" rolls for Thanksgiving dinner. I am so thankful that I was not doing the turkey this year. I don't think my back is strong enough for that yet. I will bring my therapy ball (lacrosse ball) and my heating pads to Thanksgiving dinner. Meanwhile, I am feeling very thankful that my pain has lessened significantly
Showing posts with label gluts. Show all posts
Showing posts with label gluts. Show all posts
Thursday, November 22, 2012
Sunday, November 13, 2011
What I've been doing - Part I
Note: Refer to the "What Happened..." post for background information.
One of the first things that I did once we got my arm stabilized in a sling and once we had given me some ibuprofen, was to work any trigger points that I thought would have been affected by my fall.
I visualized what might have happened in the fall. I pictured my elbow hitting the ground. I could imagine that muscles and bones in my upper arms and my forearms would be jarred quite hard. I could see that all of my shoulder muscles were probably affected. They would have to work hard to keep my shoulder in place.
I steered clear of working trigger points in my arm in the beginning because I did not want to inadvertently put pressure on the broken bone, wherever it might be.
I started out working my infraspinatus, supraspinatus, and my pecs.
The infraspinatus and supraspinatus are the muscles that lie on top of the shoulder blade, or scapula. There is a raised part of the shoulder blade that goes across the upper half of the shoulder blade. It is sometimes referred to as the scapular spine. The infraspinatus is the muscle that lies below the scapular spine. (Infraspinatus means "below or under the spine.") The supraspinatus is a muscle that lies above the scapular spine.
I worked the infra- and supra- spinatus with a lacrosse ball against the wall. I was very careful to keep my injured arm from moving. It felt good, not only because it felt good to work the trigger points, which did need work, but also because working the trigger points released endorphins; my pain was partially relieved.
Since I was already up, I decide to work my gluts, lower back, and quads, too. A fall like I had probably involved most of my body, now that I thought about it.
I also worked my pecs. I could feel that they were very tight.
During our first visit to the doctor, the practitioner suggested that I unwrap my arm from time-to-time and work on trying to extend my range of motion. Later, when I was getting zero pain relief from the meds, I wondered if I had a pinched nerve somewhere. It felt very much like pinched nerves I've had in the past. I knew that working my trigger points would help to release something if it were pinched, so I began to work on the upper arm and lower arm muscles. I had also been working on my scalenes and sternocleidomastoids.
The only measurable pain relief that I got during this time period (between the first doctor's visit and the ER visit), was when I worked my trigger points in my arms. I worked from the top of the upper arm down toward my elbow, and from the wrist area up toward the elbow. I used supported thumb or supported fingers, and sometimes used a pinching technique, which I know is not very ergonomic, but I was trying to be careful to avoid the bones as much as possible. I could feel each muscle relax and the pain subside as I released its trigger points. It became more difficult, however, as I got closer to the elbow. I was so exhausted but so happy that my pain had subsided enough for me to get to sleep. I would get to sleep, but I'd wake up an hour or two later with screaming pain again. The muscles that had just been loose and relaxed were now tight as a spring.
I knew there must be something else going on. At this point, I wondered if anyone would be able to help me with my pain at all. Here I was taking Lortab (I did not realize that I had been prescribed a half dose), and it was not helping at all. The only thing that had helped me up to that point was trigger point therapy, and that was only temporary. Plus, I was exhausted from no sleep, and from tensing up against the pain. I could feel the tightness going further up my arm, into my shoulder and neck muscles. I could also feel that my abdomen was as hard as a rock, and my hips and upper legs were tensing up, too. I felt like a giant corkscrew.
In the middle of the night on Wednesday/Thursday, my husband and I decided to try the ER. I really didn't know if they would be able to help. I anticipated them trying to take an x-ray of my elbow again. I hadn't been able to extend my elbow enough at the on-call doctor and the technician there was not very sympathetic. She said, "I warned you that it would not be fun."
Before we left for the ER, I worked my upper arm, shoulder, and pec muscles. I wanted to have as much flexibility coming into that experience as possible.
(To be continued...)
One of the first things that I did once we got my arm stabilized in a sling and once we had given me some ibuprofen, was to work any trigger points that I thought would have been affected by my fall.
I visualized what might have happened in the fall. I pictured my elbow hitting the ground. I could imagine that muscles and bones in my upper arms and my forearms would be jarred quite hard. I could see that all of my shoulder muscles were probably affected. They would have to work hard to keep my shoulder in place.
I steered clear of working trigger points in my arm in the beginning because I did not want to inadvertently put pressure on the broken bone, wherever it might be.
I started out working my infraspinatus, supraspinatus, and my pecs.
The infraspinatus and supraspinatus are the muscles that lie on top of the shoulder blade, or scapula. There is a raised part of the shoulder blade that goes across the upper half of the shoulder blade. It is sometimes referred to as the scapular spine. The infraspinatus is the muscle that lies below the scapular spine. (Infraspinatus means "below or under the spine.") The supraspinatus is a muscle that lies above the scapular spine.
I worked the infra- and supra- spinatus with a lacrosse ball against the wall. I was very careful to keep my injured arm from moving. It felt good, not only because it felt good to work the trigger points, which did need work, but also because working the trigger points released endorphins; my pain was partially relieved.
Since I was already up, I decide to work my gluts, lower back, and quads, too. A fall like I had probably involved most of my body, now that I thought about it.
I also worked my pecs. I could feel that they were very tight.
During our first visit to the doctor, the practitioner suggested that I unwrap my arm from time-to-time and work on trying to extend my range of motion. Later, when I was getting zero pain relief from the meds, I wondered if I had a pinched nerve somewhere. It felt very much like pinched nerves I've had in the past. I knew that working my trigger points would help to release something if it were pinched, so I began to work on the upper arm and lower arm muscles. I had also been working on my scalenes and sternocleidomastoids.
The only measurable pain relief that I got during this time period (between the first doctor's visit and the ER visit), was when I worked my trigger points in my arms. I worked from the top of the upper arm down toward my elbow, and from the wrist area up toward the elbow. I used supported thumb or supported fingers, and sometimes used a pinching technique, which I know is not very ergonomic, but I was trying to be careful to avoid the bones as much as possible. I could feel each muscle relax and the pain subside as I released its trigger points. It became more difficult, however, as I got closer to the elbow. I was so exhausted but so happy that my pain had subsided enough for me to get to sleep. I would get to sleep, but I'd wake up an hour or two later with screaming pain again. The muscles that had just been loose and relaxed were now tight as a spring.
I knew there must be something else going on. At this point, I wondered if anyone would be able to help me with my pain at all. Here I was taking Lortab (I did not realize that I had been prescribed a half dose), and it was not helping at all. The only thing that had helped me up to that point was trigger point therapy, and that was only temporary. Plus, I was exhausted from no sleep, and from tensing up against the pain. I could feel the tightness going further up my arm, into my shoulder and neck muscles. I could also feel that my abdomen was as hard as a rock, and my hips and upper legs were tensing up, too. I felt like a giant corkscrew.
In the middle of the night on Wednesday/Thursday, my husband and I decided to try the ER. I really didn't know if they would be able to help. I anticipated them trying to take an x-ray of my elbow again. I hadn't been able to extend my elbow enough at the on-call doctor and the technician there was not very sympathetic. She said, "I warned you that it would not be fun."
Before we left for the ER, I worked my upper arm, shoulder, and pec muscles. I wanted to have as much flexibility coming into that experience as possible.
(To be continued...)
Sunday, October 30, 2011
Sharing
You were probably taught to share at some point in your life. You may have heard phrases like, "Many hands make light work." Our muscles share, too. They often work together in teams. There might be several muscles from different areas of the body, working together to perform one function. When they all work together, the job is not too hard for any one muscle. But when one muscle stops doing its part for some reason, the other muscles take up the slack. If it is a temporary situation, these other muscles might recover quickly once the emergency is over; however, if it is a long-term situation, the other muscles may also become disabled.
Understanding which muscles perform which functions, gives us helpful information when treating our trigger points. It is a good idea to check the other muscles in a group to see what shape they are in. Muscles that work together often get trigger points together.
Have you ever used window blinds that use two cords to open and close the slats? One string pulls the slats closed one way; the other cord pulls them closed the other way. Many places in our body work on the same principle. For example, in our forearms we have the flexor muscles on the under side, which "pull" our hands and fingers down, and the extensor muscles on the top side, which "pull" our hands and fingers up. With window blinds, sometimes it is necessary to put tension on both cords to set the slats to the proper angle.
The same thing occurs with the extensor and flexor muscles of the forearm. Both sets of muscles are required for many tasks. For example, gripping requires both sets of muscles. Computer work calls on both the flexors and extensors. Many of us (including me) spend long periods of time at the computer, overworking not only our arms, but our shoulder and neck muscles, too.
The relationship between other muscles may not be as obvious. When we have back trouble, it may not occur to us to check our stomach or buttocks muscles for trigger points, but when you understand that stomach muscles work with back muscles to lift us up and carry us around, and that the buttocks muscles help us maintain our balance, it makes perfect sense to check them as well.
Sometimes, a whole set of muscles becomes disabled and we use another set of muscles to accomplish the task that the disabled muscles used to do. Often, these other muscles are not able to handle the extra job, and they, too, become disabled. This can set up a scenario of one problem after another.
A few years ago, I discovered that I could use a grabber tool to pick things up off the floor without having to bend down. At that time, my back was so disabled that I had maybe one or two bends a day before I simply could not do any more. I could not sit on the floor to pick things up because it would make my back worse. I purchased my grabber tool and I went to town. I picked up everything. I got fast at it. I was so happy that I had found a way around my disability. However, it was not long until I started to have problems with my shoulders, arms, and hands. I could hardly do anything with my hands. I distinctly remember one time trying to cut out biscuits with a biscuit cutter and being in so much pain that I took a break after each biscuit. It was excruciating. I had overworked my hands, using the grabber tool to compensate for my disabled back, and in the process, I disabled another large portion of my body.
I can now bend over and pick things up again, and I save the grabber tool for getting things in hard to reach places and for picking up garbage out in the yard. I work my trigger points before and after bending activities. I work muscles in my back, gluts, legs and stomach, since they all participate in the bending. As for my shoulders, arms, and hands, I am still working on recovering them.
So, it is a good idea to know which muscles share tasks together. The Trigger Point Therapy Workbook describes the function of muscles, and has them grouped together in a logical way. The trigger point map has some drawings that help to understand the placement of muscles. You can also analyze your own movements. Place your fingers on your forearm, for example, while you flex up and down. You will get an idea of which muscles are doing what.
Knowing more about your muscles will help you to treat your pain more effectively.
Understanding which muscles perform which functions, gives us helpful information when treating our trigger points. It is a good idea to check the other muscles in a group to see what shape they are in. Muscles that work together often get trigger points together.
Have you ever used window blinds that use two cords to open and close the slats? One string pulls the slats closed one way; the other cord pulls them closed the other way. Many places in our body work on the same principle. For example, in our forearms we have the flexor muscles on the under side, which "pull" our hands and fingers down, and the extensor muscles on the top side, which "pull" our hands and fingers up. With window blinds, sometimes it is necessary to put tension on both cords to set the slats to the proper angle.
The same thing occurs with the extensor and flexor muscles of the forearm. Both sets of muscles are required for many tasks. For example, gripping requires both sets of muscles. Computer work calls on both the flexors and extensors. Many of us (including me) spend long periods of time at the computer, overworking not only our arms, but our shoulder and neck muscles, too.
The relationship between other muscles may not be as obvious. When we have back trouble, it may not occur to us to check our stomach or buttocks muscles for trigger points, but when you understand that stomach muscles work with back muscles to lift us up and carry us around, and that the buttocks muscles help us maintain our balance, it makes perfect sense to check them as well.
Sometimes, a whole set of muscles becomes disabled and we use another set of muscles to accomplish the task that the disabled muscles used to do. Often, these other muscles are not able to handle the extra job, and they, too, become disabled. This can set up a scenario of one problem after another.
A few years ago, I discovered that I could use a grabber tool to pick things up off the floor without having to bend down. At that time, my back was so disabled that I had maybe one or two bends a day before I simply could not do any more. I could not sit on the floor to pick things up because it would make my back worse. I purchased my grabber tool and I went to town. I picked up everything. I got fast at it. I was so happy that I had found a way around my disability. However, it was not long until I started to have problems with my shoulders, arms, and hands. I could hardly do anything with my hands. I distinctly remember one time trying to cut out biscuits with a biscuit cutter and being in so much pain that I took a break after each biscuit. It was excruciating. I had overworked my hands, using the grabber tool to compensate for my disabled back, and in the process, I disabled another large portion of my body.
I can now bend over and pick things up again, and I save the grabber tool for getting things in hard to reach places and for picking up garbage out in the yard. I work my trigger points before and after bending activities. I work muscles in my back, gluts, legs and stomach, since they all participate in the bending. As for my shoulders, arms, and hands, I am still working on recovering them.
So, it is a good idea to know which muscles share tasks together. The Trigger Point Therapy Workbook describes the function of muscles, and has them grouped together in a logical way. The trigger point map has some drawings that help to understand the placement of muscles. You can also analyze your own movements. Place your fingers on your forearm, for example, while you flex up and down. You will get an idea of which muscles are doing what.
Knowing more about your muscles will help you to treat your pain more effectively.
Thursday, October 20, 2011
Dealing with Tension/Anxiety
I could feel my tension increasing over the past few days. I woke up with my teeth clenched (harder than usual), and I could feel my shoulders and neck getting tighter and tighter. Because of my tension, I really didn't feel like doing much that I considered productive--I couldn't seem to focus--and so I "wasted" some time. I responded by tensing up even more.
When you feel tense and/or anxious, it is hard to motivate oneself to work trigger points. (It's hard to motivate oneself to do anything.) Even if you want to, you may not be thinking clearly, or you may feel overwhelmed and not know where to start. You may think that it may not work anyway, etc. But, working them will help--sometimes a lot.
The number one thing to do is to start somewhere, anywhere. There is a domino effect, and releasing the tension in one muscle will help release tension in other muscles. Once you get the ball rolling, you will feel a noticeable lessening of tension.
I have found that if I try too hard to work my shoulder and neck muscles in the beginning, I am not always successful, maybe because I am using the muscles that I am trying to relax, and I am just too tense to make it work at that point. However, if I work them after I have worked some other muscles, I have more success.
Today, I will give you an overview of what I might work if I am feeling tense. Generally, I don't do this all in one go. I might do two or three areas, take a break, and then continue later with the other areas.
First, I use the lacrosse ball against the wall to work my gluts (these are your backside muscles). Remember not to press hard against the bone. But, press as much as you want on the muscles.
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| Working the hamstrings with a lacrosse ball. |
Then, I usually work my quads (muscles in front and side of the upper leg). The trigger points on the outer side of the leg are particularly painful. Take it easy. You may want to work around them at first, and gradually work up to working on them directly.
 |
| Place lacrosse ball in the front of your thigh. |
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| Working the sides of your quads. |
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| Be sure to stay off the bones of your spine. |
If you are able to lean back far enough, you can move up to your shoulder area.
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| Working the serratus anterior (below the armpit). |
I like to work the muscles under my armpit (the serratus anterior). Raise your arm and put the ball just below your armpit. These trigger points are extremely tender, so be careful. There are also some potent trigger points just below where the arm and back meet, on both the back and the arm.
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| Working the upper arm. |
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| Working the inside of the forearm. |
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| Working the outer forearm. |
Then I use my theracane on my neck and shoulder area.
Today, I found a big trouble-maker in the back of my neck. It is easier to work now that I have relaxed my shoulder and arm muscles enough to effectively use the theracane, and I have relaxed some of the surrounding muscles.
(Note: Some of these first posts are adapted from emails that I sent out before I started the blog. This was from October 12, 2011. I am keeping track of the dates because I am always looking for patterns in my pain, including how often certain types of symptoms appear.)
(Note: Some of these first posts are adapted from emails that I sent out before I started the blog. This was from October 12, 2011. I am keeping track of the dates because I am always looking for patterns in my pain, including how often certain types of symptoms appear.)
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