Let me tell ya lil story bout a messed up thumb... As a Massage Therapist, having my hands hurting constantly with fingers locking in pain, unable to work, is not conducive to making a living...paying bills, or even being somewhat effective at work. I struggled with trigger tendons for a year. I kept working and tried various therapies and was prepared to take a several month break to have surgery. But no... Trigger Tendons can be painful. They can often just be annoying or even a cool trick to show friends. The anatomy involved is, of course, tendons, but as there is inflammation on the tendon as it passes through a sheath or crosses a pulley at the joint. It can lock. The release of this locked tendon is visible with a snapping twitch, painful or not. I still have one trigger tendon that has never been painful. And it does not go away. I ignore it except to show it off at parties. I have had four other trigger tendons that brought tears to my eyes and made me articulate my feelings about said pain using colorful metaphors and choice expletives. , sometimes during treatment with a client on the table. I sought help first from an orthopedic doctor. I received injections which took away my pain 100%, until I went back to work a week later. Pain and inflammation returned w a vengeance, this time in an additional digit. I then sought help from my massage therapists, Mariam Samha and Marlene Turner. Both were able to give me some relief as they were thorough in treating all the way up to my elbow. Mariam performed myofascial release and pin and stretch methods to include each digit and short muscle of the hand as well as longer muscle in the forearm. Marlene then applied a new treatment technology using a combination of frequency-emitting wearable sticker discs, ANF therapy. I realized some relief from both but it was only temporary. I see their work as valid, yet the intensity and measure of reoccurring debilitating pain had me willing to undergo surgery.
But then a funny thing happened. This guy proposes to my daughter. My baby girl will be married come May 2019. Other than joy and happiness for both of them, I also experience fear and sadness. "I got to get my butt in better shape so as to be present at the wedding...to give my daughter away." I knew what I must do. Lifestyle changes that include diet and exercise. As I started I was intentional about eliminating all foods and beverages that cause inflammation. So sad. I also added items that combat inflammation. So, hello healthy food, goodbye processed food, sugar, alcohol. "Hey, my hands dont hurt anymore." What? I got rid of my trigger tendons even while increasing the volume of my massage practice by
It took 4 weeks to restore the strength and health of my hands and fingers without taking a break from work. Im at 90%. My therapists could have done more over time, but the root cause was an inflammatory state due to what I was consuming. Input equals Output. Ive done Adkins when Keto wasn't cool. I discovered Ketogenic research 7 years before it became a fad. Ive done Primal and Paleo. Ive lost 800 pounds over the last 15 years. Minus 50 plus 60, minus 70 plus 80, minus 20 plus 25 ...etc. Im not saying Ive arrived and have the answers to anything. Dont follow me. Im just saying my hands don't hurt. I lost weight. Im going to a wedding. Im giving my daughter away. Oh, bacon is its own food group.
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As is often the case I see clients with similar issues during a short period of time: identical headaches, same rotator cuff issue, tennis elbow...etc. The past two weeks Ive encountered several presenting with the same chief complaint, upper back pain. They usually have the same story to tell as well. "It's right between my shoulder blades but more so on the right side. I've been rolling a ball on that spot and it gets better for a day, but then it comes right back." Rolling a ball on that spot, equal to foam rolling or a therapist that only works on that painful spot, will help for a brief time. Consider that the cause of pain is coming from somewhere else. If the pain continues to return then obviously a more thorough treatment is warranted. If your Massage Therapist, Chiropractor, PT, AT isolates the area of pain in treatment without investigating as to the reason for the onset and progression of pain, much can be missed. I know many professionals ask questions about repetition, prolonged shortening, posture and ergonomics. But, too often, the simple relationship among antagonistic muscle groups, those that act opposite of each other, are not considered. MANY issues with the upper back and too many issues with rotator cuff impingement are a direct result of Upper Crossed Syndrome, medially rotated shoulders and forward head posture. While there may not be an obvious postural distortion, as with athletes and bodybuilders, it still involves the dominance of one group of muscles and the inhibition or lengthening of the opposing group of muscles. As with the cases of upper back pain I'm referring to, and with athletes and bodybuilders, the pecs, shoulders and lats are tight and weak leaving the traps and rhomboids long and weak. Having tight muscles is not a sign or guarantee of optimal strength. A short and tight muscle is not as strong as it could be. A long muscle, being pulled by the opposite group of muscles, is also not as strong as it could be. Some muscles, when stressed, shorten. Other muscles, when stressed, lengthen. This describes perfectly the relationship between the muscle groups Ive identified. Pectoralis Major, Anterior Deltoid, Latissimus Dorsis, Teres Major, and Subscapularis are all medial rotators of the shoulder. Serratus Anterior is an abductor of the scapula, pulling it around the ribcage. When they are stressed they shorten giving rise to medial rotation and Upper Crossed Syndrome. The opposite group of muscles, Posterior Deltoid, Infraspinatus, Teres Minor, Rhomboids, and Trapezius are being pulled along into a lengthened position, allowing Upper Crossed Syndrome. Restoring this balance between the groups of muscles is crucial to resolving issues of pain and dysfunction. It is crucial for optimal strength and athletic performance. How do I address it? I tell my athlete to "take a break from the gym. We must normalize the tissue first, relieve pain and reduce inflammation. Instead of working to further shorten the culprit group of muscles, I will work on them to lengthen them and then you must do the appropriate stretches for the same. If I only work on the painful area it is going to continue to come back. If we rest and lengthen the one group of muscles it will take the tension off of the long and weak group of muscles, allowing them to regroup. When you go back to the gym, double the amount of lateral rotation of the shoulder and retraction of the scapula compared to that of pushing and pulling with the dominate group. In other words, work your post delt, infra and rhomboids 2:1 to that of pecs, lats...etc. Therapy on the shortened group of muscles involves a lot of gliding, pin and stretch, and trigger point work immediately followed by stretching. After Ive worked the pecs and other medial rotators, I have them stand and stretch. I have them test the area of pain. Often it is already diminished without having worked on the painful area yet. I still work on the painful spot between the scapula., but only after Ive addressed the culprit. As has been reported, individuals are experiencing greater relief. The ones that quit the gym for a week get more results in and out of the gym. |
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September 2019
Bobby LewisNeuromuscular Therapist |