Diana's Blog
A wide spectrum of massage therapy techniques can be helpful for improvement of fibromyalgia symptoms, from light touch energy based techniques to specific myofascial release and trigger point therapy. I recently came across a book written by an MD who has fibromyalgia and has developed a working theory about the origin of the disease and a treatment regimen which has been used successfully by many patients. R. Paul St. Amand, MD, founded the Fibromyalgia Treatment Center, a 501(c)3 nonprofit corporation whose purpose is to raise money for research into the diagnosis and treatment of fibromyalgia, educate the medical community and the general public about the nature, diagnosis and treatment of fibromyalgia and aid fibromyalgics in their search for health.
Dr. Amand’s book is entitled “What Your Doctor May Not Tell You About Fibromyalgia”. His website gives information about the research being done, an overview of the book, information for patients and research links.
March 5th, 2010
I give classes about the lymphatic system geared to the general public, especially those interested in gaining more knowledge about the body and how to enhance one’s health. Classes are generally three hours long, but can be shortened or lengthened according to audience needs. The intention is to convey the anatomy and physiology of the lymphatics, explore the ways in which it supports the body’s internal cleansing and immune functions, and give information about ways to support one’s own system.
The presentation includes audience interaction, visual aids and a guided meditation through the lymphatic system, to give participants a more felt sense of the pace and flow of the system. A special focus on the anatomy of the breast and it’s lymphatic drainage patterns, and information about how individuals can support their breast health, can be included in the program. The class is provided with handouts and additional resource guides.
October 6th, 2009
Trigger points can be “deactivated” and muscles returned to normal function via a specific kind of therapeutic massage called neuromuscular therapy, but if perpetuating factors remain, they are likely to return along with the pain and dysfunction.
What are perpetuating factors? The Trigger Point Manual cites mechanical stresses, nutritional inadequacies, metabolic and endocrine inadequacies, psychological factors and chronic infection. Other factors could include allergy, impaired sleep, radiculopathy and chronic visceral disease.
One common structural factor is lower leg length inequality which can cause a tilted pelvis when standing. Resulting TPs often cause back pain. Postural stresses are another perpetuating factor, and can be caused by misfitting furniture, poor posture, abuse of muscles, immobility and repetitive movement overload.
Dr. Travell cites nine common faults of most household chairs: “No support for your low back, armrests too low or too high, too scooped a backrest in its upper portion, backrest nearly vertical, backrest short, failing to support your upper back: jackknifing effect at hips and knees, high front edge of the seat, shutting down the circulation to your legs, seat bottom soft in the center, creating a bucket effect which places the load on the outer side of your thighs, rather than on the bony points in the buttocks; an excellent chair may be the wrong size for you.”
Another common problem is poor posture, including unphysiologic positioning at a desk or work surface and head tilt resulting from poorly adjusted reading glasses. “Reading and copy material should be placed at eye level to avoid sustained forward tilting of the head to relieve the posterior neck and upper back muscles of prolonged checkreining overload. Other common sources of postural strain include malpositioning of materials that a person uses, such as placing documents flat at one side without a stand, writing on the lap, or using the neck and shoulder muscles to hold the receiver of a telephone against the ear.”
“Abuse of muscles perpetuate TPs by poor body mechanics that render body movements needlessly stressful, by sustained isometric contractions or immobility of the muscles, with too many repetitions of the same movement, and by excessively quick and jerky movements. A common example of poor body mechanics is leaning over while twisting sideways to lift an item from a shelf or the floor. The same effect is produced when a person leans over the sink to brush the teeth, or stoops forward to get in and out of a chair.
“A frequent repetitive movement can overload muscles and cause TPs…as in sorting tasks in an assembly line, post office, or movements by a performing artist. Bruxism and emotional tension can interact to overload the masticatory muscles, perpetuating TPs which cause head and face pain.
“Myofascial TPs are perpetuated by prolonged constricting pressure on a muscle, such as the pressure from a a strap of a ponderous purse hung over the shoulder or by narrow brassiere straps that support heavy breasts and groove the upper trapezius.”
Determining the perpetuating factors which apply in your case is key to improving myofascial ease and comfort.
September 18th, 2009
From Travell & Simons’ Myofascial Pain and Dysfunction, The Trigger Point Manual:
“Active Trigger Points (TrPs)produce a clinical complaint (usually pain) when a TrP is digitally compressed. Latent TrPs can produce the other effects characteristic of a TrP including muscle tension and muscle shortening (but do not produce spontaneous pain.) Both active and latent TrPs can cause significant motor dysfunction.
“The activation of a Trp is usually associated with some degree of mechanical abuse of the muscle in the form of muscle overload, which may be acute, sustained and/or repetitive. In addition, leaving the muscle in shortened position can convert a latent Trp to an active TrP, and this process is greatly aggravated if the muscle is contracted while in the shortened position.
“The patient is aware of the pain caused by an active TrP but may or may not be aware of the dysfunction it causes. Latent TrPs characteristically cause some increased muscle tension and limitation of stretch range of motion, which often escapes the patient’s attention or is simply accepted. The patient becomes aware of pain originating from a latent TrP only when pressure is applied to it. Spontaneous referred pain appears with increased irritability of the TrP, and then it is identified as active.
“The patient usually presents with complaints due to the most recently activated TrP. When this TrP has been successfully eliminated, the pain pattern may shift to that of an earlier, key TrP which also must be inactivated. If the key TrP is inactivated first, the patient may recover without further treatment.
“The intensity and extent of the referred pain pattern depends on the degree of irritability of the TrP, not on the size of the muscle. Myofascial TrPs in small, obscure muscles can be as troublesome to the patient as TrPs in large, familiar muscles.”
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