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View Full Version : Welcome to the wonderful world of referred pain!



James Boelter
08-08-2004, 02:31 AM
Most interesting experience of the week: I was giving a friend a long-promised shiatsu session (actually, there was also a lot of Canadian Deep Muscle Massage, shhh, don't tell :wink: ) yesterday afternoon. I was nearing the end of the routine and palming down the inside of the left thigh when she said in a strange voice - "...Oh...could you do that again? Up near the hip fold? That felt really good..."

Being an obliging and non-doctrinaire fellow, I went back to the requested area and applied some pressure and some cross fiber massage to some knots in the tissue . After a few moments I could sense a bit of a shift, but I couldn't put it in words.

Then she said, "You know, that part of the back of the leg, on the inside near the knee?" A little probing revealed that she meant where the semimembranous part of the hamstring muscle attaches to the back of the knee. "Could you like, press it or squeeze it, or something?" Of course I could. Acting on an obscure impulse, I 'picked up' the muscle between thumb and the first two fingers, as if I were rolling it between the digits and lifting it away from the bone ("as if", not actually!). It felt like there was a little crackly thing in there. So I grounded myself, applied the 'Zen shiatsu' approach of having a 'giving hand' and a 'receiving hand' further up the limb, put my 'intention' into the area, and squeezed/pinched the area in sync with my friend's breath - squeeze on the exhale, release on the inhale ( this is a basic shiatsu tactic, intended to help the client relax into the pressure and not interfere with their breathing cycle). After about 4 minutes, I decided she'd had enough and let go.

Now comes the cool part: my friend lay quietly on her back for several minutes, processing something, and again, I couldn't tell you exactly what was going on. Then she said in that strange voice: "Ummm...my hips just realigned themselves. My left leg has been hurting for weeks, and it's...better. And my hip and back don't hurt anymore!"

I have no idea how that worked. In my limited knowledge of trigger points and referred pain, I've never heard of that particular relationship, though I can guess at the linkages involved. I'd better go back and look at my myotherapy material again. Or it might have been something new and unique to my friend. Call it a classic case of 'The Dance of The Tissues". In any case, it made my day (and hers, of course).

Damn near a mystical experience, and another example of what the Body-Mind can do if it is 'allowed' to correct itself.

I love this stuff.

bob_stra
08-08-2004, 11:35 AM
It's good stuff, ya? It's the real joy of body work - not the endless pursuit of techniques, but figuring out connections.

I wouldn't bother with looking over the trigger point stuff too much - that stuff is useful and intellectually stimulating, but if you start thinking in those terms all the time, it's very limiting. Much like anything (Muscle energy tech, myofascial etc). Everyone thinks their method is "the one true way". ;-)

Some of the strangest connections are ... well, "anatomically impossible". So much so that you have to look into neurological stuff to explain it.

One interesting point - for me, affecting the function of a particular joint changes the function of all the related connections there. So working on elbow joint will alter the function on the forearms, shoulder and chest. The neat thing is - you can work on the elbow (1) Through / via fingers (2) Through the scapula (3) Clavicles (4) Sternum (5) Ribs. (6) Feet (7) Spine (8) Almost everywhere.

Lots of different ways of transferring / travelling force between point A and B. Lots of different "force circuits" along the way that can be "optimized" for some neat "huh - what? how?" results.

Simplifying -

Left thigh : hipfold : pelvis

Pelvis : hamstrings

Hamstrings : knee.

Next time, see what happens if you work on the knee first - or even better yet, on the knee & pelvis via the foot thru the shinbone !! Maybe some reflexology stuff? And what if there's some kind of "jam" in one of the connections for transferring force from the feet upwards? - lots of fun ways to tackle that. Deep tissue, trigger point, passive movement.....tons and tons of goodies.

Lots of fun going back and forth between the different stuctures. Real detective work. Very gratifying.

Good for you James. It took me years to grok onto this and you've started into it within such a short time. I predict big things in your future, if only you protect your damn thumbs and hands ;-)

Jarlo Ilano
08-08-2004, 01:16 PM
James,

Good stuff! Manual therapy can be very exciting.

You will start finding alot of stuff that won't be in your standard texts. This is where either physically or mentally taking notes of what you find in people and starting to correlate these findings with your patients' history, body type, mental/emotional state, etc.,

Tensegrity is a concept that would seem to explain alot of these "anatomically impossible" connections.

I'm glad you've found a vocation in something you love. It's a blessing.

Bob,

Glad to see you posting again. Your insights are always solid.

Regards,

Randell Waddell
08-08-2004, 04:47 PM
Go the big "T" !!!!!!!!

Cheers
Randell. :D

bob_stra
08-09-2004, 01:42 AM
Go the big "T" !!!!!!!!

Cheers
Randell. :D

James is the "Big T?" :?

Well in that case - Go the big T :)

Randell Waddell
08-09-2004, 01:51 AM
The Tensegrity concept, Bob.

Cheers
Randell. :D

James Boelter
08-09-2004, 01:59 AM
I think he meant big "T" as in "Tensegrity".

Bob and Jarlo, much thanks for your comments. The trick is going to be to not treat this as a 'canned' procedure (ie, if it worked once, it should work every time, all I have to do is press that spot and...) but to remain in a state of open minded inquiry. Easier said than done.

Arluk
08-09-2004, 04:15 PM
Bodywork is one of my favorite meditations. I let the clients body guide my hands and just get my mind out of the way, off to the observer state where I don't have to do anything but be aware and let it all pass as it needs to.

bob_stra
08-09-2004, 04:27 PM
> I think he meant big "T" as in "Tensegrity".

*buys James a "I'm with Stupid" T shirt, with arrow point at me*


> The trick is going to be to not treat this as a 'canned' procedure (ie, if it > worked once

True. But you might like to start next time by summarizing what you did the first time. Kind of a like a "Previously, on ..." See if it still has the same effect. Might make some of the connections clearer? Then take it where ever it goes from there.

Hell - never mind. I'm giving you advice you don't need. But do post again to keep us informed. This kinda thing is pretty interesting all around.