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Archive for the ‘Trigger Points’ Category

Self Care in Trigger Point Therapy
By Bernard L. Gladieux, Jr.

Pain, as most of us know by our own life experience, comes in a variety of forms, at any age and at any time of the day or night, often when we least expect it or when it is most inconvenient. Accordingly we would do well to consider devising an accessible approach to self care for that time when, by accident, over-use or chronic condition, our pain level rises to the point at which we become dysfunctional or distracted or both.

If the idea of taking positive charge of your own well being in this way leaves you anxious or confused or weak in the knees, seek out the help of a knowledgeable friend or health professional. Often a coach or personal trainer or massage therapist can offer insights and pointers that will lead you in the right direction.

Since most garden variety pain has more to do with soft tissue or muscles, here is where you will likely find the best answers to your most basic questions. One approach to the matter of pain is to think of the three ways of dealing with most of it that you will encounter in your everyday life. These are: Prevention, First Aid and Long Term Management.

“Since most garden variety pain has more to do with soft tissue or muscles, here is where you will likely find the best answers to your most basic questions. One approach to the matter of pain is to think of the three ways of dealing with most of it that you will encounter in your everyday life. These are: Prevention, First Aid and Long Term Management.”

Prevention:
There is no way to guarantee that you will be able to live pain free, no matter how protective or cautious you are. However, a regular program of moderate, well balanced exercise with generous amounts of aerobic, cardio vascular activity, some strength training and stretching with some variation in routine will go a long way to keeping your body tuned up, strong and limber enough to do all of the things you have always enjoyed and which give color, texture and energy to your life without your having to be concerned about hurting yourself.

Of course if your interests turn toward mountain climbing, sky diving, or skiing steep and deep powder, and the like, you will certainly want to step up your conditioning to levels appropriate for your sensible and realistic aspirations.

First Aid:
Pain is often the signal that something is amiss when injury strikes. Listen to it even as all of your best plans are falling apart. Assess the damage. Is it a broken bone, a joint sprain, a muscle strain, a traumatic injury or an over-use syndrome on the rise? Your answers may or may not point you in the right direction, but they will add to your store of experience that should help protect you in the future. For most athletes and sport oriented therapists and trainers, icing, rest, compression and elevation are the traditional first treatments for soft tissue injury. Broken bones and more severe muscle and joint damage take longer and more complicated repair and recuperative protocols.

Long Term Pain Management:
Eventually prevention and first aid lead to and then blend in with long term management of symptoms. All of these care phases then become a seamless whole. In the quest for pain free and optimally functional long term fitness, serious seekers of effective self care will search for knowledgeable, pain management clinicians, but, as David Simons, M.D. has said,* “…finding a truly skilled practitioner can be frustratingly difficult.” But, he adds, “There is no substitute for learning how to control your own musculoskeletal pain. Treating myofascial trigger points yourself addresses the source of that kind of common pain and is not just a way or temporarily relieving it.”

This self care principle is a direct outgrowth of the trigger point identification and treatment protocol that was developed both before and after World War II by Hans Kraus, M.D. and Janet Travell, M.D., among others including aerospace researcher and physician David G. Simons, M.D. By the late 1970s, nationally popular exercise therapist and promoter, Bonnie Prudden and friend and associate of Drs. Kraus and Travell, had developed her own, non invasive trigger point protocol that was a direct extension of the early work of Kraus and Travell.

Prudden called her technique Myotherapy, wrote a book on it and founded her own Academy for Physical Fitness and Myotherapy in a former elementary school in Lenox Masachusetts to train professional myotherapists. The elements of the Prudden Myotherapy treatment include the following key elements:

The success of this therapeutic protocol is measured by the subjective reduction in pain, increased flexibility and range of motion as well as in increased strength, endurance and over all physical function. Success is also measured by the degree to which patients become active participants in their ongoing self care.

Over the past thirty years the myotherapeutic model has been widely practiced by physicians and therapists representing the span of professional disciplines that define mainstream, physical medicine. And it is now well accepted as an effective and conservative treatment option.

Precipitating factors. By thorough patient intake interviews, the myotherapist
seeks to discover the conditions and circumstances that contribute to the patient’s symptoms.

Deep, manual, soft tissue ischemic compression and myofascial release of trigger points.

Individualized active and passive stretching exercises often facilitated with topical application of coolant spray.

Detailed patient instruction in home self care including deep muscle compression, stretching and strengthening exercises and the management and avoidance of precipitating factors.

In Good Heath,
Bernard L. Gladieux, Jr.
President,
The Pressure Positive Company®

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TRAIN FOR STRESS MANAGEMENT
By Bernard L. Gladieux, Jr.

Stress, in the conventional wisdom, is an inevitable feature of modern life. Some might call it a pandemic. It may well be true that even with our labor saving devices and efficiencies now so much a part of everyday living, we moderns still experience more everyday stress compared with our ancestors of even one, two or three generations ago. Given that contemporary stressors are not likely to diminish in their influence over us any time soon, our only hope must come from how we learn to cope and adapt to the tension building vagaries of our world.

StressManagement1
Personality, character, upbringing and the luck of the draw have a lot to do with how you respond when it all seems to be caving in on your head. But techniques for coping and managing stress can also be learned. One of the best, as any athlete will tell you, is just to go out and have a successful workout at whatever you do and like the best.

Here are a few thoughts about using your athletic training or fitness exercise as an approach to personal stress management.

DOING IT:
For physical activity to work as a stress countering measure, you do actually have to go at it with vigor. Thinking about it, dabbling or playing at it won’t work. You can’t go to the Nautilus center and hang out as if recovering from a hard set for an hour and a half and get any real benefits. You can’t expect too much out of your first and only work out in six months. For exercise to impact on your stress level, you need to be trained enough at it to sustain at least minimum of a half hour of uninterrupted, serious effort.

LIKING IT:
If your base activity is aerobic, and it is not physically self destructive, it matters a great deal less what you actually do than how much you enjoy it. Even if you have a masochistic quirk steering and a puritan ethic driving your enthusiasm, you probably won’t be able to support a long term commitment to your exercise program unless it yields you some level of reliable, escapist pleasure. If you have not yet discovered such an exercise pastime, get creative and keep looking.

USING IT:
Once you have settled on a favored physical activity or, even better, a variety of them, you can choose at will whatever suits your day and circumstances for medicinal, sedative or preventive purposes. You say your loud, opinionated hard drinking, smoking in laws are all coming for the family’s Labor Day picnic when it is supposed to rain, and you are all going to be jammed into the back porch for the day? Go for a long run, Lose yourself in it; come back refreshed and at peace. When it’s all over you know you can go out again tomorrow and leave any lingering nasties out on the road. It may not improve your picnic much, but you’ll be tougher

CONTROLLING IT:
One of the few psychological problems habitual athletes encounter is the addiction to regular training that can develop over time. Most medical and behavioral experts discount the seriousness of athletic addictions because they are considered positive and healthful. However, if you are aware that you have addictive tendencies and are likely to continue training even though doing so, for example, will aggravate an injury, take special pains to seek out advice and. or other training alternatives before it controls you.

BEING COHERENT:
If physical training is a valued part of your coping strategy, it doesn’t make much logical sense to otherwise dissipate your health or your energies in wasteful, counterproductive pursuits like smoking, excessive partying or overwork, all of which can load on your stress. Usually age brings with it some common sense along with physiological imperatives that help veteran athletes keep to the straight and narrow path of virtue. But beware, there are few who would not agree that we grow to soon old and too late smart.

In Good Health,
Bernard L. Gladieux, Jr.
President
The Pressure Positive Company®

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Pain, as most of us know by our own life experience, comes in a variety of forms, at any age and at any time of the day or night, often when we least expect it or when it is most inconvenient. Accordingly we would do well to consider devising an accessible approach to self care for that time when, by accident, over-use or chronic condition, our pain level rises to the point at which we become dysfunctional or distracted or both.

If the idea of taking positive charge of your own well being in this way leaves you anxious or confused or weak in the knees, seek out the help of a knowledgeable friend or health professional. Often a coach or personal trainer or massage therapist can offer insights and pointers that will lead you in the right direction.

Since most garden variety pain has more to do with soft tissue or muscles, here is where you will likely find the best answers to your most basic questions. One approach to the matter of pain is to think of the three ways of dealing with most of it that you will encounter in your everyday life. These are: Prevention, First Aid and Long Term Management.

Since most garden variety pain has more to do with soft tissue or muscles, here is where you will likely find the best answers to your most basic questions. One approach to the matter of pain is to think of the three ways of dealing with most of it that you will encounter in your everyday life. These are: Prevention, First Aid and Long Term Management.

Prevention:
There is no way to guarantee that you will be able to live pain free, no matter how protective or cautious you are. However, a regular program of moderate, well balanced exercise with generous amounts of aerobic, cardio vascular activity, some strength training and stretching with some variation in routine will go a long way to keeping your body tuned up, strong and limber enough to do all of the things you have always enjoyed and which give color, texture and energy to your life without your having to be concerned about hurting yourself.

Of course if your interests turn toward mountain climbing, sky diving, or skiing steep and deep powder, and the like, you will certainly want to step up your conditioning to levels appropriate for your sensible and realistic aspirations.

First Aid:
Pain is often the signal that something is amiss when injury strikes. Listen to it even as all of your best plans are falling apart. Assess the damage. Is it a broken bone, a joint sprain, a muscle strain, a traumatic injury or an over-use syndrome on the rise? Your answers may or may not point you in the right direction, but they will add to your store of experience that should help protect you in the future. For most athletes and sport oriented therapists and trainers, icing, rest, compression and elevation are the traditional first treatments for soft tissue injury. Broken bones and more severe muscle and joint damage take longer and more complicated repair and recuperative protocols.

Long Term Pain Management:
Eventually prevention and first aid lead to and then blend in with long term management of symptoms. All of these care phases then become a seamless whole. In the quest for pain free and optimally functional long term fitness, serious seekers of effective self care will search for knowledgeable, pain management clinicians, but, as David Simons, M.D. has said,* “…finding a truly skilled practitioner can be frustratingly difficult.” But, he adds, “There is no substitute for learning how to control your own musculoskeletal pain. Treating myofascial trigger points yourself addresses the source of that kind of common pain and is not just a way or temporarily relieving it.”

This self care principle is a direct outgrowth of the trigger point identification and treatment protocol that was developed both before and after World War II by Hans Kraus, M.D. and Janet Travell, M.D., among others including aerospace researcher and physician David G. Simons, M.D. By the late 1970s, nationally popular exercise therapist and promoter, Bonnie Prudden and friend and associate of Drs. Kraus and Travell, had developed her own, non invasive trigger point protocol that was a direct extension of the early work of Kraus and Travell.

Prudden called her technique Myotherapy, wrote a book on it and founded her own Academy for Physical Fitness and Myotherapy in a former elementary school in Lenox Masachusetts to train professional myotherapists. The elements of the Prudden Myotherapy treatment include the following key elements:

The success of this therapeutic protocol is measured by the subjective reduction in pain, increased flexibility and range of motion as well as in increased strength, endurance and over all physical function. Success is also measured by the degree to which patients become active participants in their ongoing self care.

Over the past thirty years the myotherapeutic model has been widely practiced by physicians and therapists representing the span of professional disciplines that define mainstream, physical medicine. And it is now well accepted as an effective and conservative treatment option.

Precipitating factors. By thorough patient intake interviews, the myotherapist seeks to discover the conditions and circumstances that contribute to the patient’s symptoms

Deep, manual, soft tissue ischemic compression and myofascial release of trigger points.

Individualized active and passive stretching exercises often facilitated with topical application of coolant spray.

Detailed patient instruction in home self care including deep muscle compression, stretching and strengthening exercises and the management and avoidance of precipitating factors.

In Good Health,
Bernard L. Gladieux, Jr.
President,
The Pressure Positive Company

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Quick Fixes For Aches and Pains
By Bun Gladieux Jr.

We who exercise or train regularly are generally down-to-earth, practical types, friendly to things that work. So it is not surprising that our confidence in medical care runs to the pragmatic. When we are hurt, we want the fix; we want it now, and we want it simple.

Here are some practical, approachable, effective fixes that can keep you up and chugging if they are applied appropriately. There are no magic bullets here, no dramatic cures or panaceas. Their bedrock is common sense and moderation.


Icing
:
If you hurt from plain overuse, in all likelihood the problem is in some soft tissue
like muscle or tendon. The tissue is inflamed, swollen and painful. Icing the area will help to decrease the inflammation and swelling, reduce the pain and encourage blood circulation. All of this helps to accelerate healing. Apply your ice in whatever form is most convenient. Cool the injured tissues well to achieve the desired effect using ice bags, packs, cubes or a pail of ice water- they all have their place.

Massage
By manipulating soft tissue with the hands, it is possible to reduce stiffness and pain and to increase circulation. Most people know intuitively how to rub a sore spot to make it feel better, but the results of a trained, knowledgeable, sports massage therapist can be dramatic. As a general rule, if you have access to someone who has the “gift,” be very nice to them, and if they offer to help you, accept the kindness gracefully and gratefully.

Trigger Point Compression:
This technique is different enough from massage to merit its own niche in a catalog of first-line measures for treating muscular or myofascial injury. Again, it is something you can do for yourself if you can reach the site with your hands or with a device that extends your reach. You may also be able to track down a myotherapist or a physical therapist who specializes in “myofascial release.” Although the actual physiological mechanism is not universally accepted or fully understood, ischemic compression (that is, direct pressure deep enough to slow the flow of blood through the tissue at the site) usually does provide a marked release of muscle tension that enables greater range of motion and an early return to strengthening and stretching exercise.

Orthotics:
Sometimes a problem like plantar fasciitis will go away just by changing shoes or by inserting an arch support or an insole. But the best and surest solution to a foot or foot strike related injury is professionally fitted orthotics. These devices are not cheap, but good ones should last forever. In the long run, given what they can do for you,
they’re a bargain.

Wrapping:
For some injuries, like a sprained ankle or a sore knee, you can sometimes get protection and a little more mileage out of wrapping with an elastic bandage. If you know what you are doing and have some training and experience in wrapping, it can protect you from further injury. Wrapping a new joint sprain along with ice and elevation can help to keep swelling down and promote faster recovery.

Taping:
A practice used routinely in many competitive sports, taping is often used to provide joint stability and/or rigidity. Taping is also a preventive measure used, for example, to prevent further sprain of an unstable ankle. Such taping can be very helpful, but it can also drastically alter the biodynamics of your stride to produce stress problems in your knee, hip or back. Use taping sparingly and only if you know what you are doing.

Balms:
Blisters and chafing can bedevil any endurance athlete, and potions abound. To prevent rubbing injury like chaffing or blisters, a heavy, stable grease like petroleum jelly or bag balm (made for soothing milk cows’ udders) rubbed on the likely area of skin can save a lot of grief. Once you have a spot rubbed raw, a loose dressing with a healing salve or a “second skin” type product can ease the pain and speed healing.

Rest:
The ugliest, most feared remedy of all is, in the end, the simplest, most effective and the most difficult for the habitual athlete; it is rest. No one can make you stop your training until you, yourself conclude that there is no short cut and no other way. Sadly for many athletes, arrival at that conclusion comes only when the injured part just rebels and quits working. Save yourself that anguish. Look ahead enough to see just where you are going and if you don’t like what you see, change your direction, pronto. It is easier to do before you hit the skids on the slippery slope of the overuse syndrome.
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PREPARING FOR THAT FIRST STEP
By Bernard L. Gladieux, Jr.
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However some people try to make it otherwise, running and other fitness oriented activities are not generally very complicated enterprises. They are, after all, figuratively, if not literally, a matter of putting one foot in front of the other – over and over again. But as simple and natural as such pleasures can be, to the uninitiated, the prospect of starting for the first time
or after a long period of inactivity, the prospect of starting can be as daunting as any hurdle in life.

Here are some of the time-honored steps that most experts recommend when asked,
“How do I get started?”

Check-up: Ask your doctor, especially if you are over 35, fat or smoke cigarettes.
Have yourself checked out. To do it right, you should probably have a full stress electrocardiogram plus an analysis of your blood to determine your cardiovascular risk level or anything else that might be lurking in the wings. If you have been sedentary for five years or more, you are due for a physical exam anyway. Spring for it.

Gear-up: Go to a good running or fitness oriented sports store. There are plenty around in most places. There are also plenty of good running shoes that can be used for a variety of sports and exercise activities. Expensive ones are not necessarily going to be better for your feet or for your performance. Pick shoes that feel comfortable on your feet over the kind of socks that you plan to wear when you are out in the field, so to speak. If you shoe shop late in the day, you need to take into account that your feet will be somewhat larger than they will be right after breakfast. Choose a color that you can live with day after day.

You can wear any clothes you have that work for you and won’t be an embarrassment to you or your family. Bundle up when it’s cold, and when it’s hot, shed to the same sort of common sense point. Later on at events or expos or sales, you can pick up just about any other gear and accessories you will ever need.

Ease-in: Treat yourself tenderly. Even if you were a great athlete in school, your
time away from it may have left you unprepared for anything like a rapid re-entry. As a rule, plan to do one week of very slow jogging or walking for every year you have not done any significant exercise. If you are also overweight, continue this slow startup regimen until you are within 10 or 15 pounds of your weight at 21 or what you think of as your ideal weight, whichever is the lower.

Team-up: Seek out other runners or exercisers. Try to pair up with someone who is roughly at about your level of development one or more times a week. It will help you keep your commitment to yourself. Races and fun runs are terrific places to find kindred spirits. Ask questions. Subscribe to one of the magazines in the area of activity to which you are the most drawn. Join a local club if you wish, and throw yourself into it with abandon.

Eat-well: To truly and honestly pursue your new-found purpose, and to enjoy fully the benefits that will flow from your new, exercise-induced, fitness, you need to maintain and achieve and maintain relatively lean body. This rule is somewhat less true of swimming compared with weight bearing activities, but remains a worthy objective nonetheless. If your diet is haphazard or is weighted towards steaks, fries, donuts and ice cream, you may be taking in a lot of fat and simple carbohydrate calories that go directly into storage when you don’t use them promptly. Start by cutting out or off all the fat you can plainly see. There will be plenty left to satisfy your need for this highly rich fuel. Lean toward vegetables that are raw or streamed. Rigorously avoid hydrogenated or trans-fats altogether. If you are a carnivore, opt for fish, skinned poultry and lean cuts of other kinds of animal protein. Take in plenty of water every day or mix fruit juice with seltzer if you like the fizz. And finally, avoid both sugared and diet soft drinks except, maybe, for rare ceremonial occasions.

Block-in: Scheduling may be your most persistent obstacle to a new, fitness directed lifestyle. Most of us are bound up with too many things to do already. So running or any regular exercise program is going to have to entail priority setting, some juggling and lots of hard determination and focus. Look at your week realistically. Where can you most easily and conveniently fit in an hour time block three times? Five times? Keep yourself flexible and take your opportunities when they present themselves, but mostly try to plan ahead and, above all, hang on.

Listen: If you have been away from your physical side for a very long time, there is a good chance that you have become desensitized to the simple and subtle messages that your body regularly sends to your brain. In the days after you begin, you may feel some muscle soreness.

If it is really painful, rest until it eases up, then start up again more slowly. Your body is already beginning to adapt. It gets easier and a lot more fun. Trust me.

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