Troublesome Trigger Points

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Most everyone has experienced the uncomfortable sensations of a trigger point.  It’s that dull ache or sore spot in your muscles.  You think – if only I could stretch it out – and then go to town with stretching – but it doesn’t really help. 

Then you try taking ibuprofen or another anti-inflammatory drug – but it doesn’t decrease the discomfort by much.  Taking a hot shower or bath feels good and decreases the nagging pain – but doesn’t last as long as you like. 

You may have some pesky trigger points! Currently the more official way to describe them is as myofascial trigger points or myofascial pain syndrome if you have a bunch of trigger points influencing your body. 

One more thing – trigger point discomfort sneaks up on you.  You don’t yell ‘ouch’ and think – I have a new trigger point!  They often appear after muscle strains have healed but the area still feels stiff and sore.  You may or may not feel a lump or knot in the muscle.  The pain seems to come out of nowhere!  

They can be quite challenging to get rid of – but hopefully some of the following suggestions will be useful.  You’ll know by how your body responds – and of course – if you have continued pain or can’t seem to make any headway from your own efforts – please seek medical guidance. 

Here are a few suggestions for treating trigger points

Don’t chase the pain!  

It’s really tempting to focus right where it hurts.  Trigger points often refer pain into other areas and if you just work where it hurts, you might not be working where the problem is. 

Massage

There are many gifted massage therapists out there with varying abilities to work with myofascial pain syndromes.  One of the cool things I always loved about going to get a massage was becoming more aware of where I had muscle tension.  You may want to explore having a true myofascial session where the therapist works the fascial lines of the body.  

Even a whole body massage will wake up your sensory systems and you become more aware of hidden tension patterns.  Thomas Hanna coined a phrase called SMA (Sensory Motor Amnesia) and basically it means that your sensory connection to that area has decreased.

It wasn’t unusual that after working with a client who had a chronic condition to have them come back the next week and say something like “my knee feels better, but now my hip hurts”.  Good, I replied – let’s see if we can peel a few more layers off the onion!  Feedback is feedback – and if we can non-judgmentally work with our body it is amazing what information we can gleam over time.  

Be aware of your sleeping positions

If you are stiffest first thing in the morning – analyze your sleeping position.  Is your spine able to rest in neutral or are you curled up like a pretzel with one leg in passé while side bending towards it:). Mattresses that are too soft or too hard can also be a culprit.  There is no one ‘right’ mattress for everyone.  Depends on whether you are a side sleeper or back sleeper along with your pattern of hip flexor tightness, etc.  

Traveling was always interesting to me as I got to try out lots of different mattresses and always looked at what the brand and type was when I had a super duper night of sleep.  Pillows are important to me as well as I am a side sleeper and need my top arm and bent top leg on a pillow.  I have created pillows by folding up bath towels in hotels if I didn’t have enough to have on either side of me so I can easily flip from side to side.  Perhaps not the most romantic way to sleep – but my spine, shoulders and neck are so much happier.  

Pinkie balls and foam rollers

Both of these tools along with a wide variety of other balls such as lacrosse balls, tennis balls, etc. can be very useful for targeting trigger points.  The challenge is to go firmly and sometimes slowly enough that you can feel the tissue easing up.  I like to find a point of soreness and then hold… breathing and trying to release tension in the spot and also all around it.  

I’m sitting on the sofa right now and just finished a break with my backnobber, a S-shaped tool that I’ve had for decades.  I found a pesky spot in my right gluteal area… worked the area around it as well for a minute and then came back to ‘the spot’.  Then I spent probably 2-3 minutes just holding pressure on the spot until I felt it release.  Much better!  

Release or relief doesn’t always happen as quickly as it just did for me.  It might take days or even a few weeks to feel like you have made progress.  What I will tell you is that after releasing that spot stretching my turnout muscles immediately feels much deeper and easier.  

Heat

A hot bath or sauna can feel SO good!  I’ve known a few people who  like to stretch in  the bath and even use a lacrosse or other rubber balls to work the outside of the hips and back of the the pelvis while in the tub.  I’ve used the backnobber on my upper back for a few minutes while sitting in an infrared sauna and then just relaxed and came out feeling noodle-like.  Best of both worlds… release work and heat!  

Stretching

Stretching typically isn’t at the top of the list for trigger point relief although I like stretching after working with the pinkie ball or foam rolling.  The combination is a good one for me – but may not be for everyone.  

So there are some tips to try.  I’m sure there are more techniques and certainly other tools that are out there that can address trigger point discomfort.  Please share in the comments below if you have other suggestions!  

I’ve posted below a cool YouTube clip that has an explanation of what is going on in the muscle when you get a trigger point.  

And finally… I’ve started working on a 2 hour zoom/webinar on stretching. Stay tuned for more details!

To your success, 

Deborah 

Fascia and Brain Functioning

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Exploring fascia is fascinating and I keep learning more relationships between the health of our fascia and the health of our bodies.

This post will summarize some ways it influences our brains. If these posts are interesting to you please consider attending the Texas June 21-23 workshop – where the exploration of fascia will be woven into many of the classes.

Understanding the intellectual properties of fascia is the first step – but how do we actually weave that information into technique is even more valuable – and that will be covered in this intimate workshop among other topics.

Now onto fascia and brain health. I watched Dr. Mark Hyman’s Broken Brain 2 episode on Optimizing Brain Health (no longer available for free, but series can be bought) In that episode Dr. Shalini Bhat talked about fascia’s influence on brain health.

One of the main take-aways was how poor posture (visualize sitting in front of the computer slightly slumped) can negatively influence the circulation to the brain. There is an artery that runs through the vertebra and it is compressed when there is a forward head posture which compromises the blood flow to the brain.

What’s important and yet challenging about this information is that often we don’t know that the circulation to our brain may be slightly compromised. How many people will admit to having a little brain fog – or feeling more tired than usual – but simply chalk it up to less than optimal sleep. Perhaps optimizing our spinal alignment may help. (I am much more aware of lengthening my spine and looking forward instead of down as I write this on my desktop computer)

The other way that chronically poor posture will influence the fascia is with the Golgi tendon organs. These are connected between the muscle fibers and tendons and senses changes of muscle tendons. (This is different from the Golgi tendon reflex, which is when swelling or pressure on the tendon will cause the muscle to release to prevent further damage)

When we change our posture and alignment the Golgi tendon organ tells the joint where it is in space. But… When poor posture becomes habitual – think about kids always looking down at their phone – the Golgi tendon resets where ‘normal’ is and that person’s proprioception is being influenced.

Posture can shift slowly over time. Looking at the image to the left most people would way his posture is pretty good but unfortunately, if you are a people watcher as I am, you’ll see a LOT of people standing in a forward head posture such as this.

We have to encourage our students, and ourselves, to be more self aware of our alignment – outside of dance class! (alignment assessment is another topic in the June workshop!)

One other key suggestion for healthy fascia offered in the program was stretching and moving our body in all directions and keeping it hydrated. Dancing does a good job with the first suggestion and I see lots of water bottles these days instead of soda, yay!

Take care of your fascia!

To your success,

Deborah

Exploring Fascial Plasticity

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Dancers are always concerned with maintaining or increasing the flexibility in their muscles. To really understand how muscles become more flexible we need to understand how to change the fascia that connect to the muscles.

Most dancers know that fascia, which is the dense connective tissue that surrounds the 200+ bones and the 600+ muscles of the body. It keeps structures (like muscles) separated from each other yet interconnected in a 3D like web.

Using an orange analogy, the outer rind is like the superficial fascia, and the sections of orange are similar to the fascia that surrounds our muscles, bones, nerves, etc. Fascia ties and connects everything together!

This is why if you have tightness in your neck, it may be influencing the flexibility of the hamstrings. There is a fascial line that connects the muscles along the back of the body called the superficial back line. I mention this because it bears repeating that if you are not getting the results that you want from your stretching efforts – look at other areas of the body that may be holding tension and creating a pull or tightness along the fascial line.

This young man is a perfect example of this. He was taking yoga classes and a student in the opera department. We found the tension at his neck significantly influenced his hamstrings. He was doing lots of hamstring focused stretching in yoga class but until he focused on releasing his neck tension he was unable to get release and relief along that back line. Doesn’t he look WAY more comfortable in his body in the picture on the right? That change took 3 months. As a side benefit – his vocal technique improved too!

Now back to talking about fascia and plasticity. Plasticity means the ease with which something is molded or shaped. Fascia will reshape itself when there is a slow, steady and sustained pull on it. Too fast of a stretch and fascia/muscle tears. Plasticity is different from elasticity. Elasticity is the ability of tissue to stretch and then go back to its original shape. Plasticity means the tissue over time (think potentially weeks/months) slowly reshaping itself into a new length. That is what dancers want from their stretching.

Bottom line… slow, steady, sustained stretching is the way to go. Doing some of that passive stretching that dancers love to do at the end of class can be very useful (at the end of class – not the start!) If you add on some muscular engagement from the opposite of the joint – you will get even more benefit! For example doing the typical standing quad stretch is good – but when you also lightly engage the glutes while using the abdominals to keep the pelvis in neutral – it becomes even more effective of a stretch! Hold that stretch for 30 seconds, take a quick break and then go back for another 30 seconds and see how your quads feel!

To your success!

Deborah

Anatomy of Habit Part 2

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This is a 21 minute clip – be patient – it may take a moment to load!  Enjoy!  Deborah

 

Takeaways

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holding brain copyI recently returned from TCU where I had all the freshman dance majors in a course called “The Working Body”.  And work they did… meeting every day for multiple hours a day, exploring how to bring anatomical knowledge into their technique and dancing.  They were wonderful – and I will miss this very special group!

I asked them on the last day to take 5 minutes and write down a takeaway from the week.  I was curious after such a whirlwind of a week what stuck and seemed most important.  Below are their brief statements and a few responses and explanations from me. (They gave me permission to post) I hope you find it interesting reading!

[quote style=”boxed”]I dealt with a compression fracture in my upper back for a long time, and I have had pain in that area for a long time. When we talked about the spine in the course, I learned a way to feel as though I’m decompressing my spine and putting air in between each vertebra. It definitely helps with the pain I face now, and will prevent me from future spinal injuries! AA[/quote]

I remember seeing this dancer’s spine change after focusing on increasing and balancing the rotation of the spine.  It was so cool to see that some of the lateral curves improved – it just goes to show that with every lateral curve of the spine – there is also rotation.  I’ve seen good improvement with focusing on improving spinal rotation first then focusing on stretching.

Read more

Guided Visualizations

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With the holiday countdown, Nutcracker performances, increased social engagements – stress levels can easily increase.  Dancers and dance teachers need recovery time and ways they can train (or retrain) their bodies into more efficient patterns.

I created a mp3 file of guided imagery for my students.  As I talk about in the Train Your Brain ebook for children – your brain doesn’t know the difference between what is real and what is imagined. I first learned about ideokinesis (using imagery to change neuromuscular pathways) from Irene Dowd and it has guided my rehab work with clients since then. In order to make a real physical change you have to go back to the cortical or brain level and change the message that is being sent out.

The focus of this mp3 file is to simply release all unnecessary tension and to increase your physical state of well-being. When you listen to it you can either be in constructive rest position which is lying on your back with your legs supported over pillows or on a chair – or sitting easily upright, supported comfortably in a chair. (note: it is 26 minutes)

I hope you’ll take a break over your busy week and click below to listen to this!

 

To your success,

Deborah

“Education is the key to injury prevention”

A Somatic Perspective on Ballet

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I’ve returned from TCU where I annually teach an intensive course for their freshman dance majors.  What a pleasure it is – (and what an amazing new facility they have after massive renovations last year!)  My good friend, Elizabeth Gillaspy is a professor of ballet at TCU consented to sit down and allow me to tape a conversation with her.  The first are her thoughts for new ballet teachers and the importance of exploring teaching methods and ideas beyond ‘look like this’ – which is understandably the most common way we all began in our early ballet education.  (The clip is approximately 10 minutes, so it will take a minute or 2 to load)

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This second clip is discussing how important it is to explore the ballet form from a somatic base.  This conversation took place because of my appreciation of how Elizabeth can take young adult dancers and so lovingly help them make changes in their technique.  It is hard to rework patterns of turning out from the knees down, or muscling your way through an exercise – and Elizabeth does it beautifully.  Here are some of her philosophical thoughts on how looking at ballet as a somatic practice.  Be patient, as it is about 10 minutes it will take a few moments to load!

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