"7 Best Kept Secrets to Painless Aging"

Throughout the course of my tenure as a clinical massage therapist, I find a common thread with my clients. It does not matter what their age, gender, ethnicity, career, past trauma, or current state of health. The conditioning is the same: they all believe pain is a residual of aging. In my work, I hear from sufferers even in their late twenties whose parents and friends tell them "Honey, you are getting older after all." So they begin to believe and accept that pain is a natural outgrowth of aging. In contrast I know from my work and trials conducted over several years, most pain is not a residual of aging. I believe that most pain is a residual of build-up in the muscle fiber. Further, all chronic muscle pain relates to Myofascial Trigger Points (MTrP's).

My specialty is Trigger Point Release Therapy. In a nutshell, Trigger Point Release Therapy works on removing trigger points, or knots, from the muscle fiber. People always wonder how do these knots form. Where do they come from?

Trigger Points were a discovery of Dr. Janet Travell, President John Kennedy's personal physician. She stumbled upon them treating Kennedy's condition of chronic back pain. Her research and publications provide a comprehensive foundation for the understanding of Trigger Points today. For the sake of brevity, I usually provide my clients the following explanation:

When you take the muscle outside its design, through overuse, repetition (or other forms of 'trauma'), micro tears occur within the muscle fiber in the weakest part, the insertion point. Once the micro tears occur, the various acids and toxins our body produces, in metabolic process collect and deposit in the area(s) of trauma. They collect and sit on top of the nerves. When this occurs the nerve is unable to fire. The nerve's function in the body is to fire and send messages to the brain. If the nerve is not firing then the brain does not know the tissue is there, and does not send the muscle fiber more blood and oxygen nutrients to keep it healthy. This condition is known as "Myofascial Trigger Point Pain Syndrome". In essence, it would be like having a plant and not providing sunlight and water. In time the plant will die, right? Over time the acids solidify and generate a feeling of stiffness. They create discomfort, and you can feel them in the muscle fiber. But mostly, they create pain. Trigger Points in the muscle fiber create a host of symptoms such as limited range of motion, numbness, burning, stabbing, tingling, and sometimes atrophy (death) of the muscle. Healthy muscle tissue does not have any pain or tenderness.

Trigger Points behave like water boiling. The hotter the water becomes the more bubbles rise to the surface. As it relates to muscle tissue the same applies. There are superficial muscles (which means they are closest to the surface), and deep muscles that lie beneath the superficial. So, the warmer the muscle tissue becomes, the more pronounced the deeper presentation of points becomes, and rises to the surface. This movement can create a 'sudden' presentation of pain when someone over exerts oneself. But the boiling behavior also provides an approach to eliminating trigger points. A therapist can deal with the 'superficial' presentation, employing warming techniques to draw out the points, and once resolved, address the deeper points, also through the aid of warming.

I find myself constantly educating on these little inhabitants of our muscles. And sometimes, I wonder why myofascial trigger point pain remains such an anomaly in the medical community. Is it that we have become a society so resolved on a 'quick fix' that we believe a shot or a pill is all we need for pain?

The common protocol for something that is muscle related is to administer cortisone injections and pain pills. In other words, numb the pain, reduce the inflammation and whatever is going on will go away. The logic behind this approach is that, first and foremost, pain interferes with the body's ability to heal. Inflammation works along the same spectrum. Therefore, if you arrest both, pills for the pain, and a shot for the inflammation, healing will begin. That is great in theory, but what do injections of cortisone and pain pills create as it applies to Myofascial Trigger Points?

Simply put, they mask them. In the interim, what occurs physiologically is that the toxins do not cease to grow, quite the contrary, they settle into the extra space. Once the toxins begin to solidify they give the appearance of muscle fiber, but also produce stiffness. With the pain gone, people are conditioned to believe this stiffness is an acceptable state. It is not. All stiffness is, is latent Trigger Points.

In the field of massage one of the common approaches to addressing trigger points, is called Ischemic Compression. It is also what is associated with Deep Tissue Massage. Ischemic Compression refers to applying pressure to the point using fingers or an elbow until the point releases, or breaks apart. In theory this resets the nerves and enables blood and oxygen to flow into the muscle tissue, reestablishing a healthy state.

There exists a misnomer among massage recipients that deep work yields significant discomfort and sometimes bruising. This type of thinking concerns me. It concerns me because it is the result of recurring situations involving timid clients and therapists who operate under the motto of “buck up and deal with it because it’s part of the process.” In truth, the recipient should never experience significant pain. Most educated therapists know better and clients should not be afraid to express their feelings if there is discomfort. Both should be communicating during the session to ensure a comfortable and effective result.

Clinically educated massage therapists are taught to discuss pain with their clients on a scale of 0 to 10, none to unbearable. Except in cases of dehydrated clients (discussed in the next chapter), if a therapist administers pressure exceeding a six, they are likely damaging the muscle tissue. This is not a healthy approach!

The technique I developed is a deep tissue Trigger Point Release Therapy. However, it is a lighter technique. So light in fact, that when I worked home care Hospice for a highly regarded tertiary institution, I could administer my work on terminal patients who were in the final stages of cancer and amyotrophic lateral sclerosis (ALS), exhibiting extreme muscle atrophy. The results were the same results as a healthy individual. Normally deep tissue work would be out of the question since it is too painful and damaging.

Every single person who ends up on my table and hears this information always asks the same question. “How come doctors do not know about this?” For years my response was always that I did not know why. Then, after working on someone who just completed a medical education curriculum to become a pediatrician, I asked her the question. She said it is related to an educational concentration on pharmacology. “Holistic approach is not really taught,” she said. It makes me question many things about our medical structure. I do not view myofascial pain as a holistic approach really. I view it as rudimentary medicine, Medicine 101. Muscles are a part of the body and myofascial trigger point pain is an ailment of the muscular system medically. After all, if the most abundant tissue in the human body is skeletal muscle, with more than 600 muscles contracting and relaxing to move the skeletal framework, why is it not studied more extensively as it relates to basic dysfunction?

Everyday in my practice I notice how people continuously ignore the signs the body provides when something is wrong: namely the pain response. Pain is the medium through which the body communicates to us that we need to pay attention. We need to get to a specialist to see what is happening – what our body is telling us.

The body is an amazing machine, but it requires preventative maintenance. Why do we wait until it begins to break down to have it maintained? Bob Hope and George Burns attributed their longevity and good health to daily massages. As a society, we still view massage as a luxury. Yet documentation supports, through the work of Tiffany Field at the Touch Research Institute in Miami, the many benefits massage provides to build our immune system, lower blood pressure, and produce a host of medicinal benefits. In Norway, massage is part of their government run health system. One day in the not so distant future I believe it will be a part of ours. Or so I can only hope…