The magic of trigger point therapy

The genesis

18.24 In early 1993 John Leschinski urged me to investigate trigger point therapy (which is also called, among other names, acupressure, myotherapy, pain erasure, and shiatsu—though the precise techniques of each are not necessarily the same) in an effort to help my recovery from the injuries. Leschinski, when a very ignorant youngster, had abused his body with sloppy exercise form. He was now raving over the help he had received from trigger point therapy in enabling him to get back into training. It sounded almost too good to be true and my extreme skepticism, on top of a very heavy work load, made me procrastinate the investigation.

October 1993

18.25 Nearly six months later, as a result of Leschinski's persistence, I bought the superb 350-page book, myotherapy: bonnie prudden's complete guide to pain-free living, by Bonnie Prudden, and the most basic of the wooden hand tools called a "bodo." I received these in October. ^e Prudden book is not the only one on trigger point therapy. It just happened to be the one I found first. (See page 387 for how to get this book.)

18.26 I read enough of the book in a couple of hours to give me the gist of what it was about—trigger point therapy. I found it very hard to believe that something so cheap, non-invasive, non-nutritional and not necessarily needing a professional practitioner could be so helpful.

18.27 Not only had I never known anything about how to deactivate spasm-causing trigger points until that time, I had never known that trigger points even existed. (Trigger points are highly irritable and very tender spots in muscles.) And despite being so wounded with injuries for well over a year I was not aware I had such chronic muscle spasms. But once I knew how to find them, I discovered I was absolutely loaded with trigger points. It was no wonder I was so plagued with injuries.

18.28 Be prepared for the discovery that you, too, at least in some areas of your body, are loaded with chronic muscle spasms that are causing you discomfort and pain. But you can quite easily control the muscle spasms, and thus control discomfort and pain.

November 1993

18.29 In the first week of November 1993 I started to use trigger point therapy daily on most of my troublesome areas. Toe, knees and shoulders were easy to treat, but I could not get into therapy for my lower back until December when I got the right tool.

18.30 Improvement in my right toe was almost immediate—in the first few days. By now it was close to two years since I injured it playing soccer. And I fixed it with a few applications of a single toe trigger point exercise that I held for about ten seconds at a shot. Incredible, but true. Now you can start to see why I am raving over this therapy.

18.31 ^ere was substantial shoulder improvement after a few weeks, and noticeable improvement over a mere few days; but my knees needed a few weeks before there was clear improvement. After less than a month of trigger point work lasting about 20 minutes each day I had made far more toe, knee and shoulder improvement than in the previous sixteen months. While that might not be a "miracle" in someone else's book, it is in mine. Much improvement was still needed.

18.32 From the start of the squatting with a bare Olympic bar in August 1993, adding 5 pounds a week, I persisted through the ups and downs of soreness and discomfort. ^e new squatting style made a big difference, but my knees remained very sensitive and bothersome. But with the trigger point therapy, my knees picked up, and I could squat with much less inhibition and discomfort.

18.33 At the end of November 1993 I was squatting 135 pounds for 20 reps, and experiencing less discomfort and reaction than I was with lighter weights during the previous three months. Just a few weeks of trigger point therapy made a noticeable difference. While 135 x 20 is very light squatting, if you keep in mind that a year earlier I could not do a single freehand squat without suffering considerable discomfort, then the 135 x 20 was terrific.

18.34 My shoulder was progressing well too. I had not been able to bench press without discomfort, even with only 135 pounds, since late spring 1992. Now I was able to bench press with much bigger poundages and without discomfort. ^is was tremendous progress.

18.35 ^is was a terrific start to self-administered trigger point therapy. I started to feel there was hope for my own training, and that I would not become an armchair coach after all.

December 1993

18.36 I did not start lower-back trigger point therapy until the first week of December. ^e hand tool I got with the book was fine for everything I wanted to use it for except the lower-back and buttocks area. To apply pressure to the trigger points in that area I needed a different tool—a "backnob-ber" from Pressure Positive Co. I did not get this until December.

18.37 Upon using the backnobber I discovered I was loaded with trigger points in an arc around my lower-back and upper buttocks area, especially the latter. Tackling the trigger points on a regular basis in my glutei was what made the most impact in controlling pain in my lower back. ^e glutei can take a lot of pressure during therapy. Like the ones I had in abundance in my upper back, thighs and shoulders (especially the right shoulder), the trigger points in my lower back and buttocks were almost painful to touch.

18.38 ^ere was immediate improvement in my lower back from the trigger point therapy, and after a few weeks I knew for sure I had struck gold for my lower-back problems. ^e discomfort there was reduced substantially, as was the sciatica down my left leg. Following the advice of Bonnie Prudden, most days I also did two specific stretches for my lower back. While these seemed to help with the back recovery, it was the trigger point therapy that was the big factor.

18.39 At about this time I noticed that my knees suffered much less crackling and grittiness.

18.40 I was very conscientious with the trigger point therapy, despite working 80 or more hours a week. If I could make time for it, then anyone can. I missed only a handful of days of therapy over the first three months.

January 1994

18.41 In early January my right shoulder seemed 100%, and I could add that to the complete success I had with the toe injury, and my knees continued to improve. I continued the trigger point therapy for maintenance purposes. By late January my lower back and left leg connection felt nearly 100% most days, and actually 100% on some days.

Jacknobber and (bottom) backnobber tools, from Pressure Positive Co.

18.42 In January I noticed that it was harder to find trigger points in all my former troubled areas, because I was no longer as loaded with them, and those that used to be very sensitive were now far less sensitive. Maintenance trigger point work for the right shoulder, for example, needed much less time than did the initial daily work needed to fix the problem.

18.43 I was now starting to feel youthful like I remembered in years gone by, giving me relative freedom to move around without having to watch out for this or that movement that used to bother me. I could now go down a staircase without my knees feeling rough and gritty. And I was able to carry my daughters down a staircase without discomfort—something I had not been able to do for nearly two years. It was a new lease on life.

18.44 For about eighteen months my knees would ache if I stood for more than half an hour or so. But in January 1994 I noticed that my knees did not bother me even if I stood for long periods.

"Movie goer's knee"

18.45 Even from before the peak of the 400 x 20 deadlift cycle I had what is coined as "movie goer's knee," a condition that makes keeping knees bent at around a right angle very uncomfortable, hence making sitting in a cinema difficult unless the legs can be kept out nearly straight in the aisle.

18.46 It was around January 1994 that I noticed I could hold my knees bent without much discomfort. As the months passed, the ability to keep my knees bent became less of a problem. ^e diagnosis of chondromalacia patellae and the need to "take it easy" I was given in summer 1993 by the orthopedic surgeon in Nicosia became increasingly suspect. ^is cast great doubt on the doctor's expertise and made me wonder how many people have been incor rectly treated by orthopedic surgeons. I am convinced that many people have written themselves off from vigorous activity when there was no need to do so—as long as trigger point therapy is practiced.

April 1994

18.47 Come April 1994, the "miracle" had continued. Progress was slow but steady. I was now squatting 230 x 20, stiff-legged deadlifting 300 x 8 and bench pressing 230 x 5. All very modest lifting, but for someone who was so recently disabled by injuries throughout his body, and who was starting almost from scratch but with a very sensitive body, and doing it drug free, this was fine progress.

18.48 In April I bought and started using the "jacknobber" tool from Pressure Positive Co. ^e bodo I was using previously did the job I wanted, but I substituted the jacknobber because I found it more versatile. I was now almost exclusively using the backnobber and jacknobber as my therapy tools.

18.49 Much later that year I discovered that the jacknobber could also do the job of the backnobber. ^e jacknobber has a triangular base that enables it to be placed on the floor, with stability. I could lie over the device, positioning the upright prong where I wanted it to go on my back or glutes. Eventually the jacknobber became my sole therapy tool. ^is reduces to about $40.00 the total cost of a multi-purpose therapy tool and the book by Prudden, to enable you to apply trigger point therapy on yourself. ^at is even more of a pittance than the $75.00 I shelled out to begin with, to get started on the job.

Anger with the orthopedic surgeon

18.50 I had now made sufficient progress, without surgery, to know that the diagnosis of the surgeon I visited in the summer of 1993 was way off the mark. I was already lifting weights way beyond what he would call "light," and my knees were doing fine.

18.51 I was angry that he could have been so wrong. And what makes me more angry is that the same man, and probably many others like him, so casually prescribe surgical measures that in many cases are not only unnecessary but, over the long term, may make matters worse. People like him, in private practice, are getting rich from their ignorance of non-invasive alternatives. (He was going to charge about $1,300 total for an hour or so of arthroscopic surgery on each knee, and one night in his clinic—a fee which is probably much less than it would be in the us for the same procedure.) ^at surgeons like him do what they do, with almost total impunity, is criminal.

18.52 As far as I am concerned, though of course I am not a doctor, never allow anyone to perform orthopedic surgery on you (unless it is reconstruction work following a serious accident) until you have thoroughly investigated non-invasive alternatives. Be sure you have pursued both chiropractic and trigger point therapy first. For serious problems you will need to go beyond treating yourself with trigger point therapy. See a chiropractor who has received training in this area, or a certified Bonnie Prudden myotherapist, both of which are available in the usa.

May 1994

18.53 One Friday workout in May I was not feeling 100% but foolishly decided to push myself nevertheless, even to the point of breaking form a little, to get my planned 20 squats. ^is was an example of when it would have been better to have eased back for a workout rather than push hard, or to have postponed the session for a day or two. In pushing hard my form broke down and my lower back went into a crisis of spasms. It felt worse than it ever had. I was almost crippled.

18.54 I applied myself to lower-back and glutei trigger point therapy with extra vigor. I got my wife in on the act, to apply greater pressure with a bodo than I could by myself with the backnobber. At that time I had not discovered that the jacknobber could be used instead of the backnobber. Had I, I would not have needed the assistance of my wife. ^e usual trigger points were ultra sensitive now, more so than when I first started using the backnobber in December 1993. I had my wife use a pen with indelible ink to mark the key trigger points on my skin so she could apply pressure with a bodo at subsequent sessions without my having to direct her with, "Up a bit, left a touch, down a tad."

18.55 It all seemed in vain as I continued to be disabled. But I did not give up, and by Wednesday the spasms and pain had gone. I was back to normal and I returned to a regular level of trigger point work.

18.56 ^is got me to thinking that had I known about trigger point therapy back in July 1992 I may never have had to lay off from training for more than a week or so. ^e April 1994 lower-back problem was much worse than the July 1992 one. I fixed it in less than seven days in 1994, but the 1992 injury did not start to go away until I got into lower-back trigger point therapy nearly eighteen months later. All that getting detrained in the name of resting the injury, supposedly to permit recovery. It was not only a waste of time, but unnecessary to begin with, and even detrimental. Oh for trigger point therapy in 1992. ^en I could have forged on in my training, building on the 400 x 20 deadlift instead of crumbling after it.

18.57 ^e appropriate treatment at the right time can mean the difference between needing a week off training, or years off. When you sustain an injury, seek expert non-invasive therapy immediately, and you may hugely hasten recovery time.

18.58 ^e May 1994 injury demonstrated that trigger point therapy had not corrected the root of the problem. Something was still seriously amiss—exercise technique. I injured my back again because my squatting form was not good enough. I was squatting too deeply for me (below parallel). ^is caused my lower back to round slightly. When I tipped forward excessively at the end of the set, the increased stress on my lower back caused the new injury.

18.59 ^e most devastating aspect of the 1992 injuries was that they forced me to stop serious weight training for a long period. As a result I lost a great deal of strength. I became very detrained, which in some ways made the problems worse. Rebuilding strength in a body that has more limitation than it had when the strength was originally built, is very difficult. But had I known in 1992 what I know now, I would never have lost any strength to begin with. It is critical to lose as little strength as possible while recovering from or managing an injury. Once the strength is lost you may never be able to gain it back. Of course in some acute injuries (broken bones, for example) you must have a period of immobilization. But with chiropractic and trigger point therapy, many injuries can be treated without an extended period away from intensive training, and thus without any significant loss of strength.

18.60 In May 1994 I started using the stepper that had given my knees such misery back in July 1993. While pushing through the balls of my feet made my knees feel gritty, pushing through my heels caused no bad reaction.

18.61 I had taken another step back to normality. ^e ability to do aerobic work had become but a fantasy for nearly two years. I could have been walking on flat terrain as soon as my right toe had been fixed in November 1993, but anything involving substantial flexion of my knees was out of the question until a while later.

October 1994

18.62 In October I substituted aerobic work on a ski machine, partly because of the greatly reduced knee stress of the latter relative to the stepper, and also because of the superiority of the ski machine as an aerobic exerciser, because it involves much more musculature.

18.63 Also in October I started bent-legged deadlifting. I had tried bent-legged deadlifts once in late 1993, with a very light weight, but my knees gave me hell. Instead I kept to deadlifting exclusively with stiff legs but knees slightly unlocked. I started the 1994 bent-legged deadlifts using a Trap Bar, which is superior to a straight bar in a number of important ways. See the extensive technique descriptions of the Trap Bar deadlift in the insider's tell-all handbook on weight-training technique.

18.64 I started the bent-legged Trap Bar deadlift with too much poundage. I used what was my stiff-legged poundage at the time—about 270 pounds. ^is was down from the 300 pounds of April, due to some unsuccessful training changes in the months in between. My knees were happy with it, but my back seized up and I was virtually crippled for a few days. After recovering, with the help of intensified trigger point therapy, I started again, this time with only 135 pound, and worked up slowly, as I should have done to begin with.

18.65 ^e only bad experience I had with the Trap Bar was when I tried a single set with 135 pounds while standing on a 2-inch platform. I enjoyed the much greater involvement of my quadriceps, but my knees hated it. While I cannot do this deep deadlift, it is a terrific variation for those who can.

November 1994

18.66 In November I dropped the policy of squatting to or below the point where my upper thighs were parallel to the ground. Having been imprisoned by the supposed virtues of such a depth of squatting I had been subjecting my lower back to stress that had been at the root of injury problems. Taking a few inches out of my squatting depth proved to be one of the most beneficial things I ever did to take care of my lower back. While this was a personal matter, there are many people who are squatting too deeply for their body structure and limitations.

18.67 Another training modification I made at this time was to stop bench pressing with my feet on the floor. By raising them on a 4-inch platform the lower-back stress arising from an excessive arch was eliminated.

18.68 Also in November 1994 I started to climb staircases two steps at a time, when the mood struck me. I had not been able to do this without discomfort for nearly three years. ^is was another memorable moment in my recovery.

Completing the "comeback"

18.69 In summer 1995, rather than persisting with the squat and bent-legged deadlift, I switched to the Hammer Isolateral Leg Press and the Trap Bar stiff-legged deadlift.

18.70 A factor behind the shift from barbell squatting to leg pressing was advice from Dr. Papadopoulos that I should not put a bar across my upper vertebrae. From x-rays he discovered that my upper-thoracic vertebrae have an unusual semi-compacted formation, perhaps caused by years of squatting with a bar too high on my shoulders, at the base of my neck. Continued barbell squatting, even with the bar lower on my traps, would aggravate this abnormality. So I gave up barbell squatting for good.

18.71 In 1996 I returned to the strength level and development I had in early summer 1992. What a traumatic four years it had been. It was desperately frustrating on the one hand, but enormously instructive on the other. While everything I used to try to help my recovery has not been described in this chapter, and there were other negative experiences that delayed the "comeback," enough has been included to teach you about the most important factors. You can learn a lot from my experience.

Trigger point therapy could be some of the most momentous education you have ever had, or ever will have. It was for me.

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