Acupressure or Trigger Point? Tomato or Tomatoe? What you really need to know about soft tissue techniques and picking a good bodyworker.

Ladies and Gentlemen, I would like to introduce you to Michael Stahl, fellow crusader in spreading healthcare knowledge and believer in a holistic approach to wellbeing. 

Now let’s talk about that big, fluffy, whooo-whooo word for a minute. Holistic. If it were not for spell check and your assumption that I’m just an idiot who cannot spell, I would have used the word “wholistic” in its place. Holistic medicine does not automatically = crystals, gently burning mounds of sagebrush, and talking about feelings. A holistic approach to healthcare means using a variety of disciplines and methods in order to attain your highest level of wellbeing.

One of the biggest failures of our healthcare system is the tendency to look at a physical problem is isolation. You have high blood pressure? Take this pill. Your ankle hurts? Put it in a boot. Real recovery and wellness comes when we begin to solve an issue by looking at the big picture, and addressing all of the various factors that could be contributing to it. This may require a variety of interventions and thus a variety of individuals. Your primary care doctor may not be the best person to assess your running form and functional hip strength as it may contribute to your chronic ankle pain. Similarly, your dermatologist may not be the best person to give nutrition advice and discuss how your intake may be affecting your healing. If you want long term recovery, well being, or athletic achievement start building a team of individuals whom you trust and who are passionate, dedicated, and good at what they do. 

Put Michael on that team. Prior to starting his therapeutic bodywork practice, he received his Doctorate of Law from Stanford University (FEAR THE TREE!), a Masters of Science at Vandy, and a Bachelor of Arts at Georgetown University. In short, he is obviously not that smart (sarcasm). Michael’s background as a competitive hockey player and CrossFit athlete continued to fuel his passion for wellness throughout his studies. In 2015, he opened Peregrine Center where he provides therapeutic, wholistic (that’s right, wholistic) bodywork to the Greater Nashville Area. 

Personally, I have seen Michael many times for bodywork. He always integrates multiple techniques, including: neuromuscular therapy (trigger point), acupressure, myofascial work, and massage.  What is more, he tailors these sessions to meet my goals, whether that be specific pain relief or working to feel race-ready. Michael also happens to be 50% of what we have coined Team BadAss. Together, Michael and I provide complimentary services under the same roof. 

You can read more about Michael HERE and be sure to check out his guest blog post below. As always, feel free to share this post. Use #TeamBadAss #WholisticHealthcare

leahsawyerpt.com

 

Acupressure or Trigger Point? Tomato or Tomatoe?: what you really need to know about soft tissue techniques and picking a good bodyworker.

by Michael Stahl, founder of The Peregrine Center

 

I’ve completed training in a variety of soft tissue techniques ranging from Active Release Therapy (“A.R.T”) – which is a form a fascial work, to neuromuscular (Trigger Point) therapy, and acupressure.

During sessions with new clients, I’ve noticed that I tend to get a common set of questions: what technique is that?  Was that trigger point therapy or acupressure?  Which one do you think is more effective?

Clients get hung up on the technique and it’s understandable….because bodyworkers do too.  Bodyworkers market themselves as “The Trigger Point Guy”, the “Myofascial Lady” or the “Acupressure Guru”.  These therapists market the hell out of a certain technique, touting the nirvana that awaits if you could only experience the magic that can be unleashed by [INSERT TECHNIQUE HERE].   

Only after [INSERT TECHNIQUE HERE] will you run pain free like Usain Bolt and feel as calm as the Dalai Lama.  

Why wouldn’t clients be focused on the technique when that seems to be all they hear in the advertising around bodywork and pain relief?

So, let’s address one of those questions because it will help us remember that these techniques are not magic – they are simply tools and the focus needs to be on the therapist and how they use their tool kit.

Acupressure and Trigger Point Therapy: Apples and Oranges or Tomato, Tomatoe?

So when someone asks me, is that trigger point therapy or acupressure?

My answer is always the same: Yes. And after they look at me like this:

I explain that I’m not just messing with them or being a jerk.  

Sometimes it’s really hard to tell.  Here’s why.

For the uninitiated, here’s a short description of Trigger Point therapy and Acupressure.

Trigger point therapy: 

is a manual technique focused on Trigger Points, which are tiny areas of irritation within the muscle that form as a result of an individual’s accumulated experience through movement, posture and tension.  Trigger Points have common locations and pain referral patterns across individuals.  These patterns help therapists identify the true source of the pain, locate the Trigger Point and facilitate a release.

Acupressure:

is a technique using finger pressure on acupoints, which are located on meridians. Meridians are a network of channels that transport Qi (i.e. energy), and acupoints are places along the meridians where the Qi is accessible through touch. Acupoints have common locations along the meridian system as well as common patterns of symptoms like pain, discomfort, and tension associated with the particular point and meridian.  These patterns help therapists identify the source of pain and discomfort and facilitate a release and rebalancing of the soft tissue and energy system.

It seems like they’re pretty different.  One theory talks about referral pain patterns, one talks about energy pathways.  One says trigger point, one says acupoint.  One is from the Western, clinical tradition.  One is from the Eastern, holistic tradition. 

I think it’s a much more of a case of Tomato, Tomatoe than Apples and Oranges.

Why?  They are techniques focusing on point specific work designed to help relieve pain and tension in the human body, and the human body just doesn’t change all that much from East to West.

But don’t just take my word for it.

If you put up a map of trigger points and a map of acupoints, the overlap is incredible.  The overlap happens with both the locations of the points and the patterns found in pain referral patterns and meridians. 

Here some examples that you can see for yourself.  

Neck and Shoulders

In the picture below, take a look at image on the right.  The “X” indicates the trigger point in the upper trapezius muscle and you see the red colors that map the pain referral pattern that moves into the neck and head.  I bet most of you have felt this at one point or another.  

Now compare it to the image on the left.  That upper trap trigger point sits right on the point 21 in the Gallbladder meridian.  And the pain referral pattern follows the gallbladder meridian path around the ear to the lateral corner of the eye.

Legs

In following, take a look at the image on the right.  You’ll see two “Xs” indicating the location of the trigger points in the quadriceps muscle known as the Vastus Medialis.  Now look at the picture below.  Look at the points labeled SP 10 and SP 11 on the picture – these are points on the Spleen meridian.  Once again you see the overlap.  The location of the trigger points and acupoints are the same, and the trigger point pain referral patterns follow the path of the Spleen meridian.

  

 

 

 

 

 

 

 

 

 

 

The overlap doesn’t just occur in these two spots – it’s pervasive.  In fact, a clinician from the Mayo Clinic found that there was a 92% overlap in where Trigger Points and acupoints are found on the body.

So, if I’m holding a point in your upper trap, and you ask me: is this Trigger Point therapy or acupressure? You have a better idea of why I answer “Yes.”

Before I say QED and drop the microphone….you may be saying to yourself: interesting, but so what?  What do I do with that information?

Great question. 

Here’s how I think you can use this information

You’ve seen the overlap between trigger point therapy and acupressure.  We could have just as easily done the same comparison with myofascial work and A.R.T.

If there are so many similarities between these techniques, does that mean you should expect the same results from each? 

No.  

No more than you should expect to get the same results if you handed the same paintbrush to me and Van Gogh and asked us to paint the stars in the night sky. 

It’s all about the skill, mastery and experience working with that tool.

AND it’s not just about the person painting.  The artist isn’t magical either. It’s also about what you bring to the experience: your history, your preferences and goals.  You may prefer photographs or Picasso to Van Gogh.  

The same goes for bodywork. 

The skill, experience and mastery of the bodyworker do matter, and so do you.  You’re a living being, with preferences, experience and goals that you bring to each session.  

The key is not just the technique or the practitioner or you….it’s how all of those things come together in a session.  

Because of that dynamic, the best bodywork I’ve received has come from practitioners who focus on their philosophy of practice rather than a specific technique.  They focus on how they work with individuals, the healing process, the role of pain and how to help them work together towards healing.  That is what they did with me and that is where magic can happen.

These types of practitioners often have training in a broad range of techniques to help them accomplish that, and their mastery is in how they seamlessly integrate a variety of techniques within a single session based on the client’s goals, preferences and how their body is responding.  The technique is there.  It is a tool they use; but it is always secondary.  

That approach also fundamentally changed how I saw the healing process and experienced bodywork….for the better.  

When I stopped looking for a magical cure from a technique or a bodyworker, I started to become more attuned with my body and the healing process itself.  The fact that healing was a process – not a switch to be flipped.  The importance of getting in sync with my body – like when I felt better and why rather than laying it at the feet of the bodyworker or some technique.  That paradigm shift and understanding of the process helped deepen and accelerate my healing.    It also helped me become a lot less frustrated because I stopped looking for the silver bullet that didn’t exist.  

Drawing on that experience receiving bodywork and an understanding about how much some of these techniques overlap, I have tried to model my practice on the same principles.   

My clients know that no two sessions look or feel the same.  In one session, we may only do acupressure and in another we may integrate acupressure, A.R.T. trigger point work and Swedish massage…it all depends on where the client is in the healing process (e.g. moving from an acute pain phase to one of mild ache and transition back into training), what the client’s goals are that day and how their body is responding.

I’ll leave it to my clients to tell you the level of skill and mastery during those sessions and how effective they find it.  

So when you’re looking for bodywork – here’s my recommendation:

Don’t worry as much about the technique.  Instead, look for someone who has a clearly articulated philosophy on the healing and recovery process.  Look for a philosophy that resonates with you and that is based on something broader than just a single technique. There’s no magic in these techniques.  They’re only as effective as the people who use them and the approach they and the client bring to each session. 

QED ;)