What one book would I want with me if I were stranded on a desert island? Right now, that book would have to be The Trigger Point Therapy Workbook, by Claire Davies. I've been working with a chronic pain condition for the past four years. Self-administered trigger point massage is one of my primary tools. It's relieved my pain and given me back my mobility. Without it, I'd probably still be standing when I ride the bus, unable to drive for more than a few miles at a time, and swallowing handfuls of ibuprofen throughout the day.
And I wouldn't have healed enough to get back out on my bike last summer. My wife loves to bike, and she's missed me for the past couple of years. But last summer, I finally felt whole enough to dust off my bike helmet, pump up the tires on my Trek, and pedal. We had a great time riding around Iowa City on weekends.
On Labor Day, we were flying downhill on Dubuque Street toward Waterworks Prairie Park, when the lip of the pavement caught my front wheel. I crashed down onto my left shoulder and skidded along several yards of concrete. Di said I was going about 30 when it happened. I left a lot of knee and elbow on the road and had a lovely bruise on my left hip for quite awhile, but I didn't break anything. And my bike was fine! I had a little stiffness and pain in my left shoulder, which I figured would improve with time. But gradually, the pain has worsened, and my range of motion has become more limited.
My theory about my pain condition is that it's primarily a mental disease. The problem stems from the idea that the mind is primary and is the master of the body, that will alone can whip the body into line. When pain flares up, the mind goes to work, trying to solve this problem, trying to diagnose and cure, trying to fix things. But this approach almost never works with my chronic pain condition, and in fact, it can lead to worse pain and more limited motion.
After I'd been using trigger point massage awhile and had reduced chronic pain to a manageable level, I began seeing an ease of movement therapist. She's helped me unlearn some of the body patterns that contributed to my pain condition, which has improved my life considerably. With her help, I came to see that I'd been stretching incorrectly, tensing instead of relaxing into the stretch. I've had great success with stretching the way she has taught me; I'm probably more limber now than I was before the pain condition developed.
So as the pain in my shoulder grew and my range of motion decreased, I decided to try to stretch my way back to wholeness. I made what I thought to be an educated guess as to which muscles might be causing the problem and began stretching. I should have known better. This was my old mental pattern sneaking up on me again, convincing me that I could diagnose and fix myself. In fact, I was most likely making things worse. The pain continued to worsen, and I was having trouble putting on my coat or reaching for dishes in the cupboards.
Yesterday, I was on the road for four hours. As I got ready for bed last night, I knew I'd be up again in the dark, knocking back some ibuprofen and sitting down with the heating pad. And I was right. As I sat on the sofa and waited for the heat and the pills to kick in, I dug out my Claire Davies and flipped through the section on shoulders. For some reason, I spent some time with the section on the subscapularis. And there were all my symptoms--why hadn't I seen this before?
I looked at the treatment diagrams and worked my fingers into my armpit. A flash of excruciating it-hurts-so-good-I-can't-stand-it pain, and I knew I was onto something. After I'd worked on my subscapularis for a few minutes, the pain was gone. Remarkable!
So, of course, I've diagnosed and fixed my problem, right? Wrong! The tricky thing about trigger points is that the referred pain can create trigger points in other muscles, creating a complicated web of tension and pain. The pain and limited motion affect the way I hold and move my body, which can overwork other muscles and lead to more problems--which can feed back into the original painful area. I've learned from hard experience that searching for a single cause and a single fix is pointless and can in fact worsen the situation. What works much better is a sense of curiosity and exploration, a sense of acceptance of the body as it is in the present moment and a willingness to work with it just as it is.
Right now, I'm typing this blog relatively pain-free. My shoulder feels great! I'll continue working with the subscapularis. But I know I also need to continue massaging my other shoulder muscles, continue exploratory and tension-free passive stretching, continue checking in with how I'm using my body, with how my thoughts and emotions are interacting with my muscles. It's a way of life, not a quick fix, like a pill, but a very interesting and remarkable journey.
But Claire Davies, you have saved my life again! Thank you, thank you, thank you!