Which Is Worse? Left Or Right?

No, this is not a political rant, and I promise to spare you any of those, no matter how stupid politicians act. It’s about the difference between left- and right-handed individuals, from a massage therapist’s point of view.

One thing I have noticed, amongst the myriad things I have noticed in the past couple of years studying the human body up close and personal, is that most people are right handed.

Okay, that isn’t really what I noticed in the past couple of years. What I did notice is that most people, and by most I mean 99.9% of my clients, have knots and trigger points and quite a lot of hypertonic muscles between their scapulae, their shoulder blades, because that’s where they store their stress, whether left or right handed.

You get stress in your neck moving your head, no matter what you do – even when asleep – and that stress tugs on the muscles between the shoulders.

You get stress doing whatever you do with your hands and arms all day – driving, typing, hammering nails, drawing mustaches on pictures of models in magazines, whatever it is you use your arms and hands for, and that stress all winds up in the middle of your back, between your shoulder blades, because your shoulder muscles move every time your arms and hands move.

And then also, because those big, fat erector muscles that run all the way from the base of your skull to the base of your spine pass right between your shoulder blades, you get all the pulling and the stress from below when you move your hips and legs.

This is why I usually spend a great deal of my time in any massage working between and around the shoulders. That’s where most of the body’s stress is, and where the client will feel the most relief when I squash knots, release trigger points, and unclench hypertonic muscles.

But to return to my main point, one might think that there would be more knots and kinks and trigger points and all that stuff on the right side of the spine in right handed people, because that’s where most of the right handed person’s activity is.

By now you have figured out that this is NOT the case, otherwise I wouldn’t have any startling revelation to reveal. No, fellow grasshoppers, most right handed people are significantly more jacked up (that’s a technical LMT term, by the way) on the left side, in the rhomboids, trapezius, often the teres minor, sometimes the deltoid, and even the erectors, often down as far as the sacrum.

Nearly everyone I work on has active trigger points along the medial edges of the scapula, where the rhomboids attach. Almost invariably these are more active and often more numerous on the left than the right, in right handed clients. The rhomboids themselves usually are stiffer and more hypertonic, and often even ischemic.

For a long time I explained this phenomenon to myself and sometimes to clients as some kind of compensation mechanism – the weaker left side trying so hard to keep up with the stronger right, that the muscles became overworked.

Now I have a better explanation, or at least an alternative one. I think it’s a matter of inactivity rather than overactivity. When a right handed person reaches for something he usually uses his right hand and arm rather than the left. Over time this preference for one motion over another makes the left shoulder area significantly less active than the right.

With fewer opportunities to stretch, the rhomboids especially become partially ischemic, that is, there is less blood flow, less oxygen and nutrients, and more tendency to become stiff, increasing the probability of active trigger points developing.

The reverse is not necessarily the case with lefties, because most left handed people have to be somewhat ambidextrous to get along in a right-handed world. Some even were encouraged, by which I mean forced in one case I know personally, during childhood to become right rather than left handed. The result is that most left handed clients I work on don’t have this issue. If they are jacked up, they are jacked up equally.

I have found that the same is true in those who exercise regularly and intensely. With a good exercise program, both sides of the body are worked more or less equally, so this phenomenon doesn’t occur as often.

So my suggestion to right-handed folks is to stretch more. Well, all right, my suggestion to everyone is to stretch more. Get both arms above your head, lean against a wall, hang from the monkey bars at the park, whatever you feel like, just to get the rhomboids on both sides tugged and stretched more often.

And take Epsom salt baths.

And come see me for a massage anyway.

Couldn’t hurt.

That is all.

Mark out.

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A Trigger Point Is Not Where Roy Rogers’ Horse Stands

I frequently mention trigger points in these ramblings, as in, who has them, and where they are located, and the treatment thereof, though always in passing, as if I assume everyone knows what a trigger point is.

Every good massage therapist knows this, of course, but I should say a few words about trigger points for everyone else, so I will.

You have them, and by you I mean anyone reading this. Trigger points are merely places in everyone’s musculature that get wrapped up too tightly from time to time, and grab hold of nerves and squeeze them so that the nerves think they are supposed to do something, so they clench any other muscles they might be attached to.

So then what happens is, you’ve got a whole bunch of muscles clenched for no good reason, which, even if it isn’t actually painful, makes a person feel unnecessarily tight and stressed.

All these trigger points are located in about the same places on everybody’s body. But the good news is that not all your trigger points are clenched at any given time, and in fact most of them are not clenched at all on most people, and then too, there are degrees of clenchiness.

For instance, if I push on a trigger point and the client whimpers, I can be pretty sure that that trigger point (and let’s call it a TPT from now on, like I do in my client notes) is wrapped up pretty tightly and will need some serious sorting out in order to let go, assuming the client can stand the discomfort.

Because the way I sort out a TPT is to mash the dickens out of it, with a thumb, finger, elbow, or possibly knee, though I have never had to go that far.

Mashing the TPT further stimulates already overstimulated nerves within the TPT, eventually to the point that the nerve is so overstimulated it literally cannot take anymore and gives up, releasing not only the muscle it innervates, but also the muscles that are innervated by nerves that THAT muscle was squeezing and causing to clench.

These other muscles that the TPT is making clench could be several inches or even farther away. If the TPT is squeezing the nerves that go to this distant muscle hard enough to cause discomfort, we call that ‘referred pain.’

Even if the client doesn’t feel the pain in that distant location in the normal course of things, very often he or she will feel it keenly when I squeeze the TPT. There is a TPT, a cluster of them in fact, right at the top of the shoulder, where the trapezius attaches, which, when pressured, the client will feel up the neck to the ear and scalp, or down the shoulder and arm to the fingers, or both.

In fact, most of the active TPTs I find are in the shoulders and upper back, and that is not surprising since that’s where all of us keep our tension.

Another really likely spot, especially for folks with low back pain and stiffness, is in the QL, the quadratus lumborum. This is the most posterior, that is, farthest back, abdominal muscle. In fact it’s so far back it’s right up against the very lowest bunch of muscles that border both sides of the spine.

And so quite often I find really strong, nasty TPTs underneath the lower spinal muscles, between the top of the sacrum and the lowest ribs. These TPTs really hurt when I have to mash them, and I usually warn the client that I’m going in after them.

But when I do get those suckers to let go, the whole back relaxes, bottom to top, sacrum to cranium.

Of course I do have clients who can’t take that kind of pain, or prefer not to, and for them I will coddle the nastier TPTs, stroke and caress rather than pin down and maul into submission. Usually I can get the TPT to let go somewhat if  I give it a lot of time and patience, but the release is never as complete as if I slammed it full force.

Still, if that’s what the client wants, that’s what I will do. 

Another place I find a lot of active TPTs is in the gluteal muscles, as in the gluteus maximus, gluteus medius, and so on. These are wide, strong, thick muscles at the center of the body. Everyone’s big bits pivot around the gluteals – both of the legs, as well as the whole torso, so of course this area is going to be stressed, even if you do nothing but sit down and stand up all day.

When the glutes are strained, tense, hypertonic, they feel tough and crinkly beneath the skin, like old leather that has got wet and then dried. If I feel that, I know there are active TPTs in the gluteal.  These are not hard to find because they feel like little clumps of weeds, or like half a small grape.

And fortunately, most gluteal TPTs are quick to release, though not always.

But when released, whether it’s one or two, or eight or nine (yes, unfortunately I have seen this) the TPTs let go of the entire rest of the muscle, and then the entire cheek, to use the vernacular, can rest easy. The difference in texture that I feel in the overall muscle tone, once the TPTs are silent, is quite literally that between stiff leather and silk.

Now most people don’t even know they have the stress they do, or at least to the extent they do. I often hear people say they had no idea they hurt so much until I touched them in those spots.

Which is quite all right. Because when it quits hurting, even if you didn’t realize it was hurting until it wasn’t anymore, it feels ever so much better.

Doesn’t it?

That is all.

Mark out.