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Health & Medical UnderGround >> carpal tunnel symptoms, CT test results OK...?


7/13/09 9:37 PM
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leon phelps
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Tests done for nerve pain in hand/arms, went to neurologist and hand therapists, Doctors aren't sure what is going on.

Any advice?
7/14/09 10:16 AM
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martinburke
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Most of the people I've worked on who thought they had carpal tunnel have actually had thoracic outlet syndrome.

You could also have double crush syndrome.


PNF(also called PIMR, strain/counterstrain, etc) stretches and pin-and-stretch techniques work great on the affected tissues. Anterior scalenes and pec minor are the two main muscles to focus on with PNF and pin-and-stretch.

Trigger points in pec minor, longus colli, and the lateral intermuscular septum also some of the usual suspects. I would advise against DIY trigger point therapy on your longus colli: there are baroreceptors in the vicinity and you really don't want to fuck with them.

Try to find a good LMT familiar with thoracic outlet syndrome.
7/14/09 10:48 AM
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WidespreadPanic
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Edited: 07/14/09 10:49 AM
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martinburke -  I would advise against DIY trigger point therapy on your longus colli: there are baroreceptors in the vicinity and you really don't want to fuck with them.

Try to find a good LMT familiar with thoracic outlet syndrome.
Interesting post. However, as the longus colli is a deep muscle on the anterior surface of the spinal column between the atlas and T-3 it would be nearly impossible to palpate or massage, since there are too many structures in the way.


  
7/14/09 11:03 AM
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martinburke
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While you can't get to it directly, you can affect change through the overlaying tissues if they've been softened. While it is indirect, it does work.
7/26/09 8:04 PM
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leon phelps
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hey, thanks for the info.

are any of the above techniques practiced by chiropractors or physical therapists, as my insurance doesn't cover massage therapy?

thanks again!
7/26/09 9:42 PM
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martinburke
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I think that even if the chiropractor or PT doesn't know how to do it, many of them employ LMTs in office. If the LMT went to a decent school, they should at least know some neuromuscular therapy techniques.

Chiropractors and physical therapists often take a patronizing attitude toward LMTs, and use them only to "warm up" a client/patient so that the treatments don't hurt and bruise as badly. But the techniques I outlined above can be done in a few minutes; so a good LMT can do it on the sly, and the chiro or PT would be none the wiser.:)

That being said, the general trend in massage schools is a drastic lowering of standards, and the national certification exam has been watered down so that the pass rate is about 90% or higher. It's going to get harder and harder to find decent LMTs.
7/27/09 12:50 AM
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MMADC
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Martin, I agree that many DC's and Physical Terrorists take a patronizing view. Believe it or not, sometimes I hear this from LMT's as well. As a chiropractor, I think it's a shame and there's no reason the two professions can't work great together. I refer quite a few patients to a local massage therapist and the patients really see the benefit of going to both of us. As for me personally, when I do too much in the dojo another chiropractor and the massage therapist have their work cut out getting me back on track! Thank God for both!!!
7/27/09 1:45 AM
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martinburke
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Hi Doc.

LOL at Physical Terrorists. Man, I cringe at some of the clips of PTs doing assessments on youtube...just brutal stuff. I'd swear some of these guys never had any palp training at all.

I'm with you on the two professions working together. The two seem to work synergistically. The burden is on us to prove that we're not just glorified oil spreaders and ass rubbers, but the DCs and PTs need to have an open mind, too.

I'm concerned that the lowering of standards in massage schools and certs is going to set us back 30 years...back to when "massage parlors" got shut down all the time by the vice squad.
7/27/09 4:22 PM
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MMADC
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Martin, have you heard of a technique called Pain Neutralization Technique? I have used it from time to time and I think it works near miracles for a lot of people. But since I don't do soft tissue very much any more I use it seldom. Ever heard of it? I might have some old DVD's of it laying around somewhere.
7/27/09 10:56 PM
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martinburke
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Haven't heard of it. Is it some kind of Golgi tendon organ inhibition?

I'm having a hard time finding anything about it on the web that's not an infomercial.
8/6/09 3:44 AM
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DaveM
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I had CTS symptoms about a year and a half ago and it got really bad... turned out it was actually a very tiny cyst that grew right on the nerve. Cortisone shot took care of it in a bout 4 weeks.
8/11/09 3:46 AM
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JasonE
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Good info from Martin Burke. I also treat most "carpal tunnel" complaints by treating the client's thoracic outlet syndrome. It is rare indeed for me to find a client with true carpal tunnel syndrome.

I also advise against DIY trigger point work in the anterior neck. Too many vulnerable structures for uneducated fingers to be digging around.

When seeking a massage therapist for this, be specific about what you want: someone highly skilled in treating thoracic outlet syndrome who can spend an hour or more working as they see fit. If they work for a chiro, PT, whatever and that person insists on directing the MT's work, look elsewhere.

Last - consider what you'd be willing to pay to be free of this pain, and how much you'll be paying in medical fees for office visits, deductibles, etc. already. Sometimes it's cheaper to just pay out of pocket for an expert massage therapist who doesn't bill insurance but still gets the job done so you can go on with life. If you're real lucky, you'll find one that can also teach you how to effectively stretch the problem areas so you recover faster and don't have a recurrence.

Jason Erickson
www.CSTMinnesota.com
8/11/09 9:31 AM
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martinburke
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Hi, Jason. Where've you been hiding? Haven't seen you post for a while.

The last thing you mentioned about people not wanting to pay a LMT...is one of the reasons I'm phasing out of massage.
8/27/09 1:00 AM
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JasonE
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martinburke - Hi, Jason. Where've you been hiding? Haven't seen you post for a while.

The last thing you mentioned about people not wanting to pay a LMT...is one of the reasons I'm phasing out of massage.


Hi Martin -

I'm busy as hell with both training and bodywork clients. Maybe I'm just lucky, but haven't had any problems finding clients happy to pay for the work.

Jason Erickson
www.CSTMinnesota.com

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