Common Knot

[Drake]

Hi! I'm an LMT and have just started working in October. I have found that it is very common for many of my clients to have a knot medial to the inferior scapula and at the tip of Serratus Posterior. Mainly, it's on the client's left side, and more often than not, on big-breasted women, though I do have one client who is very small and is an RN...hers is the worst I've seen. When I first started massaging it, it was red, and raised in a perfect circle about the size of a quarter, very hard, like scar tissue. It has since separated and is hard in places within the circle rather than being one hard lump. I only see one other client who has it almost as bad as her, and as for the rest of them, you can feel it forming, and it is very tender to touch.

Is this common? Am I waking up a dormant trigger point by rubbing there? It just confuses me that it's so common and has me second guessing myself. And if it's not something I'm doing wrong...other than heat and deep tissue...how do I get it to break up completely?

Thanks...
Grace

 

[SeanT]

I have found a lot of people have similar sore spots all over their bodies. It has gotten to the point I can pretty much tell by looking at a clients body type and how they stand where they will hurt.

Some common sore spots are upper traps, glutes, TFL, calves, addies, abbies, upper arms on heavy set clients, and soles of feet on clients with tight calves.

As you continue with your practice you will find more common sore spots.

A lot of times clients will comment, "Oh.... you found the sore spot." I usually think to myself, "well, duh, a lot of people are sore here."

 

[Bobber Geldkraft]

Common Knot

Is this common? Am I waking up a dormant trigger point by rubbing there? It just confuses me that it's so common and has me second guessing myself. And if it's not something I'm doing wrong...other than heat and deep tissue...how do I get it to break up completely?

Thanks...
Grace

It is very common. Like Gratelakes said, you will start to notice there are lots of similar TP's from person to person. You may or may not be able to get them to break up completely. Some will easily reduce in once session. Others are the result of long-term misuse, and will require not only longer-term therapy, but also they need the client to correct posture or whatever caused it. Show them ways to stretch the muscle, show them how to correct their posture, help them determine if it is the result of repetitive stress and find ways to counter that, etc.

Frequently it is not a deep tissue issue. Try gentler work first. It may be in the fascia, or in more superficial tissues. I work superficial to deep, and frequently a TP is worked out before I ever get to the deeper tissue. That way even the deep tissue work can feel good.

Good luck, and welcome to the forums!

ETA: If these women are all right handed, they may all be carrying their purses on their left shoulders. That will cause issues! Suggest switching arms, carrying less, or fanny packs. I know I perpetually have a TP on my right side because I'm left handed, so my massage bag goes over the right shoulder.

 

[Spot]

I have found a lot of people have similar sore spots all over their bodies. It has gotten to the point I can pretty much tell by looking at a clients body type and how they stand where they will hurt.

Some common sore spots are upper traps, glutes, TFL, calves, addies, abbies, upper arms on heavy set clients, and soles of feet on clients with tight calves.

As you continue with your practice you will find more common sore spots.

A lot of times clients will comment, "Oh.... you found the sore spot." I usually think to myself, "well, duh, a lot of people are sore here."

lol I know.. And I've also learned that when I am working on a trigger point and the client asks what it is...it's better to first say, "Oh..that's common snap, crackle, pops that most everyone has" and then go on to explain. It saves them from being startled and thinking they are dying from 'the trigger point" disease before you have a chance to explain. lol

 

[Elizabeth]

Common Knot

Is this common? Am I waking up a dormant trigger point by rubbing there? It just confuses me that it's so common and has me second guessing myself. And if it's not something I'm doing wrong...other than heat and deep tissue...how do I get it to break up completely?

Thanks...
Grace

It is very common. Like Gratelakes said, you will start to notice there are lots of similar TP's from person to person. You may or may not be able to get them to break up completely. Some will easily reduce in once session. Others are the result of long-term misuse, and will require not only longer-term therapy, but also they need the client to correct posture or whatever caused it. Show them ways to stretch the muscle, show them how to correct their posture, help them determine if it is the result of repetitive stress and find ways to counter that, etc.

Frequently it is not a deep tissue issue. Try gentler work first. It may be in the fascia, or in more superficial tissues. I work superficial to deep, and frequently a TP is worked out before I ever get to the deeper tissue. That way even the deep tissue work can feel good.

Good luck, and welcome to the forums!

ETA: If these women are all right handed, they may all be carrying their purses on their left shoulders. That will cause issues! Suggest switching arms, carrying less, or fanny packs. I know I perpetually have a TP on my right side because I'm left handed, so my massage bag goes over the right shoulder.

Thanks! I stayed up way too late reading here last night. It's great!

 

[catinhat]

I've seen such things occur in both genders who are holding the telephone with the L ear to the shoulder as well as in those who carry heavy purses, knapsacks, etc over the left shoulder. Also, in those folks working in factories will have stuff like this because of the repetitive nature of their job tasks.

 

[Tarou]

You have to ask yourself what is a trigger point (trp). Is it scar tissue? Is it a spasming muscle? Is it a stretched muscle which is sore to touch? Is it a tightly contracted muscle? Is it a bone? If they are a big breasted woman it is my guess that they are weak and the posterior muscles are all overstretched and need to be strengthened...but this too hard for most people....