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Myotherapy
is a specialized form of deep muscle massage that is said to quickly
relieve virtually any sort of muscle-related pain.
Uses
Myotherapy is
useful in tackling strains, sprains, back pain, headache, repetitive
motion disorders, fibromyalgia, shoulder pain, carpal tunnel syndrome,
sciatica and temporomandibular joint disorder. Also remedied by
myotherapy are many conditions caused by muscle spasms, including
certain types of foot and leg pain, incontinence and abdominal pain.
Although mainstream physicians regard myotherapy as a plausible
approach to treatment, it has only one major advocate: Bonnie Prudden,
the person who originated it. It is also worth remembering that,
despite an impressive collection of successful case studies, myotherapy
has never been validated through controlled clinical trials.
Procedure
of Treatment
Expect your
first visit to a myotherapist to last about 90 minutes. The therapist
will begin by taking an extensive history. You will probably be
questioned about your birth (birth trauma is believed to underlie
some types of muscle pain in both baby and mother), past and current
occupations, sports, accidents, injuries and presence of diseases.
The therapist will then evaluate your muscle strength and flexibility,
searching for the 'trigger points' that myotherapists blame for
most types of muscle pain. To relive the problem, the therapist
will apply pressure to each trigger point for about five to seven
seconds, using his fingers and hands. This pressure will be painful,
but is likely to provide almost immediate relief from at least some
of the pain that led you to seek therapy. It can also result in
a virtually instant increase in the mobility of tightly contracted
muscles. Finally, the therapist will stretch the affected muscles
and show you a set of corrective stretching exercises to do at home.
Subsequent sessions will last about one hour. They usually focus
on eradicating the trigger points, reevaluating corrective exercises,
and teaching you how to prevent pain through self-help myotherapy
and exercises. The average patient needs five sessions, and few
require more than ten. After the treatments are finished, you will
need to do exercises on a daily basis to prevent spasms-and accompanying
pain-from returning.
Benefits
The trigger
points that myotherapy seeks to eliminate are nothing more than
damaged, tender spots in the muscles. When these irritable points
are 'fired' by physical or emotional stress, they throw the surrounding
muscle tissue into painful spasms. Repeated spasms can keep the
muscle tight and foreshortened, not only causing pain but also interfering
with function, posture and imbalance. If the cycle of spasms and
pain continues long enough, the muscles will become permanently
shortened. Trigger points are thought to be the remnant of a trauma
such as the physical stress of birth (either giving birth or being
born), accidents, injury or repetitive stress. They can lie dormant
for years, then be activated by substance abuse, age or disease.
It is not clear why a few seconds of pressure is enough to correct
a trigger point. Bonnie Prudden, the technique's originator, believe
that the pressure denies oxygen to the spot, causing the muscle
to relax. Physicians, however, respond that lack of oxygen is often
the cause of a cramp. Whatever the truth of the matter, once
the point is relaxed, myotherapists use exercises to re-educate
the foreshortened muscle back to its original, relaxed position,
allowing it to once more function normally. According to Prudden,
this combination of trigger-point pressure and corrective exercise
cures pain of muscular origin 95 per cent of the time. Myotherapy
is an offshoot of the trigger point injection therapy developed
by Janet Travell, M.D., the White House physician under President
John F. Kennedy. Travell treated trigger points by injecting them
with saline and the anesthetic drug procaine. While working with
Desmond Tivy, another physician interested in trigger point injection,
Bonnie Prudden found that simply pushing on a trigger point in a
patient's stiff neck was sufficient to loosen it up. After similar
results with two patients who had a sore elbow and shoulder, respectively,
Prudden began refining the technique that was to become myotherapy.
Myotherapy is so simple that almost anyone can learn it; therapists
usually train patients and family members to do it themselves. The
trigger points are easy to find because they are relatively painful.
You simply press each muscle with your finger at one-inch intervals
until you hit a tender spot. You must then continue the pressure
until it becomes painful, releasing it as soon as the pain begins.
Once the point has released, simple exercises serve to keep the
muscle relaxed. Although myotherapy has never been scientifically
validated, it did receive a sort of ad hoc trial over a five-year
period at a General Motors assembly plant. There, the medical director
gave myotherapy to 1,000 workers with muscle injuries or other muscle-based
pains. He reported a greater than 90 per cent success rate, including
symptom relief, elimination of lost work time, and reduction of
medical costs for x-rays and physical therapy. The majority of patients
required only one treatment.
Who Should
Avoid This Therapy?
If you have
any condition that could be aggravated by deep pressure, it is best
to avoid this therapy. For example, if you have fragile blood vessels
due to leukemia, you should probably seek another form of therapy.
It is also wise to avoid pressure on a tumour, a recent fracture,
or a surgical incision.
Side-effects
Pressure on
the trigger points is temporarily painful. Bruising is also an occasional
problem.
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