What April Showers Bring

By

Victoria L. Magown, CMTPT, LMT and George S. Pellegrino, LMT, CMTPT

In the spring, we are often inspired to renew our surroundings and ourselves.  Some activities we are drawn to can satisfy the need for both.  Take for instance, a good workout in our garden.   After a long winter of relative inactivity, a glorious day of working in harmony with Mother Nature in the backyard can produce more than just the fragrant perennials of spring.

Though gardening is considered fun and recreation, it is really hard work.  Continuous bending, stooping, lifting, kneeling, raking and pulling weeds may be a labor of love but, these activities can wreak havoc with our muscles by activating Myofascial Trigger Points.

A Myofascial Trigger Point is a hypersensitive spot in a muscle that when stimulated, usually produces pain referred in a predictable pattern away from the Trigger Point. These points also trigger contractions in muscles that are called taut bands.

Take for instance the case of Mary who, unlike another gardener named Mary, was not quite contrary.  She spent the month of December planting bulbs in frozen ground which caused an aching back.  In the spring, after spending two successive weekends working in her flower garden, her pain worsened.

At the suggestion of a friend, she came to MyoRehab for a consultation.  Her first complaint was about her inability to get a good night's sleep. Mid back pain kept her tossing and turning most of the night trying to find a comfortable position.  There wasn’t one to be found and lack of a good night's sleep only made her pain worse. During her initial visit at MyoRehab, the source of Mary’s pain was identified.

The Latissimus Dorsi is a muscle that attaches to the hip, spine and the front of the shoulder.  Trigger Points in the latissimus dorsi can be irritated when raking or using a pulling motion such as in pulling weeds.  Holding her arms out in front of her while using hedge clippers also overloaded her latissimus dorsi.

In illustration A, the "X" marks the location of the Trigger Point and the shaded area in B shows its pain pattern.  When asked, Mary also said the pain went down her arm. For us, this detail in Mary’s pain pattern was confirmation.

After a few treatments, the pain was only partially relieved.  Since Mary had stopped gardening, this presented us with a new mystery.  What was Mary doing that kept perpetuating her pain?  We needed to consider other factors that might keep the pain cycle going.

It wasn't until our female therapist observed Mary changing her clothes that the answer came to light.  The constant compression by a tight bra around her chest causing deep indentations at the side of her ribcage activated and perpetuated Trigger Points in the latissimus dorsi.  Using her arms to assist getting up and down from a chair further aggravated this muscle.

When a behavior, an item of clothing or other factor causes a muscle to remain in a constant state of stress, we refer to these stressors as perpetuating factors. When Mary’s perpetuating factors were identified and eliminated, treatment was successful.  A Home Exercise Program kept her pain from returning and eliminated her need for additional visits to MyoRehab.

The therapists at MyoRehab are eagerly awaiting this year’s harvest. Mary promised to bring us flowers and fresh vegetables from her garden.

Do you have a green thumb and a sore back?  If your perennials are more than just flowers and vegetables give us a call at MyoRehab.