When Love Hurts
Victoria L. Magown, CMTPT, LMT and George
S. Pellegrino, LMT, CMTPT
Gretchen was on her way to a dinner
party given by an old friend from college. She had been out of touch
with her friend for so many years and recently ran into her at an open
house held at a local art gallery.
Driving through the winding roads
of the rural community nestled in the forest at the foot of the Sandia
Mountains, Gretchen became confused and made a wrong turn. She stopped
at the side of the road, turning her body to the right with her head
down to study the instructions she had hastily jotted down.
Without warning, she was knocked
unconscious when her car was rear-ended by a speeding driver unable to
see her car around the turn. For the next ten years, Gretchen’s
treatment focused on her upper back and neck pain. Although her
caregivers were able to provide relief, it was only temporary at best.
Her pain would return a few days after treatment.
She came to MyoRehab and during a
review of her medical history, we learned that Gretchen was happily
married and a retired architect at the age of fifty six. After college,
she enjoyed a short career as a ballet dancer. She said her continued
pain had some bearing on her decision to retire.
An in-depth evaluation of her
posture both seated and standing revealed a slight twist of her torso to
the right. On further examination, we determined Myofascial Trigger
Points in the abdominal oblique muscles were holding her ribcage in a
fixed, downward spiral rotation. (Illustration A) This kept her neck and
upper back muscles in spasm, continually trying to keep her head
A Myofascial Trigger Point (TrP) 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. Sustained contraction of a taut band can pull relentlessly at the
muscle’s attachment causing painful inflammation.
During her second visit, treatment
of her lower abdominal muscles produced an all too familiar pain that
had interfered with Gretchen’s life in a very personal way for almost
ten years. She explained that palpation of one of the trigger points in
her lower abdominal area referred pain “up, inside”. She described
vaginal pain that “has kept me from enjoying my relationship with my
husband”. In men, these TrPs can produce testicular pain and sexual
She went on to say she had been
diagnosed with Irritable Bowel Syndrome (IBS). She “developed” urinary
incontinence and suffered reoccurring symptoms of urinary tract
infections without laboratory findings of an actual infection.
Abdominal TrPs can cause
irritability and spasm of the bladder and urinary sphincter muscle
producing urinary frequency, retention of urine and groin pain.
(Illustration B) They have also been associated with bedwetting in older
children. These TrPs can also cause chronic diarrhea.
Needless to say, Gretchen was
stunned to discover that such diverse symptoms could result from a motor
vehicle accident. Even as we spoke, it was evident that she had
difficulty making the connection. She admitted her disbelief was
reserved however because, as she put it, “My health began to go downhill
within a year after my car was rear-ended”. Her symptoms, she said,
seemed to “come out of nowhere”.
Her upper back and neck pain
finally resolved after treating the TrPs in the abdominal muscles and
returning them to their normal “pain-free” length. Gretchen was given a
Home Exercise Program to maintain the gains obtained in treatment.
If you’ve had a motor vehicle
accident and suffer from symptoms that seem to have “come out of
nowhere”, give us a call.