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Diane, a 62-year-old retired female attorney, was involved in a motor vehicle
accident in March 1997. She was
wearing a shoulder and lap seatbelt. She
was moving very slowly through an intersection with her body rotated to the left
when she was rear-ended. After one
month of physical therapy, her doctor decided to include Myofascial Trigger
Point Therapy in her overall treatment plan.
presented with diffuse low back pain which was worse at the left SI joint and a
considerable amount of neck pain, worse on the left at the angle of the neck.
Myofascial Trigger Point Therapy and soft tissue mobilization to
inactivate trigger points in the SCM, scaleni, trapezius, latissimus dorsi and
paraspinals, provided a modest decrease of her pain.
intake, on her fifth treatment, Diane reported that the “butterfly stretch”
for the adductors was very tight and restricted with pain in the medial thighs.
She stated that her low back pain was becoming more specific at the SI
joints, left worse than right. She
had been experiencing vaginal pain with intercourse during the past 10 years.
This pain had increased along with her back pain.
Diane wondered if there might be a connection.
of taught bands of muscles in the lower rectus abdominis referred pain to the
vaginal area as well as her low back and recreated the pain of dysmenerea.
I treated the lower abdominal muscles including the pyramidalis and
released trigger points in the adductors, bilaterally.
I then used a muscle energy technique to mobilize the pubic symphysis and
a loud ”pop” was heard followed by a nearly complete release of her pelvic
the dramatic release of the pubic symphysis, abduction of the thighs was still
considerably restricted, right greater than left.
There was however, an improvement of approximately of 20% in abduction,
bilaterally. Pain at the SI joints
was decreased to a 1-2/10.
the sixth treatment, Diane stated that her vaginal pain had decreased from as
much as an 8 or 9/10 to a 1or 2/10. Her
low back pain at the SI joints had decreased considerably and was only slightly
felt on the right. After a very
thorough treatment of the adductor muscles, bilaterally, using ischemic
compression and soft tissue mobilization, I used a muscle energy technique to
mobilize the right hip joint. A
loud cascade of 2 or 3 “pops” came from the right hip joint and the pelvic
region. ROM in external rotation increased to almost 90°.
I saw Diane for three more treatments, most of the pain she had suffered since
the car accident was gone. On her
ninth and final treatment, Diane was both very happy and very angry.
She was in tears as she recounted the pain she suffered over the course
of 10 years while trying to have normal relations with her husband.
She was angry that after thousands of dollars on ineffective treatments
and tremendous emotional suffering, it took only three treatments to rid her the
pain that almost destroyed her marriage. Needless
to say, Diane was greatly relieved that this pain was gone.
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