 and welcome to physical therapy for a better life. I'm Christine Linders, your host, physical therapist, board certified orthopedic clinical specialist. I am so excited to kick off the new year today with this brand new show where I designed it to bring you in your homes all around the world the best tips from myself and practitioners around the world into your home to help you have your best body inside and out. I am thrilled today to welcome Letitia Tish Sharp, licensed massage therapist and wellness practitioner to help us learn how to get rid of our trigger points and our tension so we can have less pain and feel better at home. Welcome Tish, thanks for coming out to physical therapy for a better life. Hello, how are you Aloha? Aloha, I am so excited about this because trigger points are something that everybody always asks me questions about and when they're getting massage, what should they ask for? What is a trigger point? Is it this that I feel right here in my neck, feel this is tough thing? Is what does it feel like? What do I do about it? And so I wanted to talk a little bit about what is a trigger point? I see the sign behind us that shows trigger points and tell me what you know. Okay, so trigger points are super effective first of all and that's why I just, I use them every single day in my practice with everyone. And a lot of times I guess that it's a little bit deceiving because trigger points, the actual trigger point where you're working may not be exactly where the pain is. And the way I was taught was that trigger points can be turned on or off, kind of like a light switch. So if your trigger point is on, you wanna try to turn it off. And the trigger points relate to a trigger zone. So where you're feeling the pain is actually where the trigger zone is. And then just through different studies and a lot of research and trial and error basically, they found that certain points in the body relate to those pain patterns and those zones. So once you find the trigger point, then you turn it off. That's a really good explanation that the trigger point might not be where the pain is because you feel pain like say up in here, I know so many of my patients have complained including myself, since the pandemic, we were, a lot of people were forced to work at home and they're like, oh my gosh, you should feel this right here. I have such neck pain, headaches, what my patient in Connecticut call these eye grains, which is like this piercing thing from this levator muscle. And so I think it's important. I don't even know if I knew that the trigger point wasn't where the pain is. I probably did at some point, but I don't know. You feel it, we know what it feels like. So we go right for it and then their pain is relieved. So where would a trigger point be safe for, I don't know, this? Right, so it could be a few different places. And the cool thing about trigger points is that there's charts available online, all over the place. I even saw on Pinterest, they have charts for trigger points. All you have to do is just put in the search trigger points, charts and it'll show you kind of a guide. And usually how you can find them is they'll show the zone and the zone will be in a color and it'll be like a shaded area. And then it'll have an X or a circle or something like that. And that's with the same color or a white X and that's how you can find where the probable trigger point is. And one thing to know is that trigger points aren't exact, right? I mean, because I do this every day, I can find, oh yeah, that's where it's at. And it's pretty much the same on everybody's scapular and everybody's levator or whatever. But everybody's just, I could move just a tiny, tiny bit and then boom, it fires off again. So for your neck, it could be right on top of your upper trap. It could be on your neck and it could even be like the base of, right here. Oh. The occipitals. So that's a huge one that I'm finding a lot of relief with is the base of the skull, your occipitals. You know, you mentioning that has reminded me of last year, like I always hunt around for like, I guess the trigger point of the area that is relieving of someone's pain. And I had a patient come in who just had neck pain. He was working a lot of washing the walls in the airport during the pandemic and he hurt his shoulder and he had like the worst headaches. And I remember going to his scalp and like doing like the occipital region and releasing that. And I had worked on his neck in the past and it didn't work and I went up to his head and I was doing all these things that, I don't know, I, you and I both follow our hands. People say, how do you know where to go? Like, I don't know, my hands just tell me where to go and I go there. So I went there and he laughed and he said, you know what, that's so funny. I had the worst headache and you massage my head and I went away. Yeah. And a lot of people don't know that. And even one of my friends, I went over there and gave him a little head massage. He said he had a headache and I was like, and he afterward he said, wow, that relaxed me and got rid of my headache. And I think that's one thing that a lot of people out there in their homes don't realize when they have a headache and they're reaching for, et cetera, and they're ibuprofen or whatever is you can actually hit the point on the head and get relief. Yeah. First line of defense, water, right? Oh. Yeah. Second line of defense is find your trigger points. And usually it is the base of the skull there and it can even be your here, your scalenes. You can grab these guys and just sort of hold them. And the thing is though, is that a lot of people run from pain, right? They feel the pain here, but then they want to run away from it. So they try to find that quick fix. But if you actually find where it's coming from, hold it for a few seconds, just breathe through the pain, breathe into it, then it releases. And then everything else starts to respond because our bodies know what to do. I think that's great. So I know that sometimes with certain muscles, I don't know for people watching who don't know, like sometimes I will, if it's hurting on the right, I'll tilt my head to the right to kind of slack it and grab it. Does it matter? Is it better if it's like in neutral or if on stretch? Like what's the best thing? Like let's say you're gonna grab this muscle and should you lean into it and grab it? Should you just keep your head in neutral? And what are the some just, I don't know what's your expertise? So I would say definitely everybody just needs to go with what feels right because you can't tell everybody that you do it a certain way. That's why I like to say this is the way I was taught and it works for me. It may not work for you, but definitely with your scaling muscles, which are these ones right here that go from kind of your occipit here on the side, down. They're sort of on the front of your neck. You can grab onto them and also your sternocleidomastoid. So that attaches here and here and here. You can go ahead and just, I'd say leaning into it is best because you can get a good handle on it. And then just sort of trace it up and down until you find like a hot spot. Or until you find it where it's hot or where it hurts. And then you just sort of go to your level of tolerance, just a touch beyond that. And then you just hold it, breathe, wait, breathe, and then it will dissipate. And sometimes it could be as quick as like seven seconds or it may take a little bit longer. And you might need to, once it does dissipate all the way, then I like to just sort of rub it out a little bit. And then you look for another one. You find another one and it could be right next to the other one. And a lot of times where you are feeling the pain, is it where? So if you find those trigger points and then you hold it, it could actually refer to where you're feeling the pain. So yeah, that's true. So if somebody was, my kitty wants to come say hello. Hey kitty, if you're at home, let's say like you have pain, like a lot of the people at home right now working and they're getting pain kind of on the upper back of the shoulder blade. And I know you and I both will be working on someone and they'll say, oh, wow. I didn't know it would hurt there. Like I never felt pain back there. I didn't expect when you touch that it to hurt. I hear that all the time. And I always talk about one of the benefits of a massage. I want it to happen in the next five years where insurances pay for four massages a year because I think we don't know there's something wrong with the muscle or there's a trigger point or say you sneezed and something spasmed or you stopped quick in the car and something spasmed. We don't know it's back there because we might not feel pain but then you get a massage and there's abnormality in that muscle that in say 10 years could be causing shoulder pain or neck pain because it's not allowing you to move through a normal range of motion. Like I would love for that to happen but since it happened yet, if someone doesn't like say they're just tracing themselves they've got a headache, they've got neck pain should they just kind of poke around and look for the hot spot and then when they get it pushed down on that painful spot and when it releases will they feel it soften or will they feel less pain? Yeah, a lot of times both. I mean, you'll feel it soften and you'll feel less pain. And I mean, tools are incredible. So one of the things is that if you have, I mean, I have a couple. So one thing you can use is something that is local, right? So this is more of a local tool. It's made out of guava wood and you usually can only find them if your uncle makes it for you or sometimes at craft fairs you might be able to find it but the cool thing about this is you also get the mana of the tree, right? The guava tree. And guava trees are naturally curved. So that's why it's perfect to be able to help the body but you take it and you can hook it right into wherever. Like that is a good spot for me. Oh, that's great. Right, so you find it and you're not getting a whole lot of tension in the front but you're just sort of relaxing pulling forward but you can't reach that with your hands, you know? So this is a great, great tool. They also have online something that is more like this and they have all different sizes. This particular brand is a Theracane but I'm sure there's tons of different brands out there and this one is really great because you're talking about neck pain. So this one has and I don't know if you can see but I see those two little knobbies there and then these two little knobbies there. So you can actually take those two little knobs and put them on either side of your spine and your spine and you can sort of pull to the right and pull to the left. That looks like amazing, right? And then you can go up like I said, archipelago, right at the base of your skull where your neck beats your skull. You just hold it and you can notice I'm not gonna be talking much longer than that. So, but this is a great, great tool. One of the other things that I use a lot is a roller. This isn't typical of most rollers that you find because it's super, it has a very hard core and it's just surrounded with a yoga mat. And what I've noticed, and I don't know if you can see me when I go to the wall or not. Yeah, we can see you. Okay, so what I've been finding with the neck especially is that this, like your whole deltoid, all of that is directly related, right? Because it goes right out your arm and then it comes back and it goes across and it goes out your other arm. And the neck is a part of that. So, what you wanna do is find a spot on the wall and you just lean into it, right? Oh. So you just roll forward, roll backwards and then you can take it and you wanna like step your feet out from the line though you can't see that part, but you step your feet out from the wall so you're leaning in and then you find it, roll back, roll forward, you find that fault, you hold it. You wait for it to release and relax. Don't forget to breathe. You can hold it for like 30 seconds and it's gonna completely change the behavior and then you come off of it. So those are some tools because I know a big part of your objective is making sure that people know what they can do for themselves at home, right? Because I mean, even right now, finding somebody for me to demonstrate on, it's like, oh, I don't have that. Well, that's not the point, right? The point is for us to be able to help ourselves and to be able to do that throughout the day. Like it's not like, oh, I have to take an hour out of my time and go do my trigger points or whatever. No, have it on the chair at your desk, buy your computer. When you feel this, yeah, do that, you know? When you feel this, find a wall. Actually, that's even better. Get up off of your desk and walk to the wall. Take two minutes, set a timer every hour for two minutes and just roll your arm or just find a spot. Like here's another spot for the next. So you find your roller, put it where it hurts, right? So a lot of times it's the upper trap in the elevator scalp. That looks like a great one right there, yes. Right? Then you find the wall and you roll into it. And remember, you can turn it out. You can turn in, you can cross your arms. You can let your head lean back. Yeah. Something hurts like is tense, don't do it. Not necessarily hurts because sometimes this doesn't. Yeah. Right? But if it's a bad kind of feeling like it, it hurts under the trigger point, but if you have like tingling down your arm or, yeah, it's a good thing. We hear that hurts so good a lot. It hurts so good. Well, I like what you said about taking care of ourselves. And one of the things I've asked sometimes people, when I say you're in physical therapy for your knee, and I have had many people in the pandemic trying to get their 10,000 steps and coming in with a terrible knee pain. And so I get them in and the first look at what's wrong, figure out what's going on, and then I will massage out their IT band, their quad behind their knee and everyone always says, I don't know what you did last time, but my knee felt like it hasn't felt in years. What is that? And then we go through physical therapy and they go back to playing tennis or something and they come in and they say, oh yeah, my knee was a little sore and I asked them, did you massage it out? Did you ice? Oh, well I ice, but I didn't massage it out. And so we, the point of doing all this, right, is so that we can impart our wisdom so that they can help with the care of themselves. And so the trigger point release the massage that we do, little tricks, like, oh, my elbow hurts, let me massage it out before I play tennis or you do the trigger point and you just rub it out, get the blood flow there, re-educate the nervous system that it doesn't need to be like this anymore, white knuckling, it can be relaxed. And I want people to know that like they become honorary massage therapists or honorary physical therapists and they can help themselves with, it's okay to massage your leg out, it's okay to massage your neck, it's okay to, I do it to myself all the time. I'm sure you probably do it too. So I like how you, all the time, I like how you said that of helping, you know, helping them to care for themselves and learning these tricks and get up every period, you can do these things for yourselves. You know, we learned how to do them in school and a lot of the things that you and I, you've been doing it since 98, me the same. We've had years and years to find our own techniques with our own injuries and bodies and things like that. So we've developed those, but these are things that people can do at home. And I love that. I love empowering people to say, wow, my neck hurts. I just learned how to release trigger point or I just learned how to have a headache. I just learned I can actually massage my head and get rid of my pain. And then, oh, I can go out about my day, about my job and feeling good about my body and myself. Yeah, and I think a big thing also that needs to be brought up is that a lot of people try to make it too hard, right? So, oh, I don't have a guava bone or, I don't have a theracane or a roller. I just don't, I do cocoa head a lot. And on the top of cocoa head, there's, wouldn't like basically railroad ties. So what do I do? I go under them and I'll push up and find my trigger point. I'll hold it and it's also fascia release too, right? So to fix your entire body or there's a cement slab in the corner of it, I'll lay down and I'll find my belly button and then I'll roll up until I can find my hip. And then I roll over and that's that I top of the IT band that you're talking about. That helps my knees for the run down. It helps everything. It helps my legs, it helps my hips, helps my low back, all of it. So, find something if you've got a chair, if you have a coffee table, if you have a door jam, you know, find something that works. I mean, these things are a little more specific and they're a little more, I guess specialized. Yeah. But you can feel your body and you can find, and let it be an exploration, let it be simple. Set a timer and give that to yourself. Give yourself two minutes every hour. You know what I mean? I, in between each massage, I roll, I stretch, I do something to undo the repetitive motion that I've been in for the last hour, hour and a half, two hours, whatever of this and pushing and all of that forward, you know, I have been doing it a long time. So I know how to do it ergonomically. But you can't get past that. You can't get past it. You can try, but you're still doing the forward motion. So, you just have to undo it. Give yourself the opposite. I love that you said undo because I use that as kind of a catchphrase for undo the sport. And anybody that's watched movement matters over the past two years has heard me say, undo the sport. And if your sport is sitting and you're rounded forward, you need to undo that. Cause over time, your body forms like that. If you're a surfer and you're on the board and you're kinking your neck like this, you need to get there and do your chin tucks and undo your sport. You're the massage therapist. I'm a physical therapist. In between every patient, I go and stand in the door and I breathe in and I open up my chest. And so I undo it. Even with this. Yeah. Even just that, right? Yes. And I mean, a lot of people, it's funny, you know. Right, a lot of people too, it's like, they're like, oh, I don't have time for yoga. I don't have time for whole, guess what? This is yoga. Yes. Oh, wait, I just did yoga today. And what does this open? I don't know if you can see it pulling my scapula off of my rib cage. Yes. But it's pulling it off. It's creating space there. And when you create that space, then you can go back and do it again. Okay, so we're talking about these home solutions that you can do, that you can get your fine relief at home. And I wanted to bring up something really important which is I sleep with one of these, it's not really a tennis ball. It's actually a little bit bigger than a tennis ball. And I have been having ischoliosis and I moved twice in the past six weeks. And so I was doing everything right and sucking my stomach in, but still a lot of moving, a lot of more stress on my body than I'm used to. I'm not a spring chicken anymore, so to speak. So I've been sleeping with one of these. And when I get this ache that's kind of in this region in my glute, it kind of goes down the side of my leg. I will just lean over onto the ball right in here. And I'll put it just on my butt side in here. And sometimes I just lean on my side and I do what we're talking about, a trigger point release, I find that hotspot and I'm like, oh, that's good. And I let it release. Sometimes I'll move side to side. Sometimes I'll put it like down my IT band down the side of my leg. But it's just a little home remedy that you can use any sort of a ball to release. Tish, is there anything that you use for people at home to release some of these hotspots? Definitely. So, I mean, you bring up a good point. Like a lot of us are at the computer all day. We're sitting at desks. And when you're sitting there, your body kind of closes in on itself after seeing them for so long. And you're doing that at sleep, but you can also use a roller like in your car or at your desk, at your chair. And it can be sizes. It could be like just a wooden dowel that you put like right in between your sits bones and your sacrum. And you just find a spot and then you put that down on your chair and you sit on that. And you can adjust forward or backwards. If you want a little more, you can do this size. Yeah. Or you can even do this size. In fact, I have this size cut in half in my car. Oh, good. And I drive around, my daughter laughs at me because I'm high in the car. And I look like I'm super tall, but I sit on that and that's how I drive around. You can also take one of these guys, and you can, I'm gonna tilt the camera a little and you can put it against the wall. And again, you find the spot in your hip and then you go to the wall, you find it, maybe a little lower and then you roll back and forth on it. And you find, it's usually on the side floor and right by that bone, that greater trochanter femur, right? Yeah. Yeah. So it gets off of that. And so you find it, you hold it and then you let it. So you can do that on the floor also. Yeah, but it's good to be able to do it on the wall because you don't have to get down on the floor. Like I said, make it easy. Make it easy. Yeah, I like that. I like that. So I hope everybody learned so much the tips. Do you have any parting words as we wrap it up? You know, I just would say I'm super grateful that you've got this show and helping people because it's what it takes for us all to be happier for versions of ourselves. And you know, it's a segue into the whole self-care. So I look forward to seeing what else you, you can bring to us this year. Happy, Happy New Year. Happy New Year. Thank you so much. 11, 2022. So it's a great day. We got the 11, 2022. Everybody, thank you so much for joining us. And thank you to Think Tech Hawaii for allowing us to produce this for you. Stay tuned in two weeks for our next show. And as always, life is better when you listen to your physical therapist. Aloha everyone.