Hi, everyone. This week’s Facebook Live Feed is called “Please Don’t Do This.” So, what do I mean by that? Well, this is a common thing that I see practitioners doing, and I think that we could do it a little better.
What it involves is, this is a good example here. We’re looking at Lat Dorsi, for example. It’s all about who’s in control.
When we’re palpating for a trigger point, we’re going to be feeling for tenderness, some referral perhaps, and a taut band.
We’re in charge of finding that spot, rather than relying on the patient to tell you if it’s painful or not.
Because the danger of leaving it to the patient as to where it’s painful is that you can get carried away with that instruction, or that information, and start needling in areas which are not safe to needle.
For example, have a look over here. We’ve got Lat Dorsi and down here at the bottom it’s going to be a lot tighter. You’re not going to have a lot of room for error.
You’ve got less room as we go down, there’s going to be less room to needle, whereas up here, of course you’ve got more room.
You’ve got someone who’s got a really tight Lat Dorsi down here; you’ve only got probably around three centimetres there to actually grab that muscle. If we’re going to grab that like this, in a pincer grip, and we’re on this area right here and we’re palpating for our trigger point, and the patient said, “Oh, that’s it.” That’s your cue for going, “Great. We’ll just needle here.” Well, let me tell you, that there are the ribs, there. That’s your rib margin. Right there are your ribs.
The danger with that is they go, “Oh, that’s it.” You start needling right there, even if you were to go up and across like this, and you’re going straight down into the lung/ pleura territory. No good.
What I want you to do is think about well, that might be where they’re painful, but is that where I’m going to needle? There could be two different spots completely. First of all, locate where the tenderness is. Then check is that okay? Then modify the grip accordingly.
Of course, with this one, you’re going to pull away to take it away from danger, and then needle back towards you. That’s my tip for today. Hope that helps.
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