The adductor pollicis (AP) is a small, but powerful thumb muscle. The bulk of the muscle can be found by squeezing the tissue in the webbing between the thumb and the index finger. This muscle helps bring the thumb (pollicis) toward the fingers by an action called adduction.

Adducting the thumb allows us to enjoy our opposable thumb status. Because of the AP you can use utensils to eat and tools to build. You use this muscle to open jars and doors, throw a Frisbee, text your friends, and hold a brush to paint the house. Overusing, underusing, or injuring the AP can set up trigger points in the muscle.

Trigger points in the AP can refer pain to the base of the thumb, complicating or intensifying pain associated with arthritis. Deactivating the trigger points can reduce the “pain load” carried in the thumb.

I’m a big fan of the therapeutic value of walking through the neighborhood. There are so many reasons to do it and I especially like to encourage clients to do this after a session of detailed cervical (neck) massage.

Taking 10 or 15 minutes to walk through your neighborhood seems to allow for more natural neck movements than deliberately stretching. Rotate your head head to look at houses and safely cross the street; flex to admire new blooms or the dog walking past; tilt to catch the tattoo of a woodpecker; and extend to look up – yeah that was a raindrop (welcome to Portland). This seems to give you the opportunity to feel where you are gaining more freedom in motion.

The psoas (SO-az) muscle is a very important hip flexor. As such it is attached to the upper, inside femur (lesser trochanter) and to the front (anterior) of the lumbar vertebrae. On top of the psoas muscles lay the intestines and on top of that are positioned the abdominal muscles.

All walking, running, crawling, and kicking activities require you to activate your psoas muscles. In order to sit comfortably your psoas has to be able to relax; sitting for prolonged periods, however can be a perpetuating factor in pain and dysfunction. A psoas that can’t relax can also prevent you from standing up straight, giving you a stooped appearance.

When the psoas has become stuck in contraction or has developed trigger points, the problem generally manifests as low back pain. Sometimes problems also show up as groin pain. A skilled therapist will investigate the psoas of a client who presents with low back pain.

image credited to Real BodyWork

As you know one of my favorite topics is the concept of trigger points. But what are trigger points?

A trigger point is a tiny nodule in a tight band of muscle. Trigger points will be very tender when pressed on. One of the most fascinating characteristics of a trigger point is its ability to refer to a distant part of the body. This means that when a trigger point is pressed on, it is not only tender, but you are likely to feel a vague sensation radiating away from the actual point.

For example, a trigger point in the infraspinatus muscle (on the back of the shoulder blade) can refer sensation into the hand. Pain in the knee can be referred from trigger points in the quadricep muscles near the hip. Deactivating trigger points is an essential part of unlocking pain and restoring range of motion.

Trigger points have been studied for several decades now. Arguably, the most comprehensive work is Myofascial Pain and Dysfunction: The Trigger Point Manual (1983) which was written by Janet Travell, an American physician who treated John F. Kennedy’s post-surgical back pain. She released a second edition in 1992. Other books and workbooks are out on the market now as well.

For a fun and easy way to learn about trigger points to manage your own pain, join me for one of my Soft Tissue Detective Series classes: Pain Relief thru Trigger Points which are offered at Portland Community College. The next series is coming up in mid-May.

I recently read a report designed to study the use of massage for postoperative pain reduction. The report was published in 2007 by Mitchinson, et al in the Archives of Surgery.

The study chronicles the first five days after major surgery for over 600 veterans. Two hundred participants were in the group receiving a basic, daily back massage. The authors of the study found significant decrease in pain intensity and pain unpleasantness measured for the massage group compared to the control group.

The researchers conclude “massage is an effective and safe adjuvant therapy for the relief of acute postoperative pain in patients undergoing major operations.”

Here is a link to an article about this study. To read the full report you will have to have a subscription.