Question
QUESTION: I've been seeing a wonderful collaborative group in Chicago for the last week to help resolve terrible pain in my left buttock, deep inside, and radiating down the left left, ending on the top of the left foot. I have abdominal muscle issues, ligament issues on the front of the thigh where it hooks to the hip socket. We have done hot packs, blocks in different places along the pelvic bones, different adjustments, and deep tissue massage at specific points where the pain seems to come from. Several people have worked on me, but one doctor is in charge. The deep tissue is very pointed, not general massage. It lasts about an hour. I have been very happy with the work so far, even though the pain is intense during the sessions. It dissipates afterwards and I walk ten blocks each way to and from the appointment. Today, we did an hour of the deep tissue. I was so "wiped out" cognitively and emotionally afterwards that I had to cancel my afternoon appointments. I have been having memories bubble up since we started this work. My instinct is that the muscle tightness, etc., has been holding psychological issues and they are coming out as we do this work.  I do not want to cancel all appointments, but I also do not want to push myself.

My question is whether it is normal to have this kind of trauma release work cause such intense emotional and psychological reaction. It's as if my body has been holding all of this fear and pain and trauma in tightened muscles. How long should I expect this to last? How much should I continue to go with the flow and not push myself vs. pushing myself? You can probably tell I'm a little Type A and it's hard to take care of myself in this way.

Thanks for your insights. Wendy

ANSWER: Wendy,

There are numerous cases (unpublished) of people having emotional experiences with manual therapy of different sorts.   It's not abnormal.  From what I've seen and heard, it's transient.  'Just go with it.  If you find that there is any sort of disabling psyhological symptoms, then you must speak to your primary care doctor.  So long as you find that the emotional release is transient and that you feel okay, then likely all is well.  If the deep tissue work is too painful, that could provoke emotional reactions - whether that's good or bad is questionable.  There is no need for continued painful deep tissue work, and for most folks each session of soft tissue therapy should get easier and less painful.  Otherwise there is a problem or you have someone who is simply inflicting pain and not doing anything therapeutic.   

'Hope this was helpful.

Dr. G

---------- FOLLOW-UP ----------

QUESTION: Very helpful. I have one more question. How often should I expect to see my doctor during the first part of treatment which she describes as more of a crisis? Is everyday too often? I do have release from pain for longer than before I started seeing her. And my ability to move around, take long strides, turn over in bed without pain are all much better than before.

I think it's interesting that you feel there is no need for continued painful deep tissue work.......

I had blood shot eyes when I left from lying face down for so long! That has gone away now, but I had to cancel my entire day's worth of appointments due to feeling wiped out.

Answer
Wendy,

There is no viable reason to lay face down for so long that your eyes get bloodshot.  I don't know how long this was for you (you didn't give me a number).   As for deep soft tissue therapy, unless it is done on different areas each time, you must allow rest between sessions.  Your tissues need to heal from the treatment.   In the initial stage of care of a stubborn, chronic condition, daily treatment is not unreasonable.   Also, just to clarify my statement on deep tissue, there is no need for continued "PAINFUL" deep tissue work.   Skilled soft tissue therapy should ultimately be comfortable and not excruciating.  Check out the videos on my web site that demonstrate some of it.  Hopefully your providers have training in Active Release and also Graston Technique.   For most folks, a 3x/week program is more than enough to get the job done in the early stages of care, with the expectation that they will show moderate improvement after a few weeks, and at least 50% improvement in lower back pain in a few weeks.   Otherwise, the treatment is likely not working.  I hope your care also includes exercise training, ergonomic advice, home care strategies, and dietary recommendations (if needed).   The wiped out feeling is not uncommon, but it should eventually transform to a feeling of ease following a treatment session.  

'Regards,

Dr. G
www.drgillman.com