June 18, 2010

Triggers and Patterns and Bears, Oh My!

Massage therapists often hear from clients that chocolate or caffeine drinks trigger headaches.

When you work with people seeking relief from pain, these common trigger patterns tend to emerge – certain foods or bright lights, loud noises, etc.

Over the past 15 years of doing massages, I've observed some interesting developments on the list of headache triggers. As infamously infallible as observation is, I suspect many therapists use it to guide our massage therapy practices. I like to think that patterns of muscle tightening in response to outside stimulation may be responsible for a lot of headaches and neckaches, and that massage and other techniques will work to break the patterns, disarm the triggers and keep those bears away.

For instance, one of my clients told me she can't talk on the cell phone for more than a minute. The act of holding the phone to her ear triggers a headache. I think that is easy to figure out, as crimping the scalenes and shoulder girdle can stimulate muscular patterns leading to headache. I massaged her scalenes and traps, and suggested she try the speaker phone whenever she needed to stay on the phone for more than a minute.

Another client reported that that talking to her mother on the phone triggers a headache, while other cell conversations do not. Sensing a pattern, I asked her if talking to her mother in person triggers a headache, too. Gosh darn, it did. Hmmn.
Avoidance works with chocolate, but what about Mom?

That's a tough one. She decided that cutting Mom off wouldn't be practical, so together we worked on establishing and maintaining diaphragm breath even while talking to Mom. My client reports that it helps, as long as she can keep up the diaphragm breath. Once that goes, it's headache time.

Interestingly, some triggers apparently can help problems instead of triggering them. A client who at one time was having a lot of urinary tract infections told me that when she really had to pee but couldn't go, she would get in the car and go to Walmart.


Something about going to Walmart made her go pee, she said. The bright lights, the hard floors, the endless aisles, something. She'd walk around for five or ten minutes, get the urge to use the restroom, and then she could go home and get some sleep. Luckily, her nearby store is open 24 hours, she said.

As a massage therapist, I feel comfortable using massage, suggesting speaker phones and breath work to reduce the power of certain triggers, but I'm not going to go around suggesting retail therapy for urinary tract infections. Seems a little out of the scope of my practice.

While we are on the subject, I'd love to hear from other therapists about their list of common – and uncommon – triggers. Can you top Walmart?

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