WWTD - What Would Travell Do?

That darn knot was driving me crazy.

It was embedded in the rib cage, just below and under the lower vertebral border of the right scapula. It seemed to ease with heat, but no amount of myofascial release, Swedish, cross-fiber, trigger point or lymphatic or any of another half-dozen styles of massage I had tried would budge it.

Every week that darn thing was there. Everything else had budged, and my client, whose principal complaint was major migraines on the right side, had been getting better gradually as I worked to erase the right-sided pain pattern. This client is hyper mobile and thus negative on most of the muscle tests such as range of motion.

I had hunted down a huge serratus anterior knot and it bit the dust. A mondo masseter knot was opening up. I even felt the scalenes starting to slip back into the matrix.

Except for that darn knot. Instinct and experience told me it was a progenitor of the migraines. It must go. I was close to naming it – Jethro? – And I wanted it out. Bad.

I followed it as if it was from the multifidus, progressing up and down the spinal points trying to balance the tension on both sides. I followed the lines of the rhomboids, the serratus and the latissimus choo-chooing with the anatomy trains.

I must be missing something. I must be chasing the wrong thing. I can do this. And when in doubt, look it up.

Years ago, at relatively great expense given that I was a humble massage student, I had invested about $450 in a set of Travell and Simons, “Myofascial Pain and Dysfunction: The Trigger Point Manual” (it's a good deal on Amazon now - $215). I use the Travell flip charts of trigger points pretty much daily. It is, for the manual therapist, the reference books for what we know, what we don’t know and why.

I went back to the font.

There, hidden away in plain sight in the latissimus chapter, was a drawing of how to get that damn knot out. Approach from the lateral anterior, slip under the latissimus and locate the trigger point. Fix it with pressure from the hand under the lat to the exterior hand. Massage it and draw the point out laterally away from the body. Sweat was dripping down my face, and my client’s eyes rolled back, a bit like a shot of anesthetic.

I felt “Jethro” melt.

Janet Travell would have been 109 years old this past Dec.17 if she had not passed on at the tender age of 96. She got John F. Kennedy out of a wheelchair after WWII so he could run for president. She understood that people were people, even doctors, and worked to bring manual therapies back to orthopedics.

I hope all massage therapists and manual folks know her name and her books and charts. Shouldn’t we have some sort of Bodywork Hall of Fame?