Do you ever get arm/shoulder/elbow/wrist pain from a long session of crocheting? Have you been told it is carpal tunnel syndrome or tendinitis? It may not be true. And, more importantly, you don't have to keep suffering.

I am a massage therapist as well as avid crocheter. My hands and arms are my living, so I am very careful to take care of them. But I developed pain in my elbow and wrist that would cause numbness and tingling at night when I slept, and shooting pain in the arm during the day. I was told I had carpal tunnel syndrome and tendinitis in the elbow. The doctor said to quit any activity not essential that involved the hands, and see if it got better.

I knew from experience with hundreds of patients that the doctors OFTEN misdiagnose muscle problems. I have helped many patients avoid painful surgeries, even joint replacements, by working on the muscles and getting at the source of the pain and not just addressing a symptom.

Trigger Point Massage has an 87% success rate with carpal tunnel syndrome, requires no drugs, no time off work, and leaves the body intact and strong afterward. Patients who have surgery instead, 75% of the time have to have the surgery done a second time or still have the same pain and symptoms. They have to take 6 weeks off work, and their wrists are never as strong again as they were before surgery, leaving them vulnerable to future injuries.

So when the doctor told me that I had to give up crochet, possibly my job, and that surgery might be in my future... well, I've helped hundreds of patients prove doctors wrong. Time to work on myself.

I used a massage technique called trigger point therapy, and within days I was feeling better. After a few weeks, I had no pain at all. The technique is simple and anyone can do it on himself or herself. Since personally experiencing the pain and recovery, I have heard many other crocheters mention that they get pain in the same areas and have to cut back or even give up their beloved craft. To me, an addict that is hooked on crochet and strung out on string, this is a tragedy. I want to help.

(Disclaimer: This is not meant to replace advice from your doctor. Seek a doctor's opinion on any possible medical problem or treatment.)

I'll explain the basics in as much detail as I can.

First, let me explain what trigger points are and how they form. Most everyone is familiar with a muscle spasm, when the entire muscle contracts and will not release, causing pain and stiffness. A trigger point is similar, but instead of the entire muscle spasming, a few fibers within the muscle spasm and contract. These few fibers can contract much tighter than the entire muscle can.

For example, if you had a hundred sheets of paper and were to fold them in half together, you could not get a very tight crease. But if you were to fold just a couple sheets in half together, you could get a very tight crease. It is the same with the trigger points. A few fibers contract very tightly, tighter than the entire muscle could, and they create a "crease" so contracted that circulation cannot get through. Since blood cannot circulate through this knot, no cellular waste can be removed. Cellular waste is made up mostly of acids. Acids, when they are concentrated and sit for a while, form crystals. So over time, this knot in the muscle now has a solid center of crystals. The fibers cannot release to a relaxed position now, they are trapped.

Now think of a string. If you put a knot in a string, you shorten the length of it, yes? The same happens to muscle fiber. When there is a knot in the muscle, it is shortened. It begins to pull on what it is attached to, the joints. It stretches tendons, it crushes underlying nerves and blood vessels, and it causes radiating pain that even refers to distant areas of the body. And it all began with a couple of muscle fibers getting fatigued and spasming.

Massage breaks up the acids that are trapped in the knot, helps to increase circulation and move the wastes out, and lengthens the muscle back to its normal position.

Here is how to begin working on your own muscles. You will need some lotion, or oil to help feel the knots and to let your fingers slide over the skin. I use olive oil on myself.

Put a little oil or lotion on your fingers and smooth it over the forearm near the elbow. Feel how the bones run. There are two bones in the forearm with muscles running in-between and over the top of them. You want to keep your pressure running lengthwise of the arm, not across, follow the bones. Use a little pressure, about what you would use to juice an orange, and stroke along the muscles. On top of the forearm, up near the elbow crease, against the inner bone of the forearm, you will most likely feel some tenderness when you press. This is a trigger point.

Trigger points are very sensitive when pressed. You may or may not feel a knotted hardness in the area. Depending on how long a trigger point has been in the muscle, it can be as hard as a dried pea, or as soft as cooked macaroni. And sometimes the trigger points are too deep for people to feel without practice. But they will always be tender to pressure, sometimes downright painful. This is how you will find and work on the trigger points. Seek out the heart of the pain when pressed on.

When you feel the tenderness, begin stroking over the area following the length of the arm. Use pressure. It will be tender, but keep using pressure. Here is the scale to keep in mind for judging your pressure. If 1 is no pain, and 10 is unbearable pain, your ideal pressure should feel between a 5 and 7- deep enough to do good, but not so deep that other muscles begin to tighten up as you cringe against the pain. More is not better, just enough is all it takes. If you are cringing, lighten up. You will be able to use more pressure as things begin to improve.

Move the pressure in only one direction over the trigger point. In other words, if you are stroking from the elbow towards the wrist with pressure, lift the pressure off when returning to the elbow. Do not rub back and forth. The idea is to break up and move the crystals out of the area. If you rub back and forth, you are not moving them anywhere. Think of it like trying to squeeze toothpaste from a tube, push it through.

Continue working the tender points you find for no more than one minute each. But work these points several times a day. The more often, the better. (I carry a little bottle of lotion in my car, and at red stoplights I work on my arms. The lights are my best friends now.)

Seek out any tender points in the forearm, both on top, and on the underside/inner arm. Feel for more around the elbow and just below the wrist. Search the back of the upper arm near the elbow, and the front of the upper arm near the elbow and also near the point of the shoulder. In the hand, search the pad of the thumb.

There are some triggerpoints that also form under the shoulder blade sometimes. But these are a little more challenging to work. I put a tennis ball, or a kid's hard rubber ball, into a sock or old pair of panty hose. Standing in front of a wall, I dangle the ball over my shoulder into position, about 4-5 inches down. To work the right shoulder, I have to move the shoulder blade bone out of the way, so I reach my right arm across the front of my body and hold my left shoulder. Now I back into the wall, pressing the ball into the muscle that lies between the spine and the shoulder blade. I roll the ball up or down by bending my knees. I can adjust the pressure by adjusting how hard I lean back into the wall. You will feel the tenderness if there are any triggerpoints in the area. It is an exquisite pain. Hurts so good.

You can work the left shoulder the same way by dangling the ball over the left shoulder, and reaching across with the left arm to grasp the right shoulder.

Finally, always drink lots of water afterward. You are releasing toxins that have been trapped. The body needs the extra volume of water to help remove the wastes, to flush them out. Without enough water, you will feel achy. Drink water, there is no substitute- not tea, colas, juice, coolade- water!

If you have any questions, please feel free to email me. I will do my best to clarify any instructions. And there is an awesome resource book for working on yourself called "The Trigger Point Therapy Workbook" by Clair Davies. I recommend it to all my clients, and every friend.

To review:
1) Use oil or lotion on the skin to help feel for the triggerpoints and to let your fingers move over the skin.
2) Use the tenderness to pressure as a guide to your triggerpoints and an indicator of how much pressure to use.
3) Pressure should be a 5-7 on the pain scale. More pressure is not better, just enough is all it takes.
4) Stroke pressure in one direction only, like moving toothpaste out of the tube.
5) Work each trigger point only one minute at a time, but several times a day. The more often, the better.
6) Drink water- lots of it.

Happy stitching,
Kat Nelson, LMT