Massage & Bodywork

September/October 2013

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table lessons I wanted the problem to fit my answer, instead of the other way around. Why in the world could he run with no pain if the problem is a tear in his rectus femoris muscle? That is exactly when I had my "aha" moment, realizing I was incorrectly looking at this entire problem. There is a principle in logic called availability error; the tendency to choose the most obvious answer using the information that is most available to us. The explanations readily available to us can be recent examples of other people with similar symptoms, or something attention-getting— in this case, the big muscle bulge that preoccupied me. The moment I felt the bulge, I assumed, whatever his pain, that a tear had to be part of the problem. In essence, I wanted the problem to fit my answer, instead of the other way around. I decided to start over, taking the tear totally out of the equation. "Is your leg in pain now, just resting on the table?" "No. As long as I am on my back, my leg is fine. What really sets it off is if I turn to lie on that side. Lying on it can create pain that lasts for hours." "How about this muscle? Is this sensitive?" I asked, pressing into his vastus lateralis. Mr. H. just about levitated off the table. "I'll take that as a yes," I quipped. "Holy cow! I can't believe how painful that is," Mr. H. exclaimed with a strangely satisfied tone of voice. Interestingly, I could see that he was happy to have someone validate his pain. My pressure recreated his mysterious pain, something that no one else, even he, had done previously. Even Mr. H. had assumed the bulge was the source of his problem. For the next 20 minutes I treated his vastus lateralis, gluteus medius and minimus, and tensor fasciae latae slowly and methodically. The tenderness abated substantially, and he volunteered to be diligent about stretching his thigh over the next few days. I called Mr. H. about a week later to check his progress. His leg had seldom hurt, and he even awakened to find himself lying on his left side. "What about the lump," he asked. "Will it go away?" "Perhaps a better question is: should you care?" I responded. "If the pain is gone, I guess not," he admitted. Douglas Nelson is the founder and principal instructor for Precision Neuromuscular Therapy Seminars and president of the 16-therapist clinic BodyWork Associates in Champaign, Illinois. His clinic, seminars, and research endeavors explore the science behind this work. Visit or email him at See what benefits await you. 37

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