lymph node vs trigger point

[Mr.Pants!]

Okay, this is a silly question, but lately when working the neck on my clients, I often wonder if 'that big bump' is a trigger point or a lymph node. Is there a way to tell the difference? (I don't remember going over this in school.)

I started to get worried when I noticed that most people have the same 'knot' in the same spot on the left side of their necks, and have been psyching myself out ever since. (I'm worried about doing damage to the lymph nodes.)

Thanks in advance for any insight!

 

[ginkgo]

where exactly, are you working, that you are finding this 'big bump' on almost everybody? i think, often times when you see enough people, you do notice similarities in holding patterns and tension. when these adhesions occur at the attachment site, they are big and noticeable.

someone who does lymphatic work must be able to get more specific, but i think the nodes are mostly under the mandible and near the trachea (lateral to trachea, medial and deep to SCM). also some around the ears, maybe.

when working the SCM or scalenes, feel for the edges of the muscles and the fiber direction. trigger points will be found in the muscle belly or attachment site. to palpate trigger points, you must know fiber arrangement and attachment sites of the tissue. also, are you sure you are not palpating the transverse processes on the c-spine?

when treating trigger points, the client may be tender or sensitive ,but should feel some change or relief. if you are just pressing lymph nodes, it would hurt... and not feel better, but worse.

trigger points typically have a referral pattern of some sensation (pain, tingles, heat, etc...) to another place in the body. here is a good definition i found of trigger point:

Trigger Points - A focus of hyper-irritability in a tissue that, when compressed is locally tender and, if sufficiently hypersensitive, gives rise to referred pain and tenderness, and sometimes to referred autonomic phenomena and distortion of proprioception. Types include myofascial, cutaneous, fascial, ligamentous and periosteal trigger points.

 

[sreedhar s]

Generally speaking, lymph nodes are too small to be able to palpate them at all. When you can feel them, they feel like small, smooth pearls under the skin. The only time they'd be larger than that is when someone's very sick, and at that point, they'd be tender to the touch. So, I don't think you're feeling lymph nodes.

 

[Bazz]

Thanks for the feedback. Sometimes I over analyze, and I just didn't have the knowledge of what a lymph node actually feels like to answer my own question. But now I know! I think I have felt one before, now that I think about it.

The knot I often feel is usually on the left side of the neck, and exactly in the center, in line with the angle of the mandible when the head is in anatomical position. I am familiar with the muscle fiber directions I think, but I do need to look at the anatomy pics again. Maybe I'm hitting an overlapping of muscles or something...

Thanks again!

 

[Lacus]

If you're feeling the "knot" on every client, it's probably an anatomical structure rather than a muscle knot. Although clients can present with similar tension patterns, there's always some variation. When you're a new massage therapist, it's normal to have one hand that's more adept than another -- more sensitive to feeling/palpating, more flexible & more coordinated for the massage strokes. That could be why you're only feeling it on one side of the neck. In time, both hands become equally sensitive.

Many of the muscles have contours that can feel like a knot when you slide off their border & land on another muscle. This is expecially true of long skinny muscles (like those in the neck). Here's a link to a picture that shows you what I mean:

http://www.medicalarts.com.au/media/gallery/107.jpg

 

[Ranging]

Thanks, Bliss, for that insight.

After I read the post, I paid a little more attention while massaging my clients' necks and I found that you were right! My right hand seems to be less sensitive than my left! It was a surprise because I'm right handed, and, if anything, I thought it would be reversed. I actually did feel the same thing on the right side when I tuned into it. That was an interesting thing for me to figure out!

I read in a post somewhere once that the schooling for massage therapy is just the tip of the iceburg; that there is so much to learn. That just proves the point. I look forward to seeing what else I will discover along the path of massage!

(I also really liked the picture you attached.)

Thanks ccMarie and Bliss for answering [what I call] my "stupid anatomy question." Turns out it wasn't so stupid after all....

 

[dfroggyman]

The wisest people are those who admit they don't know everything & ask for help when they need it. They make the best massage therapists, too. Glad we could help!