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Repetitive Strain Injury/Questions about trigger point therapy and muscles


Hi, Julie. It's Shane again. I'd just like to update you on my situation and I have a few questions I'd like to ask you as well.

Is there ever an amount of force that's too much to apply to a muscle when squeezing it? I know the suggested force is as much as can be endured, but is there potential to cause damage to surrounding blood vessels and nerves if the force is too much?

I have been getting good results from the trigger point therapy so far, but there have also been some concerning symptoms generated as well. These have occurred with the sternocleidomastoid and splenius capitus muscles.

I have had no issues treating the lower mastoids at all. However, there was a slight issue the last time I treated the upper mastoids (the place right at the insertion point). I had no problems while treating the muscle at the time, but post-treatment I noticed there was some swelling. I figured this was normal so I didn't worry about it. However, the next morning I had several (maybe 4) bouts of faintness. I would be sleeping and then would suddenly be awoken by the sensation of losing consciousness. I was fine when I awoke later in the day and was also fine that night. As a matter of fact I felt better than I did the previous night. So I was just wondering if the reaction I had was normal. I'm looking forward to treating the upper mastoids again but I'll feel a little better if I can be assured that it isn't dangerous.

I had a similar issue treating the splenius capitus. However, the faintness I felt this time occurred during the treatment of the muscle and lasted well after. Again, I have no problems at all if this is a normal reaction. I'd just like to know if it is at all dangerous to be doing this because I don't want to damage any nerves or blood vessels.

And my last questions is - Which muscles are involved during the Valvasa maneuver? This action seems cause me the most symptoms so it's likely that the muscles involved in this are my main issue.

Thanks again as always for you time and expertise

Hi Shane,

No, this is not a normal reaction and it's telling me that when you are treating your sternocleidomastoid that you are putting pressure on your carotid artery. I have never heard of the Valvasa maneuver so I can't answer this question.

Did you get my book, "Treat Yourself to Pain-Free Living?"  The book explains how to avoid the carotid artery when you are treating the SCM. It's possible that when you were treating the insertion point you just went a bit too far down into the center of the muscle.  I don't think it was pressure, but always keep the pressure at a "hurts so good" level, not using as much pressure as you can apply.

I've never had anyone have a negative response from the splenius capitus muscle, perhaps you're pressing on the cervical vertebrae and moving them?  It's important not to move bones, leave that up to the chiropractors. Many times, if you're releasing the pressure the tight muscle is placing on the bones, the vertebrae will move on their own, and that's okay, as long as you aren't pushing on the bones.

As for waking up with the problem during the night. I suspect that you are sleeping in a position that puts pressure on your carotid artery. Do you have your head turned to the side while you sleep?  For example, if you sleep on your side, your face is angled toward either the ceiling or the pillow, or if you're on your back, your head is turned to the side.  If you sleep on your stomach you are causing so many problems in your neck that I can't list them all here. That's the only position that I suggest you work to avoid since it does cause so many problems in the entire spine.

Wishing you well,
    Julie Donnelly

Repetitive Strain Injury

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Julie Donnelly, LMT


I can accept questions that relate to chronic or acute pain caused by muscle spasms and contractions. Repetitive Strain Injury is actually Cumulative Trauma to muscles. Releasing the spasm &/or contraction will relieve the strain that is felt at the insertion point on the bone. I am the co-developer of the unique safe-stretching program "Focused Flexibility Training," which combines easy instruction for self-treating spasms throughout your body with proven yoga stretches. I have recently authored two new books: "The 15 Minute Back Pain Solution," and "The Secret to Your Best Golf Game EVER!


Since 1989 I have been working with endurance athletes and individuals suffering from chronic pain conditions. I have authored seven self-treatment books and three self-treatment DVDs and I have developed the Julstro System for the treatment of carpal tunnel syndrome, Trigger Finger, and other Hand/Wrist pain. I am a national and international presenter at conventions, seminars, and workshops. Principle topics are "Work Shouldn't Hurt," and "The Pain Free Athlete." In 2005 and 2006 I was the massage therapist for ultracyclists competing in the Race Across America (RAAM) 3000+ mile race from San Diego, CA to Atlantic City, NJ. I've taught the Julstro techniques to physical therapists at the Cleveland Clinic, to massage therapists in areas around the USA, and I've taught Julstro self-treatment clinics to dancers at Juilliard School of Performing Arts (NYC),the sprinting team at NC State, and I am working closely with several Olympic-hopeful. We have successfully eliminated the repetitive strain injuries that could keep them out of the Olympic Games, and the best part is they know how to do the self-treatments so they can stay pain-free and flexible.

Triathlete Magazine, Endurance Magazine, multiple national and international trade journals.

Swedish Institute of Allied Health, NY, NY - Initial education in massage therapy Licensed NYS Massage Therapist since 1989. SUNY Empire State College, Saratoga Springs, NY - B.Sc. degree in Interdisciplinary Health Education I was an Associate Professor helping to develop the massage training program for SUNY Rockland Community College

Past/Present Clients
Privacy prevents me from filling in this section without prior consent from my clients. Life Experience: I have been specializing in the treatment of chronic pain and sports injuries since receiving my NY massage license in 1989. A personal bout with carpal tunnel syndrome was the catalyst to my developing a self-treatment that heals the symptoms of carpal tunnel syndrome quickly and without surgery. My work with endurance athletes was the inspiration to teach people how to self-treat so they could stop pains even during a race or heavy training day. Both of these situations ultimately became the products that are sold on my websites: and I currently treat people in my offices in Sarasota, FL, Cary, NC, or Pearl River, NY

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