resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
May, 2004, Vol. 04, Issue 05
CranioSacral Therapy: Who Shall Do It?
By John Upledger, DO, OMM
In 1977, while I was preparing to conduct a research project involving the use of CranioSacral Therapy (CST) with learning-disabled children, a superintendent of special education suggested that one in 20 children (5 percent) in the Michigan public school system suffered from some form of brain dysfunction.I found this statement utterly astonishing, and very sobering.
This educator was only guessing, but he had been in the school system for over 25 years, so his "guess" carried a lot of observation, experience and wisdom. Even if he was more than 100 percent pessimistic in his estimate, how would we ever be able to offer quality CST to even one in every 100 (1 percent) of the millions of public-school children in Michigan and the rest of the country?
My initial hypothesis suggested that about 50 percent of brain-dysfunctional children could receive significant benefits from CST. (By "brain dysfunction" I mean a wide spectrum of problems, ranging from attention deficit disorder and hyperkinesis to debilitating seizure disorders and cerebral palsy, as well as dyslexia, dyscalcula, speech and motor function disorders, autism and childhood schizophrenia.) However, the children would all have to be CranioSacrally evaluated to determine who would benefit from a full course of treatment.
In Michigan in 1977, there were fewer than 10 osteopathic physicians who were functionally familiar with cranial osteopathy. There were only three or four who were familiar with our brand of CST, which is quite different from the osteopathic and chiropractic versions of cranial manipulation. CST focuses on the membrane as the most common source of craniosacral system dysfunction, and hydraulics (dictating the flow of cerebrospinal fluid through the system) as the means of evaluation and treatment.
A few months earlier, I had presented the second of a series of five-day CST seminars to a group of clinical staff members at the Menninger Foundation in Topeka, Kan. My purpose had been to introduce the pediatric group to CST as an expansion of its program for the treatment of dysfunctional children. It was during this second seminar that I devised the "10-Step Protocol," which could be used by nonphysician clinical staff members. This protocol was essentially a "cookbook" method that, if carried out by a therapist on a patient, would serve several purposes:
The rest was taken care of in the design of the 10-Step Protocol. We introduced the underlying anatomy and physiology during the CST seminars we presented at Menninger, but it was not necessary to have extensive knowledge of these principles in order to practice the protocol on a patient. This practice is safe and beneficial to the patient, and instructional to the student therapist.
I also developed the 10-Step Protocol because it was clear to me that the psychiatrists and other physicians at the Menninger Foundation would not (and probably could not) take time to do 30 or 40 minutes of concentrated hands-on therapy with a patient one-on-one, in addition to their psychotherapeutic talk sessions and psychopharmacologic-management responsibilities. Also, some expressed the opinion that "touching the patient" in the way we prescribed in CST would interfere with their objectivity as attending psychiatrists.
My second Menninger seminar was, therefore, largely attended by nonphysician therapists whom would do the hands-on work with pediatric patients. It was my first attempt to teach CST techniques to nurses, physical therapists and psychologists; it seemed successful. The interest was high and the work they were doing in the seminar was of good quality. During the following weeks, I received several telephone calls from nonphysician therapists who reported exciting successes with a variety of patients through the use of CST.
With this recent experience in mind, I saw a possible solution to the problem of how to provide CST evaluation and therapy to such a large number of Michigan public-school children. If the special-education superintendent was correct, we needed to be able to evaluate 5 percent of all public-school children enrolled in Michigan. If I was right, 2.5 percent of those enrolled in public school needed in-depth CST.
I discussed the problem of the lack of CST-qualified physicians with the dean of the College of Osteopathic Medicine at Michigan State University (MSU), where I was then a full-time faculty member. I described my positive experience teaching CST to nonphysician therapists at the Menninger Foundation, and obtained permission to explore the possibility in Michigan. As things have a way of happening, there was a school for multi-disabled children in Lansing, Michigan; CST, and my use of it, had become a major topic of conversation among its staff, because there was 4-year-old boy enrolled there whom I had treated in France earlier that year. During the series of CST sessions in France he had progressed rather dramatically - from hemiplegic to slightly motor impaired. He and his mother followed me back to Michigan for further treatment. By "coincidence," one of the physical therapists at this school had seen this little boy a year earlier at the Bobath Center in England. At that time the child was hemiplegic; now he wasn't.
My reception at the school was warm. The mother and therapist had both described the boy's progress to the staff members, who were waiting with open arms when I came in, and suggested that I teach them CST. We worked through the university. I initially taught the course one night a week for one university quarter. MSU provided the enrollees with postgraduate credit for course completion. Soon, we expanded the CST curriculum to two quarters.
The course enrollment began to include therapists of varied backgrounds from other centers for disabled children around the state, and from Ohio and Indiana nearby. (I discovered news travels very fast on the disabled-child network.) The enrollees were physical therapists, occupational therapists, nurses, special-education teachers, school psychologists and the like. Within a short time, there were a few physicians and chiropractors, as well.
At the same time I was teaching these open-enrollment courses, I was also teaching CST to full-time osteopathic and medical students within their respective colleges. This dual activity offered me an excellent chance to compare progress in the use of CST between the two groups. I taught essentially the same material to both.
In general, I found the nonphy-sician therapists a little better at learning and applying the evaluation and therapy techniques than the osteopathic and medical students. I think this was largely due to the differences in actual hands-on work experience, and the dedication of practicing therapists that develops as they see disabled children improving under their hands. The osteopathic and medical students did not have these experiences and motivating factors available to them. I also found a higher level of manual sensitivity in the majority of experienced therapists that the student physicians did not possess. This manual sensitivity is extremely necessary for the high-quality practice of CST.
The results obtained with patients (which is what it should be all about) of nonphysician therapists from a wide variety of disciplines were excellent. Since those first experiences, I've gone on to train thousands of massage therapists and other professional health care providers, who have done very well with CST. Now, we often teach the parents of disabled children to do this work on their children. After all, our goal is to help those in need.
So the question remains: Who can do CranioSacral Therapy? The answer is simple. Anyone who is motivated, compassionate, sensitive, and willing to subordinate his or her ego so that the patient is the most important factor.
Click here for previous articles by John Upledger, DO, OMM.
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