resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
May, 2006, Vol. 06, Issue 05
By Garry Adkins, NCTMB
The idea of exploring palpation came from a doctor/client of mine I was working on years ago. As I worked on her, she told me I was using advanced palpatory techniques; at that time, I had no formal training in that regard, other than traditional massage or neuromuscular therapy.
When I attended bodywork classes in the past, the instructor would lecture on anatomy, and then tell the class to just feel the structures, without telling us how.Over years of doing bodywork, I have developed a certain confidence in my sense of touch; a form of teaching myself which way to stroke a muscle or tendon to receive the most benefit. After I read the book Palpation Skills: Assessment and Diagnosis Through Touch, by the experienced clinician Leon Chaitow, ND, DO, it all made more sense to me.
Chaitow writes that, according to Viola Frymann, "Palpation cannot be learned by reading or listening; it can only be learned by palpation." He goes on to say that an open mind also is vital to the task of learning palpatory literacy: Practitioners with the greatest degree of "rigidity," in terms of their training, often have the hardest time allowing themselves to feel new feelings and sense new sensations. Those with the most open, eclectic approaches (massage therapists are a prime example) usually find it easiest to "trust" their senses and feelings.
According to Karel Lewit, noted Czechoslovakian physician, "To begin to learn palpatory skill, one must possess a firm grasp of anatomy and the supporting soft-tissue structures. Palpation of tissue structures seeks to determine the texture, resilience, warmth, humidity and the possibility of moving, stretching or compressing these structures. Concentrating on the tissue palpated, and pushing aside one layer after another, we distinguish skin, subcutaneous tissue, muscle and bone; we recognize the transition to the tendon, and finally the insertion."
Regarding the learning process, Gerald Cooper states: "To begin to learn palpatory skill, one must learn to practice to palpate bone or muscle or viscera. Gradually, one learns to distinguish between a healthy muscle, a spastic muscle and a flaccid one, and gradually one learns there is a difference in feel between a hard malignant tumor and a firm benign tumor."
Chaitow also says, "Later on, critical judgment may be used in interpreting what was felt, but the process of 'feeling' needs to be carried out with that faculty silenced." No one has better expressed this need than John Upledger, DO, OMM, the developer of CranioSacral Therapy. He states: "Learning to trust your hands is not an easy task. You must learn to shut off your conscious, critical mind while you palpate for subtle changes in the body you are examining. You must adopt an attitude so that you may temporarily accept without question those perceptions which come into your brain from your hands. After you have developed your palpatory skill, you can criticize what you have felt with your hands. If you criticize before you learn to palpate, you will never learn to palpate."
This seems to work in a diagnostic sense, but to become proficient with your palpation skill while doing bodywork, we should look at what guides us. Intuition is an internal mechanism that aids in decision-making. It's what is called an instinct, a sense of something that tells a person to go in one direction or another. Combined with knowledge and training, it gives a person the tools to make solid decisions and get results they never thought possible.
Intuition has been defined by Shakti Gawain as an inner knowingness that we all have. It's knowingness that comes not from facts or life experiences; it's deep within us and gives us a connection to the intelligence of the universe. And if we learn to trust that and look within us for the source, we can find the awareness and actually find the answers to our questions. We also can find very specific and direct moment-by-moment guidance that will let us know what we are supposed to do and what we need to understand. If you think about it, anything we really need can come to us from that intuitive sense.
The Rational Mind
In our Western culture, we have been programmed to distrust our intuitive self. We have been taught to look toward and trust our rational, logical faculty. Our rational mind is like a computer. Any fact or information we have read or learned goes into our computer. The function of the rational mind is to pull out the appropriate pieces of information and combine them in ways to come up with the best answers based on that information.
The limitation is that the rational mind can only function on information it has received through learning and experience. The intuitive principle within us seems to have access to a much vaster storage of information. We seem, through our intuition, to be able to connect with infinite intelligence and awareness. So, we are not limited to just what we have learned in this life. We are able to tap into things we have no logical way of understanding, much in the same way a baby deer has the instinct to stand up just after birth.
To examine how our culture's attitude toward the rational mind has changed, imagine how the Native Americans lived long ago. They were taught from a very early age to smell the air, feel the wind and listen to the ground, just as animals can sense danger or tell just before it is going to rain. In our modern society, we have machines that can tell us if the atmospheric pressure indicates rain or snow is imminent.
Does everything you have seen, heard and felt about the person make sense? Let your rational mind come to a conclusion on how to proceed. Check your confidence level. Know you can help or satisfy this person. Let your rational mind go to the back and your intuitive self come up front. If you have to, say to yourself, "Intuitive self, I stick with you; whatever you say goes."
The Most Effective Direction
With your client prone, uncover the back to expose the trapezius. Apply little or no oil. While using only your fingertips, glide medial to lateral on the upper trapezius, and then lateral to medial. Did you notice any difference?
Now glide inferior to superior, and then reverse direction. Did you notice any difference? Try anterior to posterior, and then reverse. Maybe try diagonal? Of the four strokes, which one is easiest; which one has more resistance?
Next, try this with your client supine. Uncover one leg to expose the quadriceps. While using only your fingertips and no oil, glide medial to lateral, and then lateral to medial. Did you notice any difference?
Now glide inferior to superior, and then reverse direction. Did you notice any difference? Maybe try diagonal? Again, of the four strokes, which one is easiest; which one has more resistance?
With these two examples, the stroke with the most resistance is twice as effective as the other three or four. By going against the grain of a muscle, you will release the muscle faster, as well as help to relieve fasical restrictions.
Develop Your Intuitive Self
Finally, I feel that the last step to develop your intuitive self is to raise your self-esteem a notch. People come up to me all the time and say they wish they had my ability. What ability? Some of those people have had more training and experience than me. Life is a series of changes, yet many people cling to familiar things, disregarding their inner desire to grow as an individual. Openness to change can be risky. These people would say something to the effect of, "To be the kind of therapist I want to be, I have to have many years of training and experience. Maybe someday I will get there."
I say that you are there right now! Take the information you have. Be open to change and allow your instinct to guide you.
Garry Adkins is a senior faculty member and clinical event director at Irene's Myomassology Institute in Southfield, Mich. He is the former president of the Association of Michigan Myomassologists and has more than 15 years of experience as a massage and bodywork professional.
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