resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
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.
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.
August, 2006, Vol. 06, Issue 08
Skills of Touch
By Keith Eric Grant, PhD, NCTMB
Touch inherently is a two-way sense - we cannot touch without being touched back. We have the sensors to receive far more tactile input from the world than we can consciously process. Thus, habitually, we filter out the vast majority of the sensory input we receive. Without such filtering, we would have a hard time living within our skins, constantly being aware of every contact and friction with clothes and other objects. Yet, in massaging another, we can learn more by training both our conscious awareness and our unconscious filtering processes to better discriminate both client tissue and client responses. Open your sensory filters and explore your awareness of touch. Compare the sensation of touching and holding with slight back and forth movements (sliding touch) or touch with slight vibration. Touch surfaces at different temperatures, with different textures and with different levels of plasticity or give. In touching surfaces with some give, slow down and observe the differences in what you perceive with different pressures of touch. Particularly with touching human skin, muscles and fascia, practice feeling the different layers and the differences in texture, temperature and direction that distinguish them.
One of the classical sensory analogies for deep tissue work is the cornstarch and water solution. In the worlds of children's play and physics, this solution has become known as Oobleck.5 Add water to cornstarch in a small bowl until the solution as the consistency of pancake batter when stirred very slowly. If you tap the surface quickly, the surface is hard. Your fingers come away without intermingling with the solution. If your place your fingers on the surface and pause, your fingers sink in. Suddenly the solution is liquid. For deep tissue work, the lesson is one of working slowly and giving the tissue a chance to deform plastically rather than trying to force a rate of movement. In teaching such work, I use the term "glacial creep," literally meaning to apply pressure obliquely to the body's surface and let the stroke move naturally with the plastic movement of the tissue beneath, much as a glacier deforms and moves under the pressure of its own weight. On a sensory level, feel for the give in the tissue and work to enhance that, working the directions of give into the directions of restriction. The sensation is one of eroding the edge of a restriction rather than jumping directly into the middle. Applying pressure and waiting also provides the advantage of making the work easier; you simply relax and lean into the technique, letting your bodyweight do the work while you "hangout" in the tissue waiting for pressure and accommodation to interact.
In looking at good resources on palpation, Philip Greenman gives a thorough overview of palpation skills in his book on manual medicine.3 He divides the process of palpation into reception, transmission and interpretation. Sensation involves the activation of skin sensors by the variations in touch. Transmission is the internal processing of the stimuli. Finally, and likely the most learned and learnable stage, you have to interpret the signal at multiple levels of awareness, your conscious mind analyzing linearly and your unconscious mind matching the signal to previous patterns of experience. Greenman's practice of palpation involves varying the pressure, depth and movement of touch, and noticing differences. How thick, how deep, how warm and how mobile are the tissues?
Leon Chaitow, in Palpation Skills provides an extremely thorough guide to using touch for assessment.1 He sets five objectives for palpation:
Chaitow notes that successful palpation requires trusting the sensory input; paying attention to what is being felt and suspending critical judgment while the process is being carried out. "Critical judgment may be used in interpreting what was felt, but the process of 'feeling' needs to be carried out with that faculty silenced."
Clyde Ford, in Compassionate Touch, describes an exercise in pacing another with touch that provides some additional insights. The exercise itself is simple, having the other person lie supine and actively pacing their breathing with a hand on their chest or abdomen (i.e. the hand is not laying there as dead weight but is actively moved with the breath). Part of the value of the exercise comes in realizing the power of simple attention to another and in attuning your actions to their responses. Another part comes from the opportunity to be still and observe. As you quietly pace their breathing with your touch, you can notice changes in the depth and rate of their breathing, in the tension and overall small movements of their body, in rates of eye blinking, and in coloration of their skin with superficial changes in circulation. Touch and attention are profound and powerful gifts. Value them and use them well and wisely.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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