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The Easy Way to Learn How to Document ICD-10
The 2015 Work Plan for the Office of the Inspector General (OIG) includes a focus on chiropractic services. This means chiropractors can expect to see more audits and reviews in the coming year because private payers pay attention to the OIG's focus as well.
Online Efforts That Convert Traffic Into Patients
Most chiropractors are using "dinner with the doc," "refer a friend," customer appreciation days, grand openings, health fairs, chamber of commerce meetings, and other networking events to get new patients.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Connections Worth Making
"If most doctors are like me, [they are] isolated physically and professionally. I do not make the time to connect with other doctors and also a lot of doctors do not want to be connected for a lot of reasons. Dynamic Chiropractic keeps me grounded and connected.
A New Era of Injury Awareness Means a New Focus on Prevention
Despite a dramatic Super Bowl last month, the National Football League has taken quite a few hits lately concerning player injuries, particularly concussions.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Leg Length and Pelvic Fixations
A common component of low back pain is sacroiliac joint dysfunction. Signs of SIJ dysfunction can include fixation with reduced range of motion, and localized pain or joint laxity and inflammation.
We Get Letters & E-Mail
We Have Come a Long Way – But There's a Long Way to Go; Grounded and Connected.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Adjusting the Occiput on the Atlas
You may never see a particular set of patients in your office – the ones who are either afraid of neck adjustments or have had a bad experience. A vast majority of those who had a bad experience did not have a life-threatening vascular event.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
What's Triggering That Point?
An orthopedic friend recently saw a patient of mine. He felt an injection of a trigger point (TP) at the upper trapezius and surrounding areas was necessary, since that was the patient's area of chief complaint and there was a tender, radiating nodule.
Joint Supplements for Athletes (Part 1)
Maintaining joint health should be a daily focus for athletes. Joint health is a complex issue for everyone, but for athletes it poses a greater concern.
May, 2007, Vol. 07, Issue 05
Cranial/Structural Soft-Tissue Releases
By Don McCann, MA, LMT, LMHC, CSETT
For the past 15 years, I have been working with a paradigm that has greatly expanded the effectiveness of my soft-tissue therapy. When I began applying the cranial/structural releases to initiate structural balance, there was a quantum leap in the effectiveness of my treatments and long-term rehabilitation for my clients.The cranial/structural releases initiated an unwinding of the body out of its collapsed spiral that had been the cause of so much soft-tissue compensation and pain; and corrected the weight-bearing separation between the rotated iliums and tipped sacrum.
With weight-bearing support quickly established in the first 20 minutes of treatment, the old compensations and myofascial holding patterns in the soft tissue began to release, resulting in more efficient soft-tissue treatment and allowing the structure to move more easily into balance. Before the cranial/structural releases, it would usually take at least five to 10 sessions for any noticeable improvement in the client's structural collapse. Even then, the weight-bearing separation of the sacrum and ilium was not completely resolved. Let's look at the difference between craniosacral and cranial/structural soft-tissue releases.
Cranial/structural techniques are very different from craniosacral techniques in intent and application. Craniosacral techniques are applied within the soft-tissue restrictions of the normal cranial motion to achieve homeostasis. Cranial/structural techniques release the soft-tissue restrictions of the distorted cranial motion, resulting in structural balance throughout the body. Let's take an in-depth look at the need for cranial/structural techniques.
Within the structure of every client's body there exists a core distortion pattern. Many liken it to a spiral that runs throughout the structure, resulting in an anterior/posterior rotation of the iliums, a tipped sacrum and a degree of classic scoliosis. This spiral is evident from the top of the head down to the feet and, not surprisingly, also is found in the relationship of the bones and soft tissue of the cranium. When clients are experiencing musculoskeletal pain, there is an observable increase in the degree of this distortion. This can be viewed as a degree of structural collapse or a lack of structural support. The resulting pain can be evidenced in the compensation for this increased distortion, the strain in the musculature or the actual distortion of the skeletal structure. Thus, the key to relieving the painful symptoms and balancing the structural support system lies in releasing this exaggerated core distortion.
For years, in developing my soft-tissue protocols, I struggled with the major components of this core distortion, in an effort to relieve my clients' painful symptoms. Whether it was whiplash flexion/extension injuries, headaches, neck pain, shoulder pain, degenerative disc disease, bulging disc, carpal tunnel, nerve entrapment, sciatica, low back pain, hip pain, knee pain or foot pain - it was related to structural collapse. Therefore, addressing and releasing the core distortion pattern appeared to be the most direct way to achieve pain relief, homeostasis and a return to normal function.
Within every collapsed structure, I found an anterior/posterior rotation of the iliums, stretched ligaments between the sacrum and the ilium at the SI joint, and a tipped sacrum. The degree of distortion was directly influenced by the degree of the rotation of the iliums, the degree of stretched ligaments and the degree of tippage of the sacrum. Further, the degree of distortion in the body was directly proportional to the intensity of the pain and symptoms the client was experiencing. The longer the client remained in this distortion, the more the entire musculoskeletal system distorted into the lack of support, which usually resulted in an extended recovery process.
One of the greatest challenges was stabilizing the SI joint. While the client was on the table, the position of the iliums could be shifted through soft-tissue releases, and the feet and legs could be aligned to support the shift. However, when the client became weight-bearing, the weakened ligaments would not be able to stabilize the SI joint and the sacrum would again slip and tip, re-creating the structural collapse.
A missing link in the treatment to stabilize the pelvis was found in the relationship between the cranial bones, reciprocal tension membrane, dura and the myofascial planes of the body. Dr. G. Dallas Hancock, a chiropractic physician, discovered the relationship between two of the cranial bones (the sphenoid and the occiput), the sphenobasilar synchondrosis (SBS) where they meet, and the torsion of the pelvis. He noted that the rotation of the iliums and tippage of the sacrum were in direct relationship to the rotation of the wings of the sphenoid and the tippage of the occiput. I had the privilege of working with him to develop the techniques of releasing the cranial torsion of the SBS that successfully released the torsion of the pelvis.
One of the ways to understand the effect of this incredible discovery of Dr. Hancock's is to view these two cranial bones (sphenoid and occiput) as handles for the reciprocal tension membrane, dura and the entire myofascial plane of the body. The distortion found in the SBS joint is supported by the restrictions in the reciprocal tension membrane, dura and fascia, which affect the entire structure of the body. The techniques that were developed to unwind the torsion of the SBS released the restrictions in the reciprocal tension membrane and dura, which, in turn, released the restrictions in the myofascial planes of the body that related directly to the dura. In addition to the release of the restrictions in the dura, its relationship to the sacrum allowed the sacrum and the iliums to balance.
The greatest significance of this was that the weight-bearing separation of the SI joint was corrected, even though the ligaments had been stretched. Another exciting discovery was that clients would not return to this weight-bearing structural collapse unless a very severe trauma was experienced. With the balancing of the SI joint and iliums, the myofascial planes of the body down to the feet also were beginning to unwind and balance, bringing support into the entire structure.
The torsion found in the cranium also was the principal cause of problems such as TMJ. When the torsion was taken out of the cranium (SBS), a balancing of the bite took place. Most clients who suffered TMJ symptoms would have an immediate improvement. Even without focusing on the usual TMJ soft-tissue treatments, clients would continue to improve and often become pain-free.
Cranial work that focuses on this structural shift is called cranial/structural due to its direct relationship to structural balance. Prior to having these techniques to balance the SBS and correct the weight-bearing collapse found in the core distortion pattern, I was not able to achieve a long-term correction of the distortion in the pelvis. However, with the cranial/structural techniques, my clients showed dramatic changes in the initial session and I was able to achieve long-term correction of this distortion throughout the body in only a few treatments by integrating my soft-tissue protocols.
Jerry, 33, an avid weekend basketball player, had been developing low back pain for five years. He was then rear-ended in an auto accident, resulting in a cervical flexion/extension injury and excessive soft-tissue damage. His chiropractor referred him for soft-tissue therapy, as he was having difficulty stabilizing his neck. At Jerry's first session, evaluation revealed a structural collapse of the core distortion with an anterior/posterior ilium rotation, tipped sacrum, scoliosis, reverse curvature of the neck and a jammed C1. Applied kinesiology evaluated the weakened strain patterns of the structural collapse and revealed weakness in the legs down to the feet.
The cranial/structural soft-tissue releases were applied and Jerry noticed an immediate improvement in the range of motion of his neck, less neck pain, a flattening of his back on the table and reduced back pain. Upon becoming weight-bearing, Jerry also noticed that both feet felt like they were directly under him with the weight evenly distributed. He was standing straighter, his arms were more equal along his sides, and the top of his left shoulder was no longer hurting. It was obvious there had been substantial improvement in Jerry's structure. It was now time for soft-tissue treatments to release the myofascial holding pattern and address shortened fascial fibers, adhesions and scar tissue from the auto accident, and the structural collapse from basketball. Jerry's neck stabilized in just two sessions.
Cranial/structural is most effective when applied at the beginning of the first session to release the core distortion pattern and balance the SI joint. However, the soft tissue (dura, reciprocal tension membrane and fascia) will only release so far using the cranial/structural techniques alone. The structure of the body is then trying to move into balance, but the soft tissue that was tightened and forming adhesions and restrictions in the holding pattern of the core distortion will impede the process. To complete the balancing process, it is necessary to include specific myofascial releases, myofascial unwinding, and scar and adhesion fiber work to allow the whole body to move into structural balance.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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