resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
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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