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Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
July, 2007, Vol. 07, Issue 07
Successfully Treating Cervical Trauma Using Deep-Tissue Techniques
By Don McCann, MA, LMT, LMHC, CSETT
Jim, a 35-year-old accountant, suffered a cervical flexion/extension injury in an auto accident. After chiropractic treatment had exhausted his personal injury protection (PIP) coverage, his chiropractor released him saying he had reached maximum medical improvement.However, he still was having severe neck and shoulder pain with headaches. He sought treatment from several massage therapists whose ads stated that they did deep tissue, therapeutic massage. He was totally unimpressed both by the amount of pain he endured during his sessions and the lack of improvement. A friend referred him to our clinic with the reassurance that not all deep-tissue therapy had to be a painful experience and he would see results.
During Jim's initial session, structural evaluation revealed a forward head posture with a reversed curvature of his neck. On his intake form he marked the back of the neck and top of the shoulders as primary pain areas. The therapist explained to him that his treatment would address the pectoralis region and anterior neck first, and then the painful areas in the back of his neck and the top of his shoulders. Jim was amazed because previous therapists had only concentrated on the areas of pain. As the treatment proceeded, he was pleasantly surprised that this therapy was very tolerable even though some of the strokes were deeper than previous work, and he was feeling better.
The important thing to learn from this is that it is crucial to have a structurally-based strategy for applying therapeutic massage techniques. Deep tissue therapy, whether it is myofascial release, myofascial unwinding, myofascial stretching, or deep trigger-point release, will result in significant long-term structural changes. If these releases and changes do not contribute to structural balance and normalization of structural function, then they are likely to contribute to structural distortion patterns and structural dysfunction, which tend to create worsening conditions and increased client pain.
In Jim's case, the tension was released from the musculature of the anterior shoulder and neck first, allowing the shoulders and neck to move back facilitating the initial structural improvement. As the shoulders and neck released, the spasms in the back of the neck and top of the shoulders began releasing even before treatment was ever applied to those areas. If therapy had been applied to the primary areas of pain in the back of the neck and top of the shoulders first, the tightened musculature in the anterior neck and pectoralis muscles would have pulled the head and shoulders forward even further as the posterior musculature was released. The structure would have worsened by the increased misalignment resulting in increased pain. Thus, it is very important for therapists doing therapeutic massage to always be aware of the structural consequences and ramifications of releasing fascia, adhesions and shortened muscles. To address Jim's complaint regarding the pain he experienced with other deep-tissue work, a three-step approach to working deep tissue was used.
The first step is the application of milking strokes to release the fluids, toxins and ischemia, which reduces the inflammation and clears some trigger points. Tissues swollen with toxins, fluid and inflammation are extremely sensitive and painful to touch, so light, slow, gentle strokes are used. This results in a decreased sensitivity of the tissues, which allows palpation of the tissues without major discomfort and prepares the tissues for deeper work.
The second step is the application of directed myofascial unwinding strokes to release the holding pattern of fascia in the structural dysfunction and to further clear trigger points. These strokes are very slow. You sink in until you feel the resistance in the tissue and then hold constant, steady pressure until the resistance starts to melt. Follow the tissue as it melts, keeping the pressure slow, steady and constant. You will feel many layers softening and releasing at a deeper level than where the actual pressure is. The deeper you go, the slower you go. These strokes released most of the myofascial holding pattern that held the structural distortion within Jim's neck and shoulders preparing this area for more specific deep work to release scars, adhesions and tightened individual fibers.
The third step is the application of individual fiber strokes to release deep fascia, adhesions, scar tissue and atrophied tissues locked in the soft tissue. Many of these deep adhesions, along with scar tissue, entrap nerves and lock the structure into distortion. These are deep, specific strokes, moving very slowly, staying within pain tolerance levels.
This three step approach can be used in any area of the body and will allow you to apply effective, deep therapeutic massage while staying within your clients' pain tolerance. Jim stated that, even though these strokes appeared to release tissues more deeply than previous deep-tissue treatments, he did not have the discomfort that he experienced in those treatments and his pain disappeared after just a few sessions.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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