resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
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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