resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
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.
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.
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 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.
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.
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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