resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
April, 2008, Vol. 08, Issue 04
The Structural Component of Soft-Tissue Rehabilitation
By Don McCann, MA, LMT, LMHC, CSETT
One of the most important factors in understanding and treating clients in pain who need therapeutic massage is evaluating the cause of the discomfort. We often look directly to the area of discomfort and find inflammation, swelling, ischemia, trigger points, buildup of fiber, scar tissue and adhesions, and think treating this is the key factor in our client's recovery. However, when we treat only the symptomatic areas, we are doing our clients a major disservice. There always is a reason for any area of the body to be in distress. One factor that is ever-present is the relationship of structural imbalance to the area of pain.
Structural balance allows the body and its musculature to function with strength and flexibility. When there is an imbalance in the structure, specific areas of the structure will overwork or be weakened to the point of injury or distress. This can be understood when looking at muscles moving bones in a lever relationship. When the structure is balanced, the lever and fulcrum are in an optimal performance relationship. With structural imbalance, the fulcrum/lever relationship is, at worst, totally dysfunctional and subject to breakdown or, at best, weakened and in need of additional support from surrounding soft tissue. This is inefficient and, in essence, the muscle that is supposed to be doing the work only has a third to half of its strength. This leaves that muscle very susceptible to strain or injury. In addition, the joint or spine is unstable and weakened and subject to strain or injury.
Thus, in therapeutic massage, a major treatment goal is to release the structural imbalance. Let's look at what happens when this is not factored into the treatment protocol. One of the easiest ways to understand this is to look at an area where most clients experience pain - the top of the shoulder, which includes the trapezius, levator scapula, supraspinatus and rhomboids. When this area is hot, inflamed, spasmed or strained, clients will present wanting relief ASAP. If the massage treatment is focused only within this area, there might be short-term relief; however, in the long run the condition could worsen. If the soft tissue in the top of the shoulder is released without balancing the shoulder, the muscles in the front of the chest will have less resistance and pull the shoulder farther forward into additional imbalance. The long-term result is that the client will most likely have more pain, discomfort and dysfunction in the area due to the increased distortion. To make matters worse, the soft tissue in the top and back of the shoulder actually are counterbalancing and actively working to hold against the stress in the soft tissue in the front of the shoulder.
So, when therapeutic massage techniques are applied first to the spasmed tissue on the top and back of the shoulder, which is invested in maintaining its holding pattern, the area will be resistant to the technique being applied. The sensation for the client is intensified and the client will experience greater discomfort because of the difficulty in relaxing that musculature. Plus, it will take two to three times the amount of work and pressure by the massage therapist to achieve results in the area. This obviously is a lose-lose proposition.
If the theory of releasing the shoulder into structural balance is applied, the muscles in the front of the shoulder are treated first, releasing the shoulder back into structural balance, and allowing the muscles in the back and top of the shoulder to release their compensation holding pattern that was counteracting the tension from the muscles in the front of the shoulder. The massage therapist will achieve greater results with much less work. In addition, the client will experience less discomfort and will be able to maintain structural balance and long term homeostasis.
Neck problems. Most clients will complain of pain in the back of the neck and at the base of the cranium. The majority of them will be holding the head forward, resulting in a reverse curvature of the cervical spine. In order to achieve structural balance, you will need to first release the soft tissue that is responsible for pulling the head and neck forward before releasing or treating the tissues at the back of the neck where the pain is located.
Low back. When clients present with low back pain, there is an imbalance in the pelvis that includes the legs and feet. This imbalance is not only front to back, but also involves torsion where one ilium rotates anteriorly, and the other rotates posteriorly. The most effective way to move the client into structural balance to relieve the pain is to release the leg and ilium that is rotated anteriorly first, and then the posteriorly rotated ilium/leg side.This concept of structural balancing to achieve long-term results, while working within client comfort levels, can be applied to any musculoskeletal imbalance found in the body.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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