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Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
March, 2009, Vol. 09, Issue 03
Massage for Surgical Adhesions and Scar Tissue: A Case Study
By Don McCann, MA, LMT, LMHC, CSETT
Weekly, I receive inquiries from massage therapists and potential clients asking for help with the pain they are experiencing from surgical scar tissue and adhesions. Scar tissue and adhesions can be effectively released. The following case study is one such example.
Sarah, a 63-year-old, was a disabled office worker. Her problems started 20 years ago when she donated a kidney for her daughter. The surgical incision was halfway around her body. Six months after the removal of the kidney, Sara had an additional surgery for the removal of surgical adhesions that had resulted from the initial surgery, and four months later had another surgery for surgical adhesions. The adhesions produced significant pain, preventing her from returning to work.
By the time she was referred to me, she had undergone a total of seven surgeries for adhesions over a 20-year period and was still unable to work. Her overall vitality and health reflected the 20 years of medication and pain, and she appeared older than her 63 years. Upon evaluation, she was severely bent over to her right side in an acute collapse of the core distortion pattern and could not rotate her upper body to the right. She was not able to fully straighten up due to the restrictions deep in her abdomen from the surgical adhesions. When I palpated the surgical adhesions and scar tissue, I found them to be fibrous, thick and hypersensitive from the surface tissues in the rectus abdominus, obliques, and latissimus dorsi all the way through the soft muscle of the intestines, and into the psoas and quadratus lumborum of the deep intrinsic stabilizing muscles. In addition, she had significant pain in the lower lumbar region of the spine, hip, neck and shoulders as a result of the structural collapse. She was also depressed due to the fact that she had not been able to work or take part in activities that she enjoyed.
The goals for the initial treatment sessions were to lessen the sensation in and around the surgical adhesions and scar tissue, release the buildup of fluid and toxins associated with the pain and inflammation, clear trigger points and soften surface layers of scar tissue to prepare the areas for deeper treatments as therapy progressed.
The strokes were applied in specific sequences and directions that would facilitate the release of the structural distortion to initiate the structural balancing. These initial strokes were lighter, milking strokes which were applied very slowly to allow more change in the tissue with less threat and less sensation for a client who is in severe pain.
In the next phase of treatment, one of the goals was to unwind the myofascial holding patterns of the structural collapse, not only in the adhesions of the scar tissue, but also in the restrictions throughout the rest of her structure that had been pulling her structure further into collapse. This would help reduce the pain in her hip and lower back from the structural collapse. We were also working to release some of the hardened fibrous adhesions and their compression on nerve tissue which was one of the significant causes of her pain. Another goal was to increase her range of motion as the fascia and scar tissue restrictions were released and mobilized.
After seven sessions, Sara was standing straighter with a significant reduction of the structural collapse. She was more mobile and was able to participate more freely in her daily life activities. Her energy was better, and her spirits were high because she was finally feeling and seeing the improvement: she was able be more active, having more fun, and feeling more satisfaction in her accomplishments. The pain was reduced both from the release of the direct pressure of the surgical adhesions on nerves, and from the release of the structural collapse causing the low back pain. She was experiencing less pain in her neck and shoulders due to the fact that she was no longer bent over, and her neck and shoulders were now more supported by a straighter spine.
The goals here were going to be specific release of the fibrous tension of the surgical adhesions, release of the shortened fibers and adhesions in the psoas and quadratus lumborum (to release nerve entrapment and allow structural balance), release other fibers in the pelvis that supported the structural collapse, and increase range of motion back to normal function. After seven more sessions that incorporated the deep individual fiber release to sufficiently lengthen and balance Sara's structure, take the pressure off the nerve entrapments and return range of motion to normal, we were able to accomplish the long-term goal of pain free living.
It was by setting goals, using them as observable and obtainable measurements allowing us to track improvements, that we were able to achieve successful resolution of Sara's long-time chronic condition.
The three-step approach of first releasing ischemia, fluids and toxins, then applying directed myofascial unwinding strokes, and finally releasing individual fibers allowed me to work with Sara staying within her pain thresholds even during the most intense phase of her rehabilitation. Using this three-step approach, the deepest of the surgical adhesions were able to be released, which ultimately released her structure into balance. Sara has gone back to work, and is finally happily participating in activities that had given her such enjoyment before the kidney donation.
As always, please be careful to work within your skill level and expertise, and refer out if necessary.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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