resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
May, 2009, Vol. 09, Issue 05
Prevention and Rehabilitation of Conditions Leading to Hip Replacements
By Don McCann, MA, LMT, LMHC, CSETT
If you are doing therapeutic work, there will be clients who are in pain from hip problems, with hip replacements being the most severe.Unfortunately, many clients, especially the elderly, never fully recover proper alignment, full range of motion or pain-free function after having surgery for hip replacements. The criteria for hip replacements involves waiting until the client experiences constant and/or severe pain for a period of time before the surgery is performed. The tragedy here is that these clients are offered little, if any, intervention other than drugs for their pain, even after chronic or acute arthritic or degenerative changes are noted in the hip joint. This is very short-sighted especially when deep-tissue therapy, properly applied, can relieve and rehabilitate much of the problem. I have had clients who were told they were in need of a hip replacement due to pain and degeneration who, after rehabilitative massage techniques, were pain-free for years without having this drastic surgery.
Conditions Leading to Hip Replacements
A very basic condition is a pelvic imbalance (an anterior/posterior rotation of the iliums) resulting in the contraction of the musculature of the hip which often involves compression of the nerves. This may occur in the gluteals (maximus, medius, minimus), the piriformis or rotators. Other muscles that directly affect the rotation of the iliums and cause a tightening of the gluteals in compensation are the quadriceps, adductors, hamstrings, quadratus lumborum, TFL, iliacus and psoas. These muscles are all involved either in compensation for, or in support of, the pelvic distortion. I have found that when the pelvic imbalance is released, the tension in these muscles is reduced and there is a marked improvement in any hip condition.
To facilitate the release of the pelvic imbalance, the deeper tissues of the pelvis and hip need to be treated. Often these muscles and other soft tissue are inflamed and painful. Even so these tissues can be effectively treated by using a three-step approach that releases fluids and toxins and surface tensions; unwinds the myofascial holding patterns; and releases deep fibers and adhesions. This sequence not only directly affects the musculature and structure of this area, but reduces the amount of sensation that the client will experience while the contracted tissue is being treated.
It is important to release the tissues responsible for the anteriorly rotated ilium in a hip problem before releasing the compensating contracted or overstretched muscles that counter that rotation. I find the best results are produced when following this sequence: quadriceps, adductors, hamstrings, gluteals, quadratus lumborum, rotators, TFL and abdominals. If the pain and problem is in the hip joint of the posteriorly rotated ilium, it is still necessary to release the anteriorly rotated ilium first. Otherwise, the pelvis will slip into compensation for the anteriorly rotated ilium, and little will be gained for long-term recovery.
Don't hesitate to work with the hip if it is arthritic or the cartilage is degenerated. I have had many clients come to me with severe pain from arthritis and hip degeneration who are presently walking and fully functional. The soft tissue changes from the balanced pelvis took the stress off the hip. So, my message to you is: By all means do intervention therapy before surgery is ever considered. Unfortunately, many clients will not believe you can make a significant change because a medical doctor has diagnosed a problem, and they feel medical treatment such as surgery or cortisone is the only way to treat the pain. However, people want to feel better. Usually, that is enough of a reason for them to allow you to work with deep-tissue therapy on this type of problem.
Treating Clients With Hip Replacements
Many clients who have had hip replacement surgery will still be in considerable pain. Once again, proper soft-tissue therapy can release that pain and facilitate rehabilitation. Limiting factors from the surgery are pelvic imbalance, misalignment of leg and hip, leg-length difference from an inappropriate length of surgical apparatus, scar tissue and adhesion, and improper gait while walking.
Oftentimes the pelvic imbalance that existed before surgery that was responsible for the degeneration of the hip will not have been addressed and will be a stress factor on the surgically repaired hip. It is therefore necessary to bring the hips into structural alignment by balancing the anterior/posterior hip distortion. When this is accomplished, the structure supports the hip and the pressure is equal on the hip joints. Many times, this is the key component for the client's recovery. This process is similar to the pelvic balancing that we would have applied before surgery as previously described in this article. The complications are increased scar tissue and adhesions from surgery, uneven leg length due to surgical apparatus and misalignment of the leg/knee/ankle being nonsupportive.
I hope this has opened your eyes to the very real possibility of successfully treating hip problems using deep-tissue massage therapy techniques.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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