resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Avoiding "Just a Pop Doc" Syndrome
Yes, it's harsh. Patients don't like to admit it. They have an unspoken plan when they first visit you: to come one time, get rid of their pain and then get rid of you. They know it's unrealistic, but they'd like to pay nothing for this service.
News in Brief
Life to Open Branch Campus in Italy; Northwestern Research Arm Benefits From Big Donation.
Make Low-Level Laser Therapy Part of Your Evidence-Based Practice
Low-level laser therapy (LLLT), also referred to as photobiomodulation, has been increasingly utilized in the clinical setting over the past decade.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
The Death of the Travel Card
As long as I have been in practice, the travel card has stood as the primary style of documentation for chiropractic. It is quick, simple and direct. Unfortunately, the rules have changed.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Solving the Pain Puzzle
Legendary former New York Yankees baseball player Yogi Berra once said, "You can observe a lot just by watching." He would have been a great chiropractor. We are trained to become experts with our hands: palpation, adjusting, soft-tissue release, etc.
Treating Acute and Chronic Neck Pain With Ischemic Compression and Exercise
There are many reasons not to manipulate the neck with cavitation: the patient is too old, their neck is too tight, etc. But the most common reason is that plenty of patients are afraid of "the crack," mostly because of the bad publicity about that procedure.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
DC App – The Next Generation
According to a survey by technology firm CDW, health care professionals gain approximately 1.2 hours per day in productivity simply by using a tablet computer in practice.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Are You Ignoring the 10,000-Hour Rule?
Having trained interns and mentored new practitioners, it has been my observation that their No. 1 clinical concern is adjusting skills. Their second clinical concern is their ability to read X-rays. Physical diagnostic skills are a distant third.
Why Drugs and Supplements Can't Cure Disease
Chronic diseases are the outcome of disease-promoting, goal-oriented behaviors. So, the notion that diseases can be cured with drugs or supplements should be abandoned. Hypertension is the best example of this.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
We Get Letters & Email
Is It Time for a Popeye Moment? The Flaw in Recommending Chiropractic as a Career.
Foundation for Chiropractic Progress Announces First Group Member
The Michigan Association of Chiropractors has joined the Foundation for Chiropractic Progress as its first group member.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Home Safety: Help Families Avoid Common Injury Hazards at Home
These days, many parents childproof their homes before a baby is even mobile. You will see an array of electrical outlet covers, bumpers on the corners of the coffee table and safety latches on the cupboards.
Are You Ready for the 2016 Patient?
In October, Apple released its iOS 8 operating system for the iPhone and iPad. The new system includes Health, a new app that will interface with an ever-growing number of other apps.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
July, 2011, Vol. 11, Issue 07
Frontal Headaches and Myofascial Trigger Points
By David Kent, LMT, NCTMB
A fundamental key to treating the muscular component of most pain, regardless of the modalities and techniques you specialize in, is to know which muscles to treat based on the location of the patient's pain.This article will review the five muscles that produce frontal headache pain based on the research of Drs. Travell and Simons', the common location of the trigger points in each of those muscles and their referral pain patterns. The muscles are: Sternocleidomastoid (clavicular head), Sternocleidomastoid (sternal head), Semispinalis capitis, Frontalis and Zygomaticus Major.
Most forms of bodywork treat trigger points. When you stimulate a trigger point during treatment, it can produce referred pain to other areas of the body. For example, trigger points in the Sternocleidomastoid muscle, located in the front of the neck, can refer pain into the forehead (Photo 2). It is important that each patient understands that you are not pressing on a nerve when treating a trigger point. Using visual aids like trigger point charts, provide multiple advantages. They educate your patients, provide you with a quick review of the trigger points and help you customize a logical treatment plan. This type of visual education also uniquely sets your practice apart from the competition. Trigger point charts are available in travel flip size or wall versions. Read Headaches: Trigger Points and Practice Building (MT, August 2010) and Practice Building: Getting Inside Your Patient's Head (MT, January 2011).
Let patients know how your charts work. For example, in photo 1 "X" indicates the common location of trigger points within a muscle. When a trigger point is activated during treatment, it will produce referred pain, which is shown in red. Solid red areas indicate an essential pain zone or area of pain experienced by nearly every patient that had that trigger point activated. The red dots indicate spillover pain zones. These are areas of pain experienced by some, but not all, patients outside of the essential pain zones. (Photo 1)
Each division or muscle belly of the sternocleidomastoid muscle has its own unique trigger point patterns. Typically, neither division refers pain into the neck, however each refers pain to the face and cranium. (Photo 1 & 2) This muscle is shortened bilaterally with a forward head posture. The claviclar division will be shortened on the high shoulder side.
Trigger points at the midlevel of the sternal division of sternocliedmastoid refer pain in an arch over the eye into the forehead, deep behind the eye and into the cheek. (Photo 1)
Trigger points at the upper end of the sternal division commonly refer pain to the occipital ridge and to the top of the head (vertex). Attachment trigger points at the lower end of the sternal division can refer into the upper chest.
Trigger points in the mid level of the clavicular division of sternocliedmastoid refer pain to the forehead. On rare occasion, the pain extends across the forehead. (Photo 2) Trigger points in the upper portion of the muscle refer into the ear and posterior to the ear.
The semispinalis capitis and other posterior neck muscles sustain enormous tension as patients maintain a forward head posture throughout their day while writing, reading, working at a computer, driving and maintaining poor posture.
There are two trigger points in the semispinalis capitis muscle that produce the same referral pattern. These trigger points project a band of pain forward that encircles one side of the head, with the intensity focusing in the temple region, then continuing to wrap around to the forehead. (Photo 3) Trigger points labeled Location 1 are found where the muscle attaches to the skull. Location 2 trigger points are located in the upper third of the muscle. Trigger points in the middle and lower portions of the muscle are shown as Location 3 and refer into the back of the head on the same side.
Trigger points form in the frontalis from direct trauma, over stress from prolonged intense frowning or wrinkling of the forehead. The referral pattern for the frontalis is local and spreads upward over the forehead. (Photo 4)
Next we will review key and satellite trigger points. A Key Myofascial Trigger Point is responsible for activating one or more satellite trigger points. It is clinically defined when an inactivated key trigger point results in the inactivation of the satellite trigger points. Satellite Myofascial Trigger Points can form for many reasons, one being in the pain referral zone of a Key Myofascial Trigger Point. Since satellite trigger points can form in the frontalis as a result of key trigger points, be sure to examine and inactivate key trigger points in the clavicular division of sternocliedmastoid (Photo 2) or the Zygomaticus major. (Photo 5)
When the zygomaticus major contracts, it makes us smile by pulling the corner of our mouth upward and laterally. Referred pain from zygomaticus major trigger points project along the side of the nose into the forehead. (Photo 5) Be sure to examine and inactivate key trigger points in muscles like the clavicular division of sternocliedmastoid that refer into the zygomaticus major region. (Photo 2)
Patients appreciate when you take a few minutes prior to the therapy session to educate them of the strategies you implement to identify and address the muscular components of their pain. Photos are powerful visual aids that leave a lasting impression in the patient's mind and help you to quickly deliver a clear message. The saying "a picture is worth a thousand words" speaks volumes when conveying postural analysis findings. Trigger points are often within the myofascial tissues involved in the postural distortions.
Keep the postural analysis process fast and simple. Using the camera of a cell phone, you can take postural photos and instantly give a report of findings to your patients. An anterior view photo will easily pinpoint a high shoulder, while lateral view photos make it easy to show a forward head posture. (Photo 6) Photos allow patients to finally see and understand why they hurt and how you can help. Postural analysis photos are extremely effective even when patients are wearing shoes and/or loose fitting clothes. Read Getting Comfortable With Postural Analysis (MT, July 2008).
Using a postural analysis grid chart with a plumb line makes it easy for anyone looking at the photos to spot postural asymmetries. Pictures also are an excellent way to document change over time. After patients understand the postural stresses their muscles are enduring, they understand why you took the time to educate them.
Treating the muscular components of Frontal headaches is easy when you know which muscles to treat based on the research. The five muscles in this article should be checked, unless contraindicated, for frontal headaches. As always, based on the patients subjective complaints, your objective finding and other factors, you will design customized treatment plans that produce positive clinical outcomes. Stay in touch and I wish you great success in your treatment sessions.
Click here for more information about David Kent, LMT, NCTMB.
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