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The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
April, 2012, Vol. 12, Issue 04
Tissue Density's Relationship to Pain and Dysfunction
By Linda LePelley, RN, NMT
A new client presented with a diagnosis of severe pain in her right arm. She had been seen by several doctors and specialists and undergone a number of tests, including an MRI and a CAT scan.A neurologist informed her that all of the tests were negative and nothing appeared to be wrong with her arm. He suggested she see a massage therapist to deal with her stress. He also suggested she seek emotional counseling to address her, "exaggerated pain" symptoms. It is not my intention to discuss her medical condition, but to share an example of what so many of us massage therapists often face in the course of our massage careers – not just a hurting client who is seeking relief, but a person experiencing anxiety over whether or not we will even believe their pain is real.
After carefully examining her arm with my fingertips, I could tell her where it was hurting. My client's relief that I believed her was just as palpable as the affected tissues I'd found in her hand, arm, neck and shoulder. Had any of her doctors laid hands on her, and known what to look for, they would also have felt the differences in tissue density. They would have known that something actually was there, something assessable, measurable, documentable and most importantly – something treatable.
Tissue Density (TD), as it pertains to therapeutic massage, is an expression of the compactness and consistency of body tissues. My theory is that musculoskeletal pain and dysfunction increases in direct association with an elevation in TD. This is significant because TD is alterable as massage therapists do it all the time. Muscle "knots", "tight" muscles, and "trigger points" are some examples of elevated TD, as well as firm, swollen areas that may be congested with lymph, or thick, hard areas such as the plantar fascia when it is engaged in plantar fasciitis. Other examples include, but are not limited to, tissue that has become fibrous, nodules, "bony overgrowth" or areas that appear to be nothing but skin over bone, and any joint, ligament, or tendon that "pops" or "twangs" with movement.
My thoughts regarding the etiology of elevated TD involve the lipid-rich components of our extracellular fluids, which I believe are attracted to the bio-polymeric nature of our cartilaginous tissues. This attraction, combined with a variety of dynamic factors, including body heat, compressive force, overuse, injury, hypo-hydration, torsion, sheer force, tensile force, inertia, chemical environment and fluid viscosity may cause the extracellular fluid to accumulate, thicken and eventually precipitate into gelatinous plaque. Over time, I believe that these plaques harden and become mineralized, turning into the rubbery nodules or bone-like overgrowth of arthritic joints, as well as contributing to many other conditions. The plaque may be as thin as a sheet of a single layer of fascia cells or it can form a large area of many tissue layers sandwiched together, such as those found over arthritic hip joints and the thick, tender pads which so often develop at the medial aspect of knees.
We know that studies have shown massage can improve blood pressure. I surmise that the improvement occurs when the massage therapist has facilitated a successful reduction of TD. We work on a client with tight, dense muscles, they get off of our tables relaxed, their muscles have softened, loosened and become much more pliable. Once the heart no longer has to force the blood through constricted vessels trapped within clenched musculature, it stands to reason that this alleviation of compression will result in a reduction of blood pressure and heart rate.
As TD increases, involved nerves, blood vessels and lymphatic pathways will become engulfed, compressed, displaced, congested or a combination of all of the above. Untreated elevated TD has many complications. Consider what might happen to tissues that have become partially isolated from a normal environment where adequate nutrients, hydration and waste removal are available for example, The plantar fascia receives the full brunt of our weight. Add compression, force and any number of other events, such as stepping on a stone, poorly fitting shoes, running, etc. Any of these factors can generate heat in the foot, melting local fat deposits. Force and condensation will have pressed much moisture out of the fascia making re-hydration even more difficult. Nerves and nerve endings get caught up between layers of ligament, aponeuroses and fascia, becoming hot-glued together into a thick, rubbery sheet. It seems likely that, given enough time in a hydrophobic environment, the result would be a loss of elasticity and tissue shrinkage. The affected plantar fascia must be warmed up with movement and painfully forced to stretch back out, bringing a measure of relief, but after a period of rest and cooling the pain cycle starts all over again when attempting to walk. Until the TD is properly restored, nerves trapped in the dense tissue matrix are going to suffer with every step.
Done correctly, TDRM is a highly effective modality whereby the client achieves pain relief and improved mobility. TDRM is a powerful tool for us massage therapists, caring professionals who lay our hands on our clients, quite literally feel their pain, and then do something about it.
Linda LePelley, RN, NMT is a registered nurse and licensed massage therapist with 19 years of clinical massage experience. She developed Tissue Density Restoration (TDR) Massage, an effective treatment for the pain found in hyper-dense tissues. For more information, visit www.MyHealingHands.com.
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