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Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
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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