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A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
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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