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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.
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.
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.
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.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
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.
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.
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.
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 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.
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.
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?
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.
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.
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.
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.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
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.
May, 2012, Vol. 12, Issue 05
Benefits of Using Massage Therapy to Treat TMJ
A brief review of an article published in the International Journal of Therapeutic Massage & Bodywork.
By Massage Therapy Foundation Contributor
Contributed by Sandra K. Anderson, BA LMT ABT and Jolie Haun, PhD LMT
Have you ever wondered what inspires research in massage therapy and bodywork? Often, it starts from the work of practitioners who write case reports illustrating their experiences with clients and patients.A case report is a detailed description of a practitioner's work with a client who has a condition which is addressed by a specific therapy or intervention. It also includes a review of published literature about research on issues similar to the client's. Both the practitioner's work with the client and the research literature can form the foundation for further scientific investigation.
This month, we at the Massage Therapy Foundation (MTF) are presenting a case report published in the International Journal of Therapeutic Massage & Bodywork in 2011. "Changes in Temporomandibular Joint Dysfunction Following Massage Therapy: A Case Report" was written by Melissa Joan Pierson, MT, and won a Silver Place Award in the Massage Therapy Foundation's Student Case Report Contest in 2010.
Most massage therapists have likely had clients with temporomandibular joint (TMJ) dysfunction as 65% to 85% of Americans experience symptoms during their lives. Symptoms include pain and muscle spasms in the head, mandible, neck and shoulder muscles; headaches; earaches; clicking noises or deviations when the mandible moves; limited ability to open the mouth; and dizziness. Causes of TMJ dysfunction include whiplash, bruxism, malocclusion, anxiety, stress, trigger points and postural dysfunction.
Treatments for TMJ disorder include splint therapy, analgesics, surgery, stress management, acupuncture, trigger point therapy, hydrotherapy and massage therapy. Data from focus groups and surveys of people with TMJ disorder suggest people experience frustration with conventional treatment, but are often satisfied with complementary and alternative medicine (CAM) treatments, especially massage therapy. However, literature regarding the effectiveness of massage therapy on TMJ disorder is limited and shows varying degrees of success, warranting more research on the topic. Pierson's case report is important because it shows the benefit of a treatment plan with detailed measurements of the outcomes associated with TMJ disorder.
Pierson's client was a 26 year-old female student who had TMJ disorder seven to ten years prior to the massage treatment series. There was no reported known cause of TMJ for this client. Her symptoms were pain, decreased range of motion, clicking and crepitus. She was a busy, stressed student who had sought treatment from a dentist and a TMJ specialist. Eating soft foods, stretching and following guidance on reducing stress decreased the majority of her symptoms, but when her stress levels increased, her symptoms returned. The client's goals from massage therapy were decreases in pain, muscle tension, stress and restrictions in the neck and facial muscles.
The treatment plan consisted of an initial assessment followed by ten treatments, with re-assessments midway through the series and afterward. Each assessment included a postural assessment using a plumb line and range of motion (ROM) and orthopedic assessments of the neck and TMJ. Pierson also conducted pre-treatment interviews which included questions about location of discomfort, duration, frequency, intensity and quality of pain, and aggravating and relieving factors.
The sessions lasted 45 to 50 minutes, and included intra-oral massage (with gloved hands) consisting of compression on the medial and lateral pterygoids to release trigger points and muscle tension and gentle stripping. Myofascial release was then performed on the neck muscles and pectoralis major to correct the client's rounded shoulder posture and release pressure on her jaw followed by stretching. The sternocleidomastoid was picked up and twisted to release trigger points and tension. Kneading, stripping and trigger point release through ischemic compression were also used on neck muscles. These techniques were done to relieve pain, increase blood flow to the muscles and elevate endorphin levels to further reduce the client's pain and stress. Shiatsu was performed on the client's scalp to restore and maintain the body's energy balance, prevent the buildup of stress and decrease pain.
Because studies have shown that 60% to 90% of patients with TMJ disorder have an improvement in symptoms after using only self-management techniques, self-care was essential to the client's treatment plan. The client performed daily exercises involving retraction to decrease forward head posture. To keep the jaw muscles from clenching, the client compressed and stretched masseter and temporalis musces, and performed self myofascial massage over pectoralis major. She also applied heat and ice alternately to painful areas. Starting three weeks prior to the treatment series, the client kept a daily journal recording her stress, pain and muscle tension levels; the amount and quality of her sleep; self-performed home care, daily activities and diet.
Overall, the treatment series was successful, yielding an increase in the client's ability to open her mouth maximally and range of motion in her neck and a decrease in muscle hypertonicity, pain and stress. Pierson states these results could be due to several factors - the client's compliance with home care, using evidence-based techniques and frequent sessions with no long breaks in between.
For greater accuracy in measurements, Pierson acknowledged that other tools could have been used. For example, a goniometer could have been used to measure the range of motion of the mandible. Instead of relying on the client's comments, valid and reliable measures could have been used to assess the client's mood, stress, concentration and patience. Also, during postural observation and resisted ROM assessment, more quantifiable measurements could have been used instead of the terms "mild, moderate, or severe."
This case report is valuable for several reasons. Because it details the techniques Pierson used on the client, massage therapists can use the information for their own clients with TMJ disorder. This case report warrants further study to investigate the benefits of massage therapy for TMJ disorder. And just as important, this case report may provide inspiration for other massage therapists to conduct and author case reports about their experiences using treatments with their clients.
The Massage Therapy Foundation has annual student and practitioner case report contests that are intended to enhance professional development and research skills of practitioners and students. For information about how you can submit a case report, please visit www.massagetherapyfoundation.org/grants-contests/case-report-contests/. Who knows? Maybe your case report could be the foundation of ground breaking research in the massage and bodywork field. To view the complete article in IJTMB, visit www.ijtmb.org/index.php/ijtmb/article/view/110/201.
For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.
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