resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
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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