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Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
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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