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F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
September, 2012, Vol. 12, Issue 09
The Significance of Tissue Density Measurement
By Linda LePelley, RN, NMT
Massage therapists often struggle with the perceptions and beliefs expressed by others about the validity of massage therapy. Some massage therapists end up questioning the benefits of massage as well.It saddens me when I hear a therapist state that massage is just a "feel-good" experience. While there is nothing wrong with basing one's personal practice on providing relaxation massage, there are many therapists who dedicate their work to the relief of pain. Those of us who strive, and are able, to relieve our client's pain are often told that our results are subjective, therefore, "anecdotal."
It's been suggested to me a few times that the reason I'm successful at relieving pain is that I'm so kind and my clients like me. Supposedly my, "therapeutic presence" makes people feel better. Therapeutic presence is very comforting and beneficial, but it alone will not change a physical problem. I've also been told I possess "innate healing abilities." Some of us may have been seduced by the heady notion that we are magical healers, an idea that finds room for consideration when one cannot otherwise explain good results where others have failed. However, we do the profession a great disservice by cloaking our positive outcomes in ambiguity. Such is the stuff that quackery surrounds itself with, "mysterious ancient secrets" and the like. Better to acknowledge that while we may not know why a treatment works, we use it because it causes improvement. By studying and refining such treatments, perhaps the improvements can be increased and eventually understood.
It was during a devastating period of time when a medical condition caused me to lose the ability to walk that I became aware that palpable changes in tissue density (TD) are a reliable gauge of musculoskeletal pain. I was not willing to give up my massage practice, so I made adjustments to my clinic, such as removing the legs from my massage table to lower it and working from a seated position in a rolling task chair. I looked at what I was doing from a different perspective, and started trying new things that I would never have considered had I still been able to stand correctly and utilize proper body mechanics. I can laugh now, looking back at the dark days when I feared I would no longer be able to make a real difference in medical conditions such as arthritis, back pain, sciatica and other painful conditions. I believed I would have to relegate myself to doing relaxation massage, that I could only do, "feel-good" work. I resolved, however, to give it my all and deliver the most relaxing, best feeling massage each client had ever gotten. It was at this point in time that my work became most effective. Seated, and spending more concentrated time on a focused area, I came to recognize the subtle changes in the density and texture of tissues.
Painful, elevated TD can absolutely be felt by the therapist. Once a therapist has developed the skill of TD palpation, they can recognize problem areas before the client is even aware of them. It is not a psychic or intuitive knowledge; it is a universally assessable, measurable and documentable state of being which can be determined, recorded, and understood by any skilled clinician. Most importantly, elevated TD is restorable, and, once restored to normal density, pain is relieved and function often returned. This is what successful massage therapists have been doing all along. By narrowing the focus of whichever method we use that effectively restores TD; one can increase positive outcomes dramatically.
I think of the existence of elevated TD as a sort of, "Rosetta Stone." You may recall that it was the discovery of the Rosetta Stone that led researchers to understand the meaning of ancient Egyptian hieroglyphics. Upon it is recorded the same message in two languages using three different scripts, some understood at that time of discovery, the other, hieroglyphic, unknown. To over-simplify it, they were able to plug in what they knew about some of the writing and decipher that which was unknown. The association of elevated TD to a Rosetta Stone comes to mind when I think about conditions we don't understand, for example, the affect weather has on people with arthritis and old injuries. Science tells us that the complaints of pain that occur with changes in weather are subjective, therefore, are simple folklore and can't be proven. But "plug in" elevated TD as a factor, and there is an assessable, measurable, and treatable explanation. And, once recognized, it is undeniable.
Elevated TD results in tissue hardening and contraction, which can form various secondary compartments within the body. Our nerves become caught up in these formations and are subject to the stresses applied to the makeshift walls of these compartments by weather related changes in barometric pressure - similar to the discomfort we experience in our ears with changes in elevation. The severity will depend on the grade of TD involved.
Through the measurement of TD we can now provide consistent, corroborative, objective data about the condition of tissues before and after treatment. Combine that with a client's subjective statements, and the efficacy and benefits of therapeutic massage are provable. There is no longer justification for the benefits of massage to be questioned by doctors, clients or massage therapists. There is no reason left to deny the effectiveness of therapeutic massage, nor is there any acceptable excuse to decline payment for treatments.
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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