resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
January, 2013, Vol. 13, Issue 01
TDR Massage for Headache Prevention and Relief
By Linda LePelley, RN, NMT
There are many different types of headaches and most of them, while painful and even debilitating, are not considered to be medically serious. As massage therapists, it is not within our scope of practice to diagnose the type or severity of a client's headache, but once we have determined there is no underlying pathological cause, there is much we can do to relieve, and even prevent, their headache pain.
The Tissue Density Restoration (TDR) massage method of headache prevention and relief is based on the belief that the pain being experienced is directly related to the density of the involved tissues. Whatever the headache trigger might be - emotional stress, muscular tension, etc.- it can be relieved by restoring those tissues to a normal, healthy density.
Hyper-dense tissue hurts because the involved nerves are entangled and compressed within them. When a person's scalp, neck and/or shoulders contain areas that are too dense or hardened, normal movements tug and tear at nerves which are no longer able to slide and glide within their surroundings. It is interesting to note that, in the throes of a headache, one may press into the scalp over the area that hurts and find pain experienced inside the head, which can often be palpated on the outside of the skull because, in actuality, that is where it is. The same phenomenon is present in painful knees and joints where a client will state that the pain is inside the kneecap or bone. The locus of pain is found within a dense area of tissue outside of the bone, and can be felt as a firm or hardened spot. Because that nerve has become immobilized and hardened, and is adhered so closely to the bone, it is experienced as being within the bone.
A good gauge of the condition of the head tissues is to press your fingertips into the middle of the forehead at the hairline, then firmly make circular movements. If the back of the scalp moves around with it, you know there is a TD issue. You will often find the hyper-density can be felt down the back of the neck and into the shoulders. This widespread stiffness indicates the tissues have become locally dehydrated, separate layers are adhered to each other and the fascia has lost some degree of elasticity.
The TDR massage treatment for headache consists of first, determining the area of focus, which is the place that hurts the most, and second, warming the tissues to facilitate their becoming softened and mobilized. And then, massaging them until they have been restored to their normal, pain-free density. It is important to remember the TDR massage rules. Do not go over a three on the 1/10 pain scale. Causing pain is counter-productive, it results in localized swelling, which increases the density (creating even less room for the nerves) and therefore, an increased level of pain. And remember to work on the tissue that hurts the most first.
Have your client indicate the area that hurts the most, and while massaging, warm the affected tissues with a heated pad or pillow. Once the area is well warmed, I use a scalp brush, pressing it firmly enough to grip the scalp, and make circular motions until the area responds by softening and becoming more mobile. If you don't have a scalp brush, you can use your rigid fingers to do the same. As the pain subsides, have your client direct you to the next painful areas. Use the fingers of both hands together, press and rub into the scalp as if you were trying to gently lift the tissues away from the bone. As one area responds, softens and is relieved of pain, move slowly to the next, until the entire scalp will move easily.
The nuchal ridge is an area where many people have an extensive buildup of density, within which much pain develops. With the client prone, warm this area for several minutes and then use the scalp massager (or your fingertips) to mobilize the area in large circles. Once you find that the tissues are moving more fluidly, use your full hand and fingers to petrissage the area. Reapply heat as needed to increase mobility. With your fingertips, move into the area of the ears, moving all tissue surrounding them, then gently cup the ears and move them in wide, smooth circles. Work your way down into the neck and shoulders, with the aim of mobilizing and softening all areas. When you find hardened areas, apply more gentle heat and continue movement until tissues are malleable.
For those who are having sinus-related pain, have them lie supine. Warm a small amount of oil in your hands and massage, starting from the neckline and collar bone. Using gentle petrissage, work your way up the throat, below the ears, over the Eustachian tubes, to the chin and cheeks, under the eyes and sides of the nostrils, around the eyes, over the temples and especially the forehead and eyebrows. Follow with light effleurage down all areas worked in reverse, encouraging drainage. Place the palms of your hands over the forehead and make wide, circular movements and slowly work your way up into the hair into the sides and top of head, then all the way back to the mastoid area.
It is important to understand that this can be a time consuming process. It is futile to prescribe a specific time period for the application of these procedures. One must focus on what hurts and treat it until the tissue responds. I surmise that the reason one cannot fit TDR massage into a neat little package of protocols is because each person's condition is different. While two may have the same pain, in the same place, their response to treatment is going to be affected by several factors such as the length of time the condition has been present, how well hydrated they are in general, etc. However, the results of this treatment are significant. Once the tissue has been restored from firm, hypo-hydrated, elevated density to a warm, well-circulating, and well-hydrated condition, the pain has been eradicated.
To prevent their headaches from returning, it is my policy to teach clients how to maintain their restored tissues. I explain to them that by keeping their head, neck and shoulders moving freely, they maintain the appropriate environment for the nerves to exist comfortably. I suggest they massage their scalps vigorously all over when shampooing, and while drying off they should place the towel behind their neck, taking one end in each hand, raking it firmly from side to side and pressing the neck and back of the head into it in an attempt to move the neck and lower scalp tissues around on the skull. For the face, I suggest they use a light facial oil or virgin olive oil, and massage every bit of it, from the hairline at the forehead to the sinuses under the eyes, the cheeks, chin and around the ears, as well as the neck and throat area, down to the collarbones. They should take note of any tender area and continue to gently massage it until it clears up.
Many clients report they have no more headaches after treatment and those who still get them say they have fewer headaches and the ones they do experience are less painful and shorter in duration than before receiving TDR massage and following the maintenance routine.
Click here for previous articles by Linda LePelley, RN, NMT.
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