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News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
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.
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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