Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
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Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients, in May 2014, researchers showed that drinking the equivalent of 2 to 4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
What Does Success Mean to You?
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Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
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Use Technology to Gain New Patients and Improve Efficiency
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The Source-Luo Point Combination
The luo collaterals are part of the acupuncture channel system presented in the Su Wen and the Ling Shu (The Nei Jing). The function and clinical application of the luo mai are primarily presented in chapter 10 of the Ling Shu, however, they are also found in others chapters in the Su Wen and the Ling Shu.
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Acupuncture and the Pulse
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We Get Letters & Email
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Breath: The Movement of Oxygen and Energy
I remember with surprising clarity the first time a patient started crying during an acupuncture treatment I was giving. This is now quite a long time ago, back in 1999, when I was a student.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
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The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Calculating Billable Units
I recently learned of an office that was audited based on the number of acupuncture sessions performed in one day. Is there a maximum number of sessions that can be performed in one day?
TMF 2015 Scholarships
The Trudy McAlister Foundation (TMF), a nonprofit organization established to support students who are on track to make contributions either to clinical practice and/or to the understanding of the role of Traditional Oriental Medicine, has announced the 2015 scholarship recipients.
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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