resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What They Don't Say Could Hurt You
I have written previously regarding the difficulties of drawing information from patients who are poor historians, forgetful or just plain uncooperative. The thought to revisit the topic occurred recently during preparation for an upcoming seminar.
News in Brief
Controversial Florida PIP Law Under Review; D'Youville Chiro. Students Learning Art of Co-Managing; And the Award Goes To...; F4CP Recognizes Major Contribution by ChiroTouch.
Medicine Presents: A Great Opportunity
The changing nature of health care presents both opportunities and challenges. While we tend to focus on our profession, we can sometimes forget the impact other health care professions can have on us.
Research Abstracts From the Journal of Manipulative & Physiological Therapeutics
Effect of Pain Relief on Lumbar Muscle Function and Activation; Effects of Thrust Amplitude and Duration of HVLA Spinal Manipulation; Immediate Effects of Upper Thoracic Manipulation on Cardiovascular Response.
A Building Block of Healthy Aging
Coenzyme Q10 has gained enormous attention in recent years, and with good reason —it's the Energizer Bunny of the cellular world.
We Get Letters & E-Mail
Patient Perception and the Farce of "Fast Relief"; A Fly in the Ointment; Persecuted for Choosing to Practice Chiropractic.
Some Thoughts on the TMJ
The temporomandibular joint is an interesting and dynamic articulation that can cause a lot of problems.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
What the Science Says About Magnesium Stearate
It's often been said that scientific studies can be used to support just about anything. But discoveries are never made one study at a time.
SOAP Notes: It's Time for a Cleaning
I have been planning for some time to write an article about how traditional SOAP notes do not fit chiropractic practice, and the unfairness of holding DCs to a model clearly created for and primarily applicable to medical physicians.
Going Shoeless: The Pros & Cons of Barefoot Running
With the subculture of barefoot runners and the products catering to them growing daily, just about every chiropractor has been asked at one point or another about their opinion regarding barefoot running.
The Potter's Wheel: Reflections on Practicing in a Technology-Driven World
In my very early years of practice, an older patient named Cora would call me at home, usually late Sunday night after she had consumed an unknown quantity of beer.
Correcting Kid Logic in Health Care and Research Design
A recent broadcast on public radio described a fascinating phenomenon known as kid logic.
Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
Let's face it – patient evaluation takes time. Unless you are really into the diagnostic evaluation game, you probably have found the formal exam protocol tedious if not downright annoying.
Are They Finally Fixing Medicare Reimbursement?
Even with federal sequestration cuts taking effect in March, including a 2 percent reduction in Medicare reimbursement to health care providers, hope may be on the horizon in the form of a much-anticipated, perpetually suggested overhaul of Medicare's Sustainable Growth Rate formula, which serves as the basis for determining physician reimbursement.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
Side Effects From Big Pharma: Wellbutrin – Dangerous for You and Your Baby
Are some of your pregnant patients taking Wellbutrin? If so, it could be a danger to them and their baby. This drug is extremely popular, but it has a serious history.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
Why You Should Get to Know the National Vaccine Information Center
Barbara Loe Fisher has been a diligent advocate for providing parents with the information necessary to make informed decisions regarding the usage of vaccinations for their children.
Happenings in Our Evolving Profession
Good things seem to be happening for our profession and recent developments show we are all on board. Talking about being on board, this September The Veterans Express-Purple Heart Tour is expected to make its way out of the station.
Remembering Joe Weider (1920-2013)
With the death of Joe Weider, the world's most famous body-building visionary, crusader, fitness magazine publisher and icon, on March 23, 2013, chiropractic has lost one of its greatest friends and supporters.
Chiropractic: The Right Choice for Relieving LBP
"Low back pain (LBP) is a common threat to medicine and a reasonable threat to all national health care systems. ... Reducing ineffective treatments is necessary to decrease the LBP associated costs."
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
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 17 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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