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NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
March, 2013, Vol. 13, Issue 03
TDR Massage for Self-Care of the Breast
By Linda LePelley, RN, NMT
A new client stated that his doctor had recommended massage to reduce his anxiety level. He had been experiencing frightening episodes of chest pain, but all the tests indicated that his heart was fine – hence the diagnosis of anxiety.I found elevated tissue density (TD) in his chest overall, as well as several pectoral trigger points. I released the trigger points and instructed him on how to massage his chest, and his chest pain has never returned.
Tissue density restoration massage for the breast was developed to relieve non-cardiac related chest pain, and to help detect and prevent breast cancer. If you experience chest pain but have been told by your doctor that it is not related to heart disease, a simple routine of chest/breast massage can relieve and prevent pain symptoms. Hyper-dense chest and breast tissues can be a source of pain, especially during periods of elevated tension, for men and women alike. When tissues harden, nerves are caught up within them, impairing normal sensation. While many men assume breast massage would be for women only, it is important to point out that men get breast cancer as well, as many as 1 in 1,000. Whether you are seeking to relieve achy chest tension, or promote breast health, the treatment is the same.
Several years ago, in the course of having a sonogram on my liver, pancreas and gall bladder, the doctor told the technician to try to visualize my heart as well. He added that it most likely would not show up. I asked why, and he told me that at my (plus) size, my tissues would most likely be too dense to "see" through. I explained to him that, as a massage therapist, I made it a practice to keep my breast tissues massaged so that they are malleable, and hopefully, any lump that might develop would be easily detected. He dismissed the idea that massage could change the density; stating that it is either dense or it is not. At completion of the testing, the technician let me know that there were no visualization problems, even at my size. I do not offer this one, personal, anecdotal experience as proof that TDR massage can improve the ability to visualize breast tissue; I would have needed to have a pre-massage test, as well as several other subjects being tested. I do, however, offer it as a possibility. It is my hope that one day someone researches the visualization differences in breasts before and after TD alteration massage.
I am gratified that my suspicion from years ago of the relationship between breast density and cancer has been found to be accurate. I discussed the cancer risk of having elevated breast density with anyone who would listen to me, from radiation nurses to doctors, but was told that density had nothing to do with it. That opinion has changed; a government cancer fact sheet states that having dense breasts is a breast cancer risk factor. And by "gratified," I mean I am pleased that - even though we can't change our genes or physiology, elevated tissue density is a condition that can easily be altered, by the individual, at no cost.
Self TDR massage for the breast is performed the same way for men as for women. You will want to be sure the space you are working in is warm and free of drafts. Warm the chest for about 20 minutes before performing assessment with a warming pad or pack. You will be looking for tissue that:
The guidelines of TDR massage are to keep the tissues warm and not to go over a 3 on a 1/10 pain scale. Keeping that in mind, the goal is to use as much pressure and movement as possible to ensure that each layer of tissue is fully hydrated, perfusing well and is not immobilized. Remember that normal, healthy tissue does not hurt when pressed into.
Lie on your right side. Raise your left arm and grasp it firmly at the elbow with your right hand. Gently jiggle the underarm area, looking for tight, firm or hardened areas. Palpate the tissues from the elbow, moving toward the armpit with your fingers in long, smooth strokes. Do this several times all around the arm, on the top, sides and bottom. Make a fist of your right hand and press it into your left armpit, making wide, firm circular strokes. Cup and lift your left breast with the left hand and, using the tips of your fingers, press gently into the chest wall. Using small, circular movements, palpate the borders of your entire breast. Still cupping the breast, use fingers to lightly jiggle the body of the breast, noting any sensations of tightness, adhesions or discomfort. Press the fingers of your right hand into the ball of left shoulder, dragging towards the center of your chest, palpate the tissues around the collarbone. Repeat on left side. In an upright position, place the palms of your hands at the sides of your chest wall, gently press and rake your palms across the chest, toward the mediastinum, mobilizing the pectoral muscles.
You now have a good idea of where you may have elevated TD. You can restore the density by massaging thoroughly, using massage cream and a heated pad, or simply a good warm shower and gentle soap. I would do any work needed in the axillary region first, simply because it will encourage and promote proper lymph drainage. After that, pick the area that was most uncomfortable and clear it up first. If it feels too tight, warm and massage it as firmly as possible without eliciting pain. Once you are able to press into that tissue without discomfort, move to the next worst area. If an area feels denser than it should, warm it and move it around until it softens and normalizes. Even slight sensory changes indicate elevated TD, so if there is a muscle or area that feels tingly or itchy, work on it as well. Always modulate the amount of pressure and movement you use based on the pain level, keeping it under a mild 3.
Another important aspect of any form of TDR massage is to take whatever time is needed to affect a change in the tissue density. I expect to spend at least 45 minutes on a hardened area before it will soften, pink up and stop hurting. Once an area is cleared up it will stay that way for a long time, maybe permanently with maintenance massage. For this reason, you really need to emphasize to your clients that they will be better served to work on one area until it improves, rather than to try to work on multiple areas during a single session. Once they experience the benefits of TDR massage, they appreciate the improvements and are willing to "do the work."
A female client once complained that her breasts felt like hard balls in a sagging sack. I suggested she perform breast massage in a warm shower every day. Several weeks later she told me she was very pleased that her breasts were no longer hardened and, rather than sagging, they felt full, plumped and buoyant. She no longer had the sensation that the tissues were separated from each other.
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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