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Shouldn't the Pentagon Know More About Chiropractic Care? Office Flow: Have You Reviewed the Patient Experience Lately? Let's Stop Confusing the Public About Chiropractic; Cutting Down the Cherry Tree.
Anti-Aging: Educating Your Patients About The Skin
We know that cosmetic acupuncture works but what then? Education is a key part to the practice of Chinese medicine and when you practice cosmetic acupuncture, facial rejuvenation, etc., it is time talk about skin with your patients.
Are You Driving Patients Toward Dependence on Big Pharma?
Over the years I have had the opportunity to talk to doctors of chiropractic about health promotion, wellness and preventive care in chiropractic practice.
Colorado to Have the First Acupuncture Medical Reserve Corps in the U.S.
In the summer of 2012, Colorado was on fire. Literally. Many acupuncturists from around the state, especially those who had received disaster response training through AWB, wanted to help those affected by the fires as well as the first responders and tireless state and local officials, with the healing and stress-relief of acupuncture.
The Right Idea at the Right Time
On Feb. 28, 2014, Virginia Governor Terry McAuliffe appointed David Brown, DC, as new director of the Virginia Department of Health Professions.
Evaluating Prenatal and Pediatric Automobile Injuries
Often in a family practice, one of your patients or an entire family is in an automobile accident and you are sought out to provide care for their soft-tissue injuries.
Your Chance to Go Back to High School
As the father of a student who recently entered high-school sports (soccer), I have come to recognize an untapped opportunity for the chiropractic profession.
Alternatives to the Rainy Day Fund: Better Things to Do With Your Money
Google "rainy day fund" and you'll find the predominant and traditional advice given today is that you need to have three months of living expenses saved for an emergency. Some even recommend six months or more.
News in Brief
In Remembrance: A Moment of Silence for Dr. Dick Versendaal; NYCC Named Chiropractic College of the Year by ACA; National University Partners With Indiana VA Facility.
Chiropractic Management of Sports-Related Tendinopathy
Tendinopathy is increasing in prevalence and accounts for a substantial percentage of sports injuries. Despite the magnitude of the disorder, research on chiropractic treatment is limited.
Making Sense of Chronic Inflammation
Inflammation is big business, evidenced by not only the laundry lists of medications patients bring me aimed at managing inflammation, but also the never-ending stream of advertisements for anti-inflammatory supplements that constantly find their way to my desk.
No Whining on the Yacht
This admonition – no whining on the yacht – may sound familiar to you. Many claim its origination.
Shoulder Strategies: Reduce Pain, Improve Function With Proper Taping
Shoulder pain / dysfunction is a common problem for chiropractic patients. Clinicians who utilize elastic therapeutic taping as part of their treatment approach know it can be effective for a variety of shoulder problems.
Through the Eyes of a Child
Once upon a time there was a girl name Lucy. Lucy had cancer, but she had a heart filled with love and compassion. Please come along to hear this story of an amazing child, her tenacity and her dream to help other children.
Arch Height and Running Shoes: The Best Advice to Give Patients
Because runners with different arch heights are prone to different injuries, running shoe manufacturers have developed motion-control, stability and cushion running shoes for low-, neutral- and high-arched runners, respectively.
Revisiting the Neurological Exam
In spinal trauma or disease, the neurological exam chiefly aims to determine whether one (or more) of three basic neurological conditions is present: myelopathy, radiculopathy and peripheral nerve disorder.
How Much is Enough?
One of the primary arguments used against acupuncture care is the overuse of treatment. Some people say, "once you go, you have to go forever."
Socializing In My Slippers
When I graduated college, I had grandiose dreams of becoming an amazing acupuncturist. I wanted to build a great practice and make a good living. For four years, 13 semesters to be exact, I had a spreadsheet.
Environmental Toxins: Cause of Modern Illness (Part I)
Environmental toxins have created burdens on the human body that put demands beyond our evolutionary development. Modern diseases that historically did not exist to any great degree have been rising sharply in the last 40 years.
Dietary Supplement Research: Contradictions, Bias, Misinterpretation and Confusion
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
San Zhen Protocols Part II: Case Studies
In my last article, I presented a collection of three-point acupuncture combinations which can provide effective clinical results.
Dry Needling is Acupuncture: Anatomy of a Legal Victory in Oregon
On January 23, 2014, the Oregon Court of Appeals overturned the Oregon Board of Chiropractic Examiners "dry needling" administrative rule, which allowed chiropractic physicians to perform acupuncture after only 24 hours of training.
The Recliner Test
"Hi, Bill, how are you?" "Oh, I'm OK, Doc. I've got pain down the leg again, so I thought I would stop by and get you to check it."
AAAOM: Facing An Ultimatum
On the heels of the growing discontent with leaders of the AAAOM, the Council of State Associations (CSA) recently took it upon themselves to present the organization with an ultimatum: for all board members to resign from the board and turn the organization over to the CSA or they will proceed on their own to become the primary representative of the AOM profession.
Chinese Herbs Debut at the Cleveland Clinic
Chinese herbal medicine is now being prescribed at the Cleveland Clinic thanks to a trailblazing team of people.
May, 2013, Vol. 13, Issue 05
Soft Tissue Tools Help Post-Natal Calf Pain: A Case Study
By Massage Therapy Foundation Contributor
Contributed By Derek R. Austin, BS, MS, CMT, Sandra K. Anderson, BA, LMT, ABT and April V. Neufeld, BS, LMP, NCTMB
Do you use massage tools in your practice? Do you work with post-natal women? If so, this month's Massage Therapy Foundation (MTF) research column features a case study that might interest you.According to the Massage Therapy Foundation's website (www.massagetherapyfoundation.org) a case study documents a massage therapist's experience with an individual client. Case studies help the practitioner and the massage therapy profession improve communication and critical thinking skills, and they can contribute to future research and clinical practice. If you are a massage therapy student, read on to see how you can enter the MTF Student Case Report Contest.
We all want to save our thumbs and have long, pain-free careers. This month, the MTF is reviewing what could be called massage tool research. It is not a commonly researched topic, so we are highlighting information from the Department of Physical Therapy at Indiana University. In this case study, Amy Bayliss, et al, reported on how instrument-assisted soft tissue mobilization (ISTM) was used to treat a post-natal patient with chronic calf pain.
Musculoskeletal pain is often reported by women at the end of pregnancy and following delivery. While lower back pain is most common in pre-natal women, non-specific lower leg pain is another common symptom reported during pregnancy. Such pain is thought to decline at some point after delivery. However, massage therapists know that this musculoskeletal pain can linger and is often successfully treated with massage. One method is cross-fiber friction (CFF), sometimes known as Cyriax technique. ISTM is based upon the concepts of CFF, applied with a uniquely-shaped instrument.
The patient in this case study was a 35-year-old female who had a two-year history of right mid-calf pain, beginning during the last trimester of her first pregnancy. The calf pain was preceded by severe lower leg edema. On a scale of 1 to 10, the pain was described as a dull ache, rating 2 on the day of examination, 0 at best and 5 on her worst day. Pain with deep palpation was an 8. There were no relieving activities and her symptoms were aggravated by direct pressure on the calf such as crossing her legs, and by activities that created tension in her calf, such as walking up stairs, jogging or strength training. The calf pain limited her activities of daily living, including standing and lifting her 35 pound son.
There were no significant issues with the arteries, veins or nerves, or with the endocrine and gastrointestinal systems. Additionally, the hip, sacroiliac joint and lumbar spine were cleared of dysfunction. An MRI was considered normal, although a dense soft tissue abnormality in the small superficial venous tissue network was noted that corresponded to the patient's pain in the right calf. Range of motion testing was normal. The instruments used by the physical therapist during treatment were those specifically for Graston Technique. The Graston Technique is a form of ISTM combined with a targeted stretching and strengthening program. (Currently, Graston tools are limited to chiropractors, physical therapists and athletic trainers and are restricted from massage therapists.)
The goals of treatment were for the patient to be able to stand for two hours, sit cross-legged and walk up stairs without right calf pain, as she was previously able to do. The patient also wanted to be able to lift 40 pounds from floor to waist without right calf pain so she could lift her child. The patient received nine treatment sessions over eight weeks, consisting of a 5 minute warm-up of brisk walking, 6 to 8 minutes of ISTM on the posterior right calf, standing stretches for gastrocnemius and soleus, eccentric exercise for the right calf and ice for 10 minutes to reduce inflammation.
On reassessment after eight weeks, soft tissue quality of the right calf was considered normal, meaning supple and easily moved. Additionally, her pain was reduced from 8 with deep palpation to 0. Her pain at rest had also improved to 0 and 0 to 1 with activity. Follow-up at one month and four months showed no return of pain. A follow-up MRI was not possible because the patient became pregnant three months after conclusion of treatment.
This study has several notable limitations for immediate application into massage practice including being a case report without experimental or comparison groups; featuring patented tools and techniques requiring specialized training and expense; and excluding any massage techniques such as gliding, kneading or compression, which are commonly used during a massage session.
Additionally, two points represent the gap between the work physical therapists and massage therapists do. First, the term "trigger point" never appears in this case study, even though it could be a possible cause of the tender mass in the patient's calf. Second, the authors write, "One of the consequences of targeted soft tissue mobilization and in particular ISTM is bruising over the site of the soft tissue dysfunction." They include an image of the patient's bruise, clearly visible after a treatment session and a few inches in diameter. Most massage therapists adjust their pressure to avoid bruising clients.
The authors conclude, "ISTM offers a mechanical advantage afforded to the clinician as well as the potential to minimize the clinician's joint stress. […] Allowing the tools to absorb mechanical stress rather than the therapist's hands has the potential to reduce over-use injury to the treating clinician." While the evidence is still preliminary, it points toward the continued use of massage tools. However, as massage therapists cannot practice Graston Technique, the application of this research to massage practice is unfortunately limited. Although alternative massage tools may be as effective, massage therapists should continue to rely on clinical judgment when deciding whether to use massage tools in practice.
To learn more about the effects of massage therapy, review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies. For more information on Graston Technique, see their website.
Are you a massage therapy student with an interesting case of your own? The MTF Student Case Report Contest submission deadline is June 1, 2013. The Massage Therapy Foundation has offered Case Report Contests since 2006 to provide massage and bodywork practitioners and students a way to develop research skills and enhance their ability to provide evidence informed massage to the public. Cash prizes are available to the winners of each contest, contingent on publication of the case report.
Click here for more information about Massage Therapy Foundation Contributor.
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