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A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
June, 2013, Vol. 13, Issue 06
Adventitious Tissue Structures of Elevated Tissue Density
By Linda LePelley, RN, NMT
A 12-year-old boy was brought into my clinic complaining of pain in his right heel, which impaired his ability to participate in sports, even to walk normally. His doctor, having x-rayed it, diagnosed a bone spur, explaining that the pain may or may not resolve on its own and it could be surgically removed if it continued to bother him.The boy's mother had heard I'd helped a friend with a similar problem so she wanted to see if I could help her son with the pain until something could be done about the bone spur. A hard nodule the size of a pea was palpable on his right heel.
A mechanic came in complaining of right-sided upper back pain, with trouble raising his right arm. I found a large mass of dense tissue, approximately 9 cm long, 4-5 cm wide, with an approximate depth from 1 cm at the outer borders, to 3 cm deep at its center. Its presence, at the medial border of the scapula, involved all of the musculature at that region, and prevented full range of motion. Palpation indicated it was ensconced all the way through to the bones of the ribs.
A 65-year-old woman presented with severe low back pain. She stated that she had never had any problems with her back until several days earlier. She had driven for 6 hours to visit her daughter, stopping only for fuel and then going directly to bed once she had reached her destination. The following morning she awoke to find herself barely able to walk without grimacing and crying out in extreme pain. Upon palpation, I found a large, rubbery, firm area the approximate size and shape of a 5 x 3 cm oblong pancake, 2 cm deep, engulfing her right sciatic nerve and the tissues around it.
A friend showed me her left wrist where, over the period of just a few months, a knot had formed on the radius, proximal to the scaphoid bone. Her doctor had told her it was arthritis, and her sister told her that she had suffered the same thing on her wrist, and had it surgically removed – suggesting my friend should do the same. My friend was no longer able to wear her watch, due to tightness and irritation. The knot felt just as if it was solid bone.
What these seemingly unrelated conditions have in common with each other is that they all involve the formation of a new tissue structure. I refer to these tissue structures as "Adventitious" because they are extraneous and they do not belong where they occur. And while they are likely the result of a body's attempt to maintain homeostasis; their development often results in pain and dysfunction. In my previous article, "Tissue Density's Relationship to Pain and Dysfunction", from the April 2012 issue, I wrote as follows: "My thoughts regarding the etiology of elevated TD involve the lipid-rich components of our extracellular fluids, which I believe are attracted to the bio-polymeric nature of our cartilaginous tissues. This attraction, combined with a variety of dynamic factors, including body heat, compressive force, overuse, injury, hypo-hydration, torsion, sheer force, tensile force, inertia, chemical environment and fluid viscosity may cause the extracellular fluid to accumulate, thicken and eventually precipitate into gelatinous plaque. Over time, I believe that these plaques harden and become mineralized, turning into the rubbery nodules or bone-like overgrowth of arthritic joints, as well as contributing to many other conditions. The plaque may be as thin as a sheet of a single layer of fascia cells or it can form a large area of many tissue layers sandwiched together, such as those found over arthritic hip joints and the thick, tender pads which so often develop at the medial aspect of knees." (I suspect that the main component of this conglomeration is cholesterol.)
Elevated Tissue Density (TD) is, in my opinion, the first sign of adventitious tissue structure formation. It seems to continue to increase in size and hardness over time. I wouldn't characterize it as "growth," but as an accumulation. Tissue Density Restoration (TDR) massage is an effective way to prevent and reverse this condition. In most of the examples above, the structures were stable, easy to isolate, and not too difficult to resolve.
In the case of the mother who spent several hours driving, the problem was a little more complex. An adventitious tissue structure had formed and become dense at her sciatic nerve area. Because it had not impeded movement or caused her pain, she was unaware of its existence. Over time, it continued to accumulate and condense, holding the nerve firmly in place until, that is, it shifted. When my client spent several hours driving, with her right leg extended to the gas pedal, enough heat was created in the affected area to slightly melt the outer layer of the adventitious structure. She then went to bed, sleeping in a side-lying position. During the night, her tissues resumed their normal temperature and the structure re-hardened, but now it was in a slightly different position. While the structure maintained its solid grip on the nerve, it had shifted, pulling the sciatic nerve painfully out of place.
Adventitious tissue structures can form sharp points, such as the bone spur on the young man's heel; large, immobile, lumpy barriers to free movement, as found in the mechanic's back; unstable, shifting bodies such as the one experienced by the traveling mother; and some so smooth and solid one would easily believe that it was simply a large, bony prominence. Fortunately, these affected tissues can often be restored to normal density and function through the proper application of TDR massage, as happened with each of the examples listed above.
A client who has rheumatoid arthritis complained of pain in her right ankle, stating that she had erosion in an ankle bone, as explained to her by her physician, and evidenced by x-ray. She brought her x-ray in. It occurred to me that perhaps the eroded area might actually be an adventitious tissue structure, formed over the bone, which had then melted in one spot (due to the heat of RA inflammation), leaving the appearance of erosion. I applied TDR massage, relieving her pain. Our hope was to then have the ankle x-rayed again for comparison; however the health care provider was not interested in exploring the matter. Whatever the actual etiology may have been, almost a year later, the client has not suffered pain in that ankle since.
I surmise that the reason elevated TD and these adventitious tissue formations have been overlooked, is due to the fact that they are largely invisible to diagnostic imaging. They are, however, palpable and once located, treatable through the proper application of massage. Massage therapists have the ability to resolve a great deal of human suffering, literally, within their grasp.
Click here for previous articles by Linda LePelley, RN, NMT.
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