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Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
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.
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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