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Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
August, 2013, Vol. 13, Issue 08
Vacuum Therapies for Surgical Preparation and Recovery
By Anita J. Shannon, LMBT and Rita Woods, LMT
Surgery can be one of the most traumatic, yet helpful, events that a person can undergo. Proper preparation and effective techniques for recovery can make a world of difference in the experience.Vacuum therapies present a successful path to integration with the medical community, and allow us to work directly with the surgeons and have access to diagnostic reports.
Preparation for surgery includes vacuum therapies to drain and clear lymphatic pathways, decongest the tissues, and release any soft tissue restrictions to movement of muscles and fascia or flow of blood and lymph. Post-surgical care includes the same approach, and adds in potential scar work to diminish appearance and adhesions, along with release of inflammation, pockets of anesthesia, and soft tissue issues that may have resulted from surgical positioning.
Surgical complications often include the formations of adhesions, nerve compression damage and reactions to the anesthesia. While any adhesion is a potential restrictive problem, abdominal adhesions are a particularly burdensome complication. They form in approximately 90% of all patients undergoing any type of abdominal surgery, but the risk is greater for operations on the lower abdomen including pelvic, bowel and gynecological surgeries.
These surgery induced adhesions can be caused by tissues incision, especially those involving internal organs, the handling of organs, the drying out of internal organs and tissues, contact of the internal tissues with foreign materials such as gauze, surgical gloves, stitches, etc., as well as blood or blood clots that were not rinsed out during surgery. Abdominal adhesions are bands of tissue that form between tissues and organs causing them to adhere and stick together. They can become larger and tighter as time passes causing problems years after surgery.
Other less common, but just as serious, causes of abdominal adhesions involve inflammation from sources not related to surgery including appendicitis- in particular appendix rupture, radiation for cancer treatment, gynecological infections and abdominal infections. The use of vacuum therapies is extremely effective in working with these scars and adhesions, with very little discomfort for the client.
Prolonged surgeries in which the body has been placed and maintained in an unnatural position can lead to peripheral nerve damage. While the cause of damage varies, it can range in severity from mildly annoying to disabling. In most cases, the damage is temporary and the discomfort or numbness decreases in the weeks following surgery. But a small percentage of patients have lasting nerve problems. Decompressing the involved area with vacuum therapies relieves the pressure and allows the tissue to return more quickly to a normal state. Damage can also occur at the site where medications were injected or at the site of a spinal epidural.
Another potential complication of surgery relates to the anesthesia. Most problems arise from the use of general anesthesia (when the patient is put to sleep) but some problems may arise with local or regional anesthesia- usually at the site of medication injection as mentioned above.
General anesthesia, however, can foster a whole different set of problems. Two separate studies, one from Sweden and one from Duke University, showed that the length of time spent under deep anesthesia is a significant risk factor for predicting death up to two years after surgery. In both studies, the common cause of those deaths after surgery (non cardiac surgeries), were primarily from heart attacks or cancer. Additionally, a subsequent study indicated a cognitive decline in elderly patients up to two years following surgery. One popular theory as to why this happens is based on the production of inflammatory neurochemicals that negatively impact the body and undermine the immune system. One of the key uses of vacuum therapies involves the ability move fluids and clear the body of toxins and inflammatory residue.
The most incredible aspect of this work for preparation and recovery from surgical issues is the decompression that the vacuum produces. The lifting and stretching of the tissue and the release of restrictions, as well as the drainage and clearing of debris creates space and the opportunity for the body to resume normal functioning.
Protocols for each client will depend on a thorough intake and review of supporting documentation from the surgeon (if possible), and then the application of a six-step evaluation and tracking criteria that we developed over years of creating protocols using vacuum therapies. Recovery techniques can be used on clients of any age, and can produce some surprising results on sites that are quite old.
A recent experience while teaching in France was the perfect opportunity to show the class how the age of a scar can determine the techniques used to treat it, yet the results were dramatic with both examples. A wonderful German man who was also a guest at the inn where we stay and hold our classes offered to let us work on his recent scar from carotid artery surgery.
As he settled on the massage table, we could not help but notice a large scar completely surrounding his right knee and restrictions in his leg. His leg would not lay flat on the table and the posterior attachments and muscles felt like bands of steel. He described a low level of pain and restriction on both the neck area and leg, with discomfort beginning to radiate to the hip and low back.
These scars were both from surgery, but the approach to relief for the neck was to address the congestion in the scar area by working superficially with a very small cup to smooth puckering and facilitate soft pliable tissue that will move and blend with the surrounding area. For pain relief, the anterior and posterior muscles of the neck were treated, starting with slower pumping movements using deep suction to gently release the muscles from the position they were held in during surgery.
The approach for the older knee issues was to do much deeper techniques directly on the scar with straight suction and a larger cup, and look for areas that needed released. The anterior, posterior, lateral and medial knee attachments were worked with deep, slow pumping movements while the entire leg was treated with the largest cups possible and observed to develop protocols for subsequent treatments. The leg was treated with pumping movements first and then gliding and other techniques were introduced at a comfort level that was kept pleasant for the client.
Vacuum therapies can be used to work on so many conditions and prepare the client for a speedy and full recovery. Consider the approach for vascular issues, assess the client for any lymphatic and vascular restrictions and use decompression to open those up, see if there is dark congestion that can be cleared from spider veins, and finally use techniques designed to strengthen the vascular walls and stimulate lymphatic flow.
Mastectomy issues are usually best addressed post-surgically, with the focus on softening scar tissue and establishing lymphatic drainage. As with any oncology work, please have training and a thorough understanding of this condition, being especially careful with vacuum therapy for clients who have had recent radiation or are currently under chemotherapy treatment. Vacuum therapies have a very different effect on the body and can release radiation and chemotherapy from the tissues.
Scoliosis, joint replacements and carpal tunnel syndrome are also a real favorite at our clinic and the physician referrals keep rolling in due to the great results that their patients experience from this work combined with expert surgery. Each of these conditions will require research to understand the best way to treat safely and effectively, combined with a sound education in the use of vacuum therapy techniques and assessment, to produce significant results.
Vacuum therapies have begun to link the medical and massage community in a new way where we can work directly with physicians to greatly assist their patients with pre- and post-surgical issues. The constant stream of new cases makes each day an adventure, and the results from these techniques make clients and their physicians extremely happy. Much of the stress is removed when the clients know that they are well prepared and that they have a gentle and effective program in place for recovery and pain management.
For the practitioner, producing excellent results requires thorough training in and experience with vacuum therapies techniques and this powerful tool can also utilize the foundation of knowledge you currently possess. Developing critical thinking based on specific evaluation and tracking criteria, along with practical experience, can lead to such high levels of personal satisfaction and further evolution as a therapist. Service fees can be raised to be commensurate with the results you produce and successes build your reputation as a premier and specialized service provider.
Anita Shannon is a Licensed Massage Therapist and a licensed Cosmetologist since the 1980's, specializing in skin care, body treatments, clinical aromatherapy and various modalities of massage therapy. She is a national educator since 1990, and the Director of Advanced Continuing Education (ACE), an NCBTMB CE provider established in 2001.
Click here for previous articles by Rita Woods, LMT.
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