resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
September, 2013, Vol. 13, Issue 09
Tissue Density Restoration Massage for Plantar Fascitis
By Linda LePelley, RN, NMT
Plantar Fasciitis (PF), is a painful condition of the connective tissue of the bottom of the foot. While its etiology is not well understood, its symptoms are easily recognizable; acute pain upon walking after a period of immobility, which then dissipates, only to return again after extended use.
I have had the opportunity to treat many cases of PF with very good results using Tissue Density Restoration (TDR) Massage, which is based on the theory that there is an elevation of tissue density associated with musculoskeletal pain; and the belief that by restoring the density to normal, pain is relieved and function restored. I approach foot pain by focusing on the painful areas of elevated tissue density (ETD).
All tissues have a normal density and in the incidence of it becoming denser than it should be, it is often accompanied by pain. The etiology of ETD is a matter that I myself, not being a research scientist, can only guess about and hope that one day it is determined, which may provide the path to prevention. Until then, I focus my work on identifying ETD and restoring it to normal density, eradicating the pain in the process.
You will need warm towels, a heating pad, a massage cream with excellent glide, a couple of dry washcloths and a large, pink eraser. Explain to your client that you need them to let you know if their pain level becomes greater than a three on the 1/10 pain scale. You don't want to elicit a pain response that may worsen the condition and there is just no benefit or need to inflict pain. TDR massage takes about 45 minutes per area of concentration to affect a change in density, so if you are working on bilateral PF, you will want to schedule at least an hour and a half.
Prepare the feet for treatment with a warm foot soak, if available, then wrap in warm towels and work over a moderately warm heating pad unless your client is a diabetic, in which case the heating pad should be avoided. The whole point being that you want the feet warm, relaxed and as naturally soft and pliable as they can be. While working on one foot, keep the other wrapped warmly.
Warm massage cream in your hands and apply it to the foot. Massage the entire foot for several minutes to increase circulation and warmth, and especially to soften the tissues, engaging the foot with the full palmar surface of both hands and fingers, pressing and squeezing, moving the tissues of the toes, ball, arch and heel as if you are trying to stroke the surfaces of the underlying bones. Press firmly with the base of your palm into the heel and bottom of the foot, hold that pressure a moment, then release and repeat several times, to encourage circulation into the deepest layers of tissues in the foot. Do the same for each toe, grasping and rolling them so that all sides are manipulated. Take the foot in both hands, grasp the sides and with the joint of the big toe in one hand and the lateral side in the other, gently roll the foot back and forth, encouraging movement between the metatarsals. Once the foot is sufficiently warm, and has become relaxed, begin to look for the areas of ETD. Your clients will be able to direct you, if needed, to the area that is hurting.
As you focus in on the specific spots that are affected (they hurt), you will be able to palpate ridges and areas that are more firm than their surroundings. Areas of ETD can often feel as if a layer of candle wax has been melted over the bones and under the skin. As you continue to massage the entire area, the more normal tissues will soften first, making the areas of ETD more palpable and apparent. They often have a rubbery, "gristly" feel. These are the most tenacious tissues and they take the most effort to restore. This is where the large, pink eraser comes in handy. Use it to press into the firm, rubbery tissue, massaging in small circles. Have your client direct you to the spots that are the most painful and work on them first. You will likely notice that as the areas clear up, the pain shifts to adjacent spots. Every five minutes or so go back to massaging the entire foot for several strokes, and use a dry washcloth to vigorously rub the whole surface of the top and bottom of the foot to stimulate and keep the tissues moving, and maintain overall warmth.
As the affected tissues soften and become more pliable, you will be able to increase the pressure and movement without causing additional pain. If there is a heel spur involved, gently use the eraser to move the tissue around over the spur. It can take quite a bit of time for it to reduce and fade away, but the relief that brings is well worth the effort.
My clients with PF usually need six to eight treatments to clear the problem up, sometimes a few more, and sometimes in just a couple of treatments. By creating diagrams depicting the areas you worked on and cleared, with before and after measurements of the size and locations of dense tissues with descriptions of texture, quality and clients input regarding pain levels, you will have helpful indicators of the progress you have made. They are also the documentation you need to share your results with other members of the health care team.
As you become familiar with the feel of ETD, you will notice additional areas that are affected. Your client will often say they hadn't realized it hurt and sometimes it doesn't hurt at all. If it doesn't hurt, leave it alone for the time being. Make a note of its location after the treatment and suggest to your client that you work on it once the painful areas have been restored as a part of maintenance and to prevent future pain and dysfunction.
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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