resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Where to Adjust: Best / Worst Tests
Wondering which methods are best (and worst) suited for determining the appropriate manipulation site?
PCOM Symposium Celebrates 25 Years
Acupuncture and Oriental medicine practitioners and students, as well as providers representing various other health care disciplines, flocked to San Diego's Catamaran Resort Hotel to attend the PCOM Annual Symposium on Oct. 24-27.
Partnerships Leverage Power for Our Profession
While there are many recognized benefits and advantages to developing partnerships between organizations, the main reason why partnerships are established is relatively simple: There is added value in working together for a common cause or purpose.
Promoting Acupuncture with Acupressure Demonstrations
Dan and his wife Marla were admiring the beautiful bouquet of flowers at our booth at the Business Expo when our receptionist asked him if he knew anyone who had tried acupuncture.
Give the Gift of Change
As human beings, we are blessed with something remarkable that we generally take for granted: the gift of conversation.
B Vitamins May Reduce Risk of Age-Related Macular Degeneration
A study published in the July 2013 issue of the AJCN provides additional evidence suggesting higher nutritional status of certain B vitamins may be important in the prevention of age-related macular degeneration (AMD).
Acupuncture In Haiti: Aid that Works
I recently returned from Haiti. So many people ask whether Haiti has recovered since the earthquake of January, 2010. Once you've been to Haiti, you would never ask that question. It doesn't make any sense.
Acupuncture & Substance Abuse Rehabilitation
One of the most rapidly changing areas of healthcare is that of addiction medicine. Advances in brain imaging technology have allowed doctors and scientists to understand addiction, and recovery from addictive disorders, at the level of the individual neuron in the brain.
How to Enhance Exercise Rehab With Manipulation and Soft-Tissue Therapy
As chiropractors, we are in a unique position to use our manual therapy techniques to facilitate exercise rehabilitation.
Peer Points: In The Business of Herbs
When it comes to herbs, acupuncturist Cathy Margolin wants her patients and customers to know she is the expert they need. In order to do this, Margolin has studied the marketplace and incorporated key business lessons to build an herbal company that sells and markets herbs to the masses who may be skeptics.
News in Brief
WFC Documents the Global Advance of Chiropractic; National to Conduct Study of Orthotics for Back Pain.
Treating CTS and Wrist Tendinitis of Myofasial Origin
Carpal tunnel syndrome (CTS) is the most common and most clinically significant of all nerve entrapment syndromes, present in 2.7 percent of the adult population.
Acupuncture: The Key and Future of High Sports Performance
Acupuncture is commonly utilized in the intervention of pain and has also been gaining popularity in sports medicine. Athletes are treated with acupuncture for the relief of soft tissue injuries such as sprains, muscle strains, and tendonitis.
Cervical Compression and the Lower Back
When a patient presents with lower back pain, we expect to see some amount of antalgic lean. It is understood that this lean is both a conscious and reflexive protective mechanism of the body to reduce the pain and prevent more irritation in the back.
Thrive in 2014: Five Habits to Start Cultivating Now
The entire health care system is once again – or perhaps I should say still – in a state of flux, and our profession is not immune to the brouhaha.
Acupuncture Today Continues To See Unprecedented Growth
For the past decade, the profession has seen steady growth in stature with legislators and the general public. The growing presence of the profession has been directly reflected in the growth of our publication.
Studies: Acupuncture Effective For Depression
Many people suffering from depression can find a natural and effective way to treat their symptoms with acupuncture, according to the latest study.
Informed Consent and Your Practice (Pt. 1)
Earlier this year, The Back Letter gave extensive coverage to an article by Dagenais, et al., in The Journal of Manipulative and Physiological Therapeutics on informed consent in the chiropractic profession, calling it "perhaps the best article ever written on informed consent for low back pain."
Dedicated to Excellence
For 27 years, Horace C. Elliott, executive vice president of the National Board of Chiropractic Examiners, has set new standards of excellence for chiropractic licensure and testing.
Managing a High Protein Diet
One of the most common clinical presentations in today's clinic is patients following a high protein diet. It seems that every year a new version of a high protein diet appears promising weight loss and physical transformation.
The Shoulder Girdle's Importance to the Cervical Spine
The shoulder girdle consists of three bones: the clavicle, scapula and humerus. It is suspended at its posterior margins from the cervical and thoracic spine by the trapezius muscles, levator scapula, rhomboid, serratus and latissimus dorsi.
Facial Rejuvenation: The Key to Exceptional Results
Acupuncturists make the best detectives. I know this first hand because I'm an acupuncturist and a private investigator and in both professions, there is a need to dig deep to solve the mystery.
Breathing Techniques To Resolve Patient Issues
When a patient of mine who has practiced yoga for nearly 30 years, told me that she was experiencing panic attacks, I was surprised. "After so many years of training, can't you turn them off?" I asked. "I do turn them off, but only temporarily," she replied.
Electric Qigong: An Ancient Therapy Evolves
Recently in a small, dimly lit treatment room in downtown Taipei, Wesley Chen instructed his patient to lie down. A frayed wire, which he wrapped around a small piece of metal, is now plugged in.
Continuing Education Showdown: Online Learning vs. In-Person Seminars
Many state TCM and acupuncture regulatory bodies and associations are interfering with the success of their members by limiting the number of continuing education credit hours they can earn online.
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 17 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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