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.
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.
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.
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.
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.
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.
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...
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.
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.
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.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Click here for previous articles by Linda LePelley, RN, NMT.
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