resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
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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