resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
November, 2013, Vol. 13, Issue 11
The Sternocleidomastoid Muscle and Cervicogenic Headaches
By David Kent, LMT, NCTMB
There are many types of headaches with a long list of triggers from hormones to food, drinks, sleep deficiency, dehydration, and emotional and physical stress. A cervicogenic headache (CeH) is characterized as unilateral head pain with a cervical source.Symptoms include a dull ache with restricted cervical range of motion. Contributing factors often include poor posture, sedentary lifestyle, prior neck injuries, and improper computer and workplace ergonomics.
While many muscles can be involved in a cervicogenic headache, I want to share information on the sternocleidomastoid muscle and ways to educate clients of its referred pain, as it can directly affect whether the client reschedules, upgrades to a package of treatments or refers friends, family and co-workers.
Physicians, depending on their specialty, can be a great referral source for clients suffering with cervicogenic headaches. Doctors are familiar with myofascial trigger points and referred pain. A cervicoengic headache can also be caused by the bones, discs and or joints in the neck.
Clients rarely report pain in the front of their neck when experiencing a cervicogenic headache unless recently involved in a motor vehicle accident or other physical trauma. Educate clients about the sternocleidomastoid muscle, integrating three learner styles; visual, auditory and kinesthetic.
Take postural analysis photos with your smartphone, iPhone or iPad to show the position of their head and how the sternocleidomastoid muscle is involved. Use skeletal, muscular and trigger-point charts to show the structural and myofascial patterns.
Provide auditory support for each visual by explaining the details in each photo and image. For example, in posture photos, discuss a high shoulder or forward head posture. On trigger-point charts, explain that the "X" indicates the common location of trigger points and the red color indicates the referral areas patients report pain, tension, burning, tingling, numbness and headache (Photos 1-2).
Now, when you palpate (kinesthetic) an active trigger point in the sternocleidomastoid muscle and it refers pain to the patient's head, they realize why and what is taking place. Without pretreatment education, the patient might think you are pressing on a nerve versus treating an active trigger point.
Use intake forms to screen clients and identify contraindications. Watch for procedures like coronary bypass, stints, angioplasty or a carotid endarterectomy, a surgical procedure for cleaning out the carotid artery to restore blood flow to the brain. Other red flags include blood thinners and carotid sinus hypersensitivity (CSH); even if a client states they have previously received massage, I will not proceed without a prescription for treatment from their physician.
Practice palpating and treating the sternocleidomastoid muscle on your own neck. The name of this muscle reveals its attachments to the sternum, clavicle and mastoid process. To palpate the right SCM, begin in a supine position, shorten the muscle by turning your head to the left, lateral flexion of the cervical spine and place support under your head. Practice muscle testing the right sternocleidomastoid by lifting your head from the support and palpating the outline of the muscle. Relax the muscle prior to treatment, by placing your head back on the support and then using pincher compression to treat each division, checking for active trigger points.
In Myofascial Pain and Dysfunction, The Trigger Point Manual, Drs. Travell and Simons documented numerous active trigger points in the sternocleidomastoid muscle. They found the sternal division refers pain into the forehead, behind the eye, the anterior cervical region and can produce throat pain, discomfort or tightness (Photo 1); while active trigger points in the clavicular division can refer pain to the forehead, behind and/or into the ears (Photo 2).
Recently, the Journal of Manipulative and Physiological Therapeutics published a pilot randomized clinical trial titled, "Manual Treatment for Cervicogenic Headache and Active Trigger Points in the Sternocleidomastoid Muscle." The preliminary findings show that manual therapy targeted to active TrPs in the sternocleidomastoid muscle may be effective for reducing headache and neck pain intensity, and increasing motor performance of the deep cervical flexors, pressure pain thresholds (PPT) and active cervical range of motion (CROM) in individuals with CeH showing active trigger points in this muscle. Studies including greater sample sizes and examining long-term effects are needed.
Active trigger points in the sternocleidomastoid muscle may be a contributing factor to a client's cervicogenic headaches. Providing education to the general public, local doctors, healthcare providers and clients is essential to building your practice.
Click here for more information about David Kent, LMT, NCTMB.
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