resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
AAAOM – Making Promises They Can't Keep
When the AAAOM first formed in 2007, their mission was clear: to support the profession through education, resources and legislative advocacy. The first years of the organization were filled with promise and hope.
Resilience is the New Longevity
Sometimes we must enter a room through one door and not another, even though they both lead into the same space. I am talking now of the recent cachet with the concept of "resilience" regarding health, chronic pain and longevity.
The Healing Properties of Light: An Interview With Researcher Anna Cocliovo
This interview is with Anna Cocliovo, a light researcher and Acupuncturist in Arizona. During my own research in light, I came across the article she published for the American Journal of Acupuncture and sought her out as a result.
Risk Factors for Heel Problems
Heel pain and gait disability are common occurrences in adults, often the result of thinning heel pads and a lifetime of exposure to heel-strike shock. One condition experienced by many people is plantar fasciitis.
Are You Guilty of Paternalism in Your Approach to Patient Care?
Einstein is purported to have said, "When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity." In some way, everything is relative to one's point of view.
Green Tea Catechins Lower PSA, Other Biomarkers in Men With Localized Prostate Cancer
A 2006 study (Cancer Research) was the first human investigation to show that green tea catechins (GTC) are highly effective in reversing premalignant prostate lesions (high-grade prostate intra-epithelial neoplasia), an established precursor to prostate cancer.
Epigenetics: The Western Science Supporting Essence
Since the days of Darwin, western medicine has touted that our genes were set in stone, that our genetics were our destiny. We were told that the diseases that ran in our family were likely coming to us as well.
One and Done: Keeping Patients From Vanishing After Just One Appointment
What happened to my 3:30 p.m. ROF? They may have rescheduled, but there are two common answers no one wants to hear: 1) "She called to cancel. I tried to get her to reschedule, but she refused." 2) "She no-showed.
Creating Child-Friendly Clinics with ABT
The Zurich Dojo was scattered with toy ducks, dolls, trains, exercise balls and teddy bears during my recent pediatric workshop.
Steven Rosenblatt: Birthing A Cross-Cultural Acupuncture Profession
The existence of a cross-cultural acupuncture profession in the United States, one that is legalized, licensed, supported by formalized, academic training and inclusive of non-Asian practitioners, is an important part of the medical landscape in this country and is responsible for improving the lives of hundreds of thousands of Americans.
Stress in the Modern Age: Impact on Homeostasis and What You Can Do (Part 1)
In 1926, Hans Selye first used the word stress in a biological context, referring to the nonspecific response of the body to any demand placed upon it.
Collaboration for a Cause
The Patient Protection and Affordable Care Act strongly encourages the formation of multidisciplinary practitioner teams called Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs).
Leaving a Lasting Legacy: Donna Liewer
For the past 31 years, Donna Liewer has been on a personal mission "to comfort the afflicted and afflict the comfortable." In her role as executive director of the Federation of Chiropractic Licensing Boards, Liewer has accomplished that and much, much more.
Flexion-Intolerant Lower Back Pain (Pt. 3): Mobilization & Soft-Tissue Treatment
What is the biggest challenge to the chiropractor in treating discogenic pain? You have to completely reframe the purpose of your manipulation. It is rarely about unlocking a stuck segment at the disc involvement level; it is not about putting a joint back in alignment.
AAAOM – The Beginning of the End (Part II)
In 2012, the AAAOM board members met in Chicago for their annual meeting. The goal was to come to a consensus on a long list of issues the AAAOM needed to work on including a functional board and budget.
Get That Shoulder to Move: Restoring Internal Rotation
How many times have you mobilized, performed ART, Graston, FAKTR and PIR, and stripped a patient's posterior capsule, yet on re-exam, discovered it was still blocked?
News in Brief
Hamm Elected New President of the ACA; WFC / ACC 2014 Education Conference: Call for Papers; F4CP Recognizes Standard Process as $1 Million Supporter; Texas Chiro. College Begins Search for New President; League of Chiropractic Women Hosts Women's Success Summit.
Successful Strategies in Integrating Acupuncture and Shiatsu in a Hospital Oncology Program
Colleagues from the Network of Researchers in Public Health in CAM recently published an article of interest to our Traditional Asian Medicine community.
Why DCs Need to Understand the Principles of "Inclusive Design"
In the past few columns, I've written about the negative effects of prolonged sitting at work. I've attempted to make the point that prolonged sitting (or prolonged standing) takes a toll on workers. Now let's discuss a related issue: the concept of "inclusive design."
Chiropractic Prevents ADHD? Research Shows...
Now that I have your attention, let me tell you what the latest study actually states. As you may have noticed, research over the past few years has begun to reveal that acetaminophen (the primary ingredient in Tylenol) is not as safe as once thought.
What is a Discipline in Medicine?
In my now prolonged dialogue with physicians, one question emerges with enough regularity to deserve mention and naming: what is a discipline?
Monoculture of the Mind: Part II
Cases are built within boundaries. Such bounds may be a program, event, activity or individuals. In this instance, a medical case has boundaries that include clinical interactions that are comprised of history, signs, symptoms, diagnoses, treatment plans and treatments.
December, 2013, Vol. 13, Issue 12
Using TDR Massage When Treating Sciatic Nerve Pain
By Linda LePelley, RN, NMT
A new client called, asking to be seen as soon as possible. She was experiencing severe right-sided low back pain. Her chiropractor had sent her to a joint and spine specialist. She was diagnosed with Sciatica and given an injection containing pain relievers and steroids, with no abatement of her pain. Diagnostic tests concluded there were no disc problems, so her doctor gave her permission to seek massage.
I palpated the tissues of her right sided glutes, pirifomis and hip joint. Together, we determined the precise locations of the pain. I was careful to ascertain that my client agreed with my findings as I went along. For example, I would say, "This spot feels denser than the tissues around it. It feels to me there is a border here where the tissues thicken, how does it feel to you?" And, "I feel a thick strand of tissue right along here, is this tender?" I was able to feel with my fingers the hardened, dense tissue at the places that were hurting her. She guided me to the areas that were the most involved with her pain and discomfort. I generally find the tissues which are most dense will also be the ones which hurt the most, although this is not always the case. While I have consistently found tissues that hurt have elevated tissue density (TD), not all dense tissue hurts. In this case, however, the most firm tissues were the most painful.
I found what felt like a thick, fibrous pad, approx 3' by 5", over the client's SI joint, which she identified as the location of the worst pain. The second worst area, and the one most responsible for my client's inability to lay on her right side, was another thickened mass of dense tissue which had formed over the greater trochanter, approx 9" by 4". Both felt to be variably ¼ to ¾ inches in depth, with the thickest part over the most firm, dense area (I consider these hardened pads to be Adventitious Tissue Structures (ATS) (see "Adventitious Tissue Structures of Elevated Tissue Density," Massage Today, June 2013). Other involved tissue was noted to follow the probable course of the sciatic nerve behind her thigh on down to her knee; also involving a notably tender ATS at the medial aspect of the knee; and finally, the distal lateral portion of her right leg, which felt as firm as a rubber tire.
Tissue Density Restoration (TDR) Massage is based on my observation and theory that musculoskeletal pain and dysfunction increases in direct association with an elevation in TD. I find this method to be very effective. Over my years of clinical observation and experience with TDR Massage, I have developed a few principles of application:
Having determined that the worst of my client's pain involved the ATS at the SI joint and the greater trochanter, and using a massage cream with excellent glide; I began massaging the areas with wide handed, circular motions, reminding my client to let me know if her pain level reached or surpassed a 3 on the 1/10 pain scale. At the beginning of a treatment, the overall area may feel uniformly tight and firm. As the tissues warm with the friction of the circular massage movements, the least affected tissues will begin to relax and soften. At this point, the outlines of the hardened, painful areas will become more apparent and easily palpable. As you are able to do so without causing pain, increase the intensity of the pressure and movement. Use your thumbs, knuckles or the ulnar side of your hand to target and focus on the boundaries of the hyper-dense tissue.
As you work, the tissues will eventually begin to feel as if they are becoming smoother, then softer. I checked with my client often, making sure I was still at the right level of pressure and that I was still working on the area that hurt. As dense tissues are warmed and moved, they become softened, resulting in pain relief. So, you will find that over the course of the treatment, the area of focus will often slowly shift into adjacent areas. As you are able to use more pressure and movement, you will find tissues that felt quite firm and solid at the outset become malleable to the point that you will be able to gently grasp and squeeze the area of focus without causing pain. It is at this point that the density of the deeper tissues may be reached through the increased pressure and mobilization you will be able to implement. Eventually, the tissues will be restored all the way to the bone.
Throughout the course of the massage, I explained to my client that my goal was to soften all of the overly dense tissues. As her pain levels and elevated TD areas were relieved, she was amazed to see there was indeed a relationship between the density and pain. I explained to my client that, once cleared, there are things she can do to help prevent the return of the elevated TD. They include staying appropriately hydrated, using warm packs or baths for sore muscles whenever they occur, massaging any area that feels tight and sore, being as active as possible and getting a regular, full body massage.
The worst of my client's pain was resolved at the first massage, giving her a great deal of relief and allowing her to sleep. She had a second massage three days later and then once a week for the next 10 weeks. At the point in time when the thickened pads at the hip and SI joint were no longer palpable, I worked my way down her leg to restore the density, ending at the calf. The tissues are now malleable and pain-free.
Clients often feel proud of the hardness of their muscles; they believe it is a sign of strength. I recall a gentleman who pounded his fist into his thigh, telling me, "This is all muscle! I don't want to lose my muscle, I just want the pain to go away!" I explain that as the tissues become denser, they crowd, engulf, squeeze, and compress the nerves and nerve endings within them. These nerves are no longer able to slide and glide around with movement, so they end up being tugged, pulled and pinched – which hurts and eventually causes dysfunction. My evidence is the repeated observation that dense tissue that hurts is relieved of the pain once it has been restored to an uncompressed state.
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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