resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
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.
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."
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.
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.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
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.
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.
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.
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.
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.
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 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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