resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
February, 2014, Vol. 14, Issue 02
The Integration of Cranial Structural and Soft Tissue
By Don McCann, MA, LMT, LMHC, CSETT
Massage therapists around the world have taken to cranial work and have seen the vision of helping to facilitate homeostasis for their clients. Since massage therapists address musculoskeletal pain, it is only natural that new adaptations of cranial work have arisen and that rehabilitation from musculoskeletal pain has become a focus.
Cranial/structural therapy is a cranial therapy that seeks not only a restriction-free cranial rhythm, but also the elimination of soft tissue restrictions in the cranium that can create structural distortions throughout the entire structure. This therapy not only releases restrictions within the normal cranial motion (which can be hydraulic or energetic or mechanical), but it also addresses additional soft tissue restrictions that hold the structural balance or imbalance of the body. Cranial sutures, like any joint in the body, are limited in range of motion by soft tissue restrictions in the reciprocal tension membrane, the tentorum, the dura or the fascia/musculature. Therefore, cranial/structural therapy includes soft tissue releases to achieve long lasting release of restrictions around the cranial sutures that will produce long lasting structural rehabilitation from musculoskeletal pain.
The chief cranial distortion we all have is the core distortion that directly affects the cranial motion and the SBS (Sphenobasilar Synchondrosis). Put simply, the soft tissue around the cranium connected to all the cranial bones, specifically the sphenoid and the occiput and their interrelationship with the other vault bones, has restrictions in the soft tissue that cause an imbalance in the cranial motion. This cranial imbalance is reflected in the pelvis with one ilium rotating anteriorly, the other posteriorly and the sacrum tipping from the lack of support of the anteriorly rotated ilium. This creates not only a long and short leg, but also a tipped unlevel sacrum at the base of the spine which results in exaggerated curvatures, some as severe as scoliosis. Imagine the excitement when it was discovered the distortion in the cranium was the same distortion found in the pelvis, and that when the distortion in the cranium was released and balanced, the rotation of the iliums was significantly bought into balance creating a weight bearing support for the sacrum and an immediate lessening of the distortion on the entire structure. Especially exciting was the reduced curvature of the spine and the leg lengths becoming equal.
One of the big challenges in treating clients with severe musculoskeletal issues such as disc conditions, migraine headaches, degenerating joints etc., has been trying to create long term structural support to maintain the improvements that move the body into balance to facilitate maximum healing and pain free function. This is even more important with the advent of stem cell injections as the structural imbalance would just damage the new tissue if left in the same imbalance, and results would be minimal. This is also the case with prolotherapy and bone tissue replacement. The good news is when the core distortion in the cranium is released and balanced, this new balance brings the pelvis into weight bearing support allowing the above mentioned therapies to be more effective. Even more important is that the need for those therapies is often eliminated. However, it is also necessary to integrate myofascial soft tissue releases for the rest of the body. This is especially true in the areas where the imbalance has created pain and degeneration.
When the core distortion is released from the soft tissue of the cranium, the pelvis returns to weight bearing support with the dramatic reduction of the degree of rotation of the iliums and leveling the of the sacrum. This starts an immediate process of the soft tissue unwinding out of its previous holding patterns throughout the body. This often results in a quick reduction of painful symptoms and prepares the body for more extensive myofascial therapy to release and balance the other soft tissue throughout the body. Prior to having the core distortion released the client's body had literally grown into the distorted pattern and much of the soft tissue is limited in the degree that it can unwind.
If a client had come for a session with back pain and a bulging disc, the unwinding from the cranial/structural core distortion releases would have taken some of the pressure off the disc as the spine straightened, but the client would probably still be in pain due to the compensation in soft tissue around the area.
If the curvature of the spine had so much pressure that it caused a bulging disc, then the soft tissue would have significant inflammation, fibering, shortening and splinting that could not unwind without specific hands-on soft tissue therapy. This would also be true not only in the area of the spine but around any joint in the body where pain and degeneration were a problem. This is a pain site-specific observation. However, if long term rehabilitation from pain is your goal then you need to look throughout the entire structure of the body, not just at the specific site of the pain. Releasing the core distortion from the cranium affects the pelvis and reduces the long leg/short leg discrepancy, but any distortion in any part of the body can have an effect on the site of the major collapse and pain.
Therefore, to fully rehabilitate the body so that it can maintain the improvements it is necessary to treat the entire structure of the body which has also been in core distortion for the lifetime of the client to achieve a balance that will support the area that had been in pain. If this is not done, the areas with the greatest imbalance will still be creating problems and painful symptoms in the client's body. In other words, the area that was most damaged will not be supported by the rest of the body, but will be still stressed by lack of support from other imbalanced areas of the body. A simple way of looking at this is any imbalance in the body affects the whole, and a weakened area will be most affected.
Thus, for maximum rehabilitation the concept of integrating the cranial/structural core distortion releases with soft tissue myofascial techniques to treat the tissues that had the most structural and direct effect on the area of pain is most effective. Initially, spending extra time on these areas and not trying to treat the whole body in the early sessions directly addresses and relieves the client's pain for which the client is grateful. Once this is achieved, it is then necessary to release the soft tissue throughout the rest of the body to support the increased balance in the area that was the original presenting pain. For the client who had a bulging lumbar disc, after the cranial distortion was released, the initial soft tissue treatments would work with the pelvis and leg distortions from the long leg/short leg discrepancy and the low back. Once the client had little or no pain in the area of the bulging disc, the rest of the structure would then be treated. Usually, next in importance would be the upper part of the spine with treatment of the head/neck/and shoulders area. This would be followed with a thoracic session to take the rest of the core distortion holding patterns out of the musculature releasing the curvatures in the thoracic spine which would allow the entire spine now to maintain a vastly improved pain free support. Additional soft tissue sessions would still be needed to release the remaining imbalances in the rest of the legs, feet and arms.
Once the cranial core distortion has been released, the structure of the body is trying to balance and release the holding patterns of the core distortion from all the soft tissue. It can only do so much on its own and needs a therapist's skilled hands to assist it. Since the soft tissue is now beginning to unwind out of the core distortion the therapist has an opportunity to work more effectively with the body as it tries to unwind into a new more supported balance with all levels of soft tissue releasing. Because the entire structure is trying to release at once it is possible to work all levels of connective tissue even in the first session.
Using this model it is possible and beneficial to work deeply to achieve maximum results even in the first session. An approach into the soft tissue that will first release fluid, ischemia and inflammation prepares the area for deeper work. Deeper strokes then allow the myofascial holding pattern to unwind and are most effective when providing direction to the unwinding in the same direction that the body is trying release. The soft tissue and the client are now prepared for deeper more specific strokes to release adhesions, scar tissue and lengthen connective tissue fibers.
As you can see, integrating cranial/structural therapy with soft tissue myofascial work can produce rapid long term results in rehabilitating clients with musculoskeletal pain. This new integration of advanced techniques may be the answer for many of your clients who keep returning with the same problems over and over. I have been developing this integration and using these techniques successfully for the last 25 years. Even the most complex cases who have given up hope after having been everywhere seeking treatment have been able to resume normal life activities pain free.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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