resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
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.
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.
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.
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?
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 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.
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.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.