resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
May, 2014, Vol. 14, Issue 05
A Practical Application of the Tissue Density Grading Scale
By Linda LePelley, RN, NMT
The Tissue Density Grading Scale (TDGS) was developed to reliably represent the condition of musculoskeletal tissues at all stages of treatment or progression. By comparing pre-treatment assessments that include the TDGS with a post-treatment follow-up assessment, the effectiveness of any massage therapy treatment can be objectively depicted and documented.
While the following example makes reference to the use of Tissue Density Restoration (TDR) massage, it is important to understand that the TDGS is representative of the state of musculoskeletal tissues regardless of any type of treatment, or what treatment that may be. TDR massage is just the modality I happen to use, but any other type of massage may be evaluated in the same manner, whether it is Trigger Point Therapy, Myofascial Release, CST, Bowen, etc.
The basic TDGS follows. A more complete explanation of the scale may be found in the March 2014 issue of Massage Today.
Tissue Density Grading Scale
A Case Study
A 54-year-old male client presented complaining of moderate to severe pain in his left shoulder stating, "It hurts all around, it's stiff, I have trouble lifting my arm and turning my head to look back is difficult." He attributed it to a 20-year-old auto collision, combined with age and a recent drop in the temperature seemed to have made it worse. He was not able to raise his left arm to shoulder height. He stated that he didn't want to go to a doctor because he didn't want pain medication or muscle relaxers, which were all he'd been offered on previous visits to complain about the same symptoms.
Having the client right side-lying, I gently grasped the glenohumoral joint and attempted to mobilize it. I found the entire region was resistant to movement, resulting in rocking the client's entire upper left quadrant and head. The scapula's medial border seemed to be firmly engulfed within the tissues above and below it; they felt rubbery and solidified. The client's right side, by comparison, was found to be very mobile, with normal range of motion.
I explained to my client that, because I could feel and demonstrate to him the elevated density in the affected tissues, I believed I could help relieve his pain and improve his range of motion. I suggested several treatments, with the first ones given as closely together as possible.
The basic guidelines for Tissue Density Restoration (TDR) massage are:
I started the assessment/treatment with the client on a warm table, using a heat transferring device, similar to a hot stone. I began to feel areas that were notably firmer than their surroundings. As the tissues became a little more malleable, I asked my client to identify the areas that hurt the worst. He directed me to spots just above the superior border and superior angle of the left scapula; the top lateral edge of his humerus; and near the base of the deltoids. We also found a large, hardened area between the upper medial aspect of the scapula and the spine. Its location and density prevented the scapula from being able to adduct. I explained to my client that while it didn't belong there, it probably consisted of multiple layers of tissues that do belong – they have simply adhered to each other and conglomerated. The good news, however, is that no matter how uncomfortable and disruptive the structure may be, it can be restored to normal density and proper functioning.
The first hour of my client's initial two hour visit was spent determining the areas that were causing the greatest amount of pain and dysfunction. These target areas were determined to be:
The remainder of the session was spent using TDR massage techniques. By the end of the massage, the borders of the identified areas were more pronounced and easier to locate, due to softening of the surrounding tissues, as well as some improvement in the target areas. The results of the post-treatment assessment were:
This client received four treatments in the first week, followed by six more weekly treatments. The client states he is very happy with the results, he feels as if he is 75% to 80% improved. He claims he is able to turn his head easily when backing up in his car; and he has a full range of motion in his arm and shoulder. At this point the TDGS is:
I hope this example of how I use the TDGS portrays the value and usefulness of this tool. You may have noted that a color is associated with each grade. By color coordinating the numerical grade, one may provide a more comprehensive illustration of the size, location and condition of affected tissues on any anatomical diagram. The TDGS is easily adapted into whatever documentation form you prefer, whether it be written, drawn or both.
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.
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.