resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
July, 2014, Vol. 14, Issue 07
Following the Body's Clues
How 29 minutes of massage therapy changed a life.
By Debbie Roberts, LMT
There was a higher power at work when I helped Marianne. You know as a therapist when you jump right in and try to help someone and all your efforts work, but you are not entirely sure why.Then your mind is reeling in the possibilities of what just happened, followed by you can't wait to get your nose into a text book to further investigate how exactly you made those dramatic changes. A twenty-nine minute demonstration at a massage therapy conference using a gross cervical movement screen, a piece of equipment that allows firm pressure and my hands led the way to an incredible, life changing event for my volunteer, Marianne.
On January 5, 2012, Marianne and five of her children were in their minivan stopped about 10 cars away from a red light. She was one and a half car lengths away from the car in front of her. Her two-year-old had just woken up and they all had turned around to give the child attention, when they were hit from behind and then shoved forward to hit the car in front of them. The driver was texting while driving and the approximate speed was 55 miles per hour on impact. She was knocked unconscious from the whiplash as her head did not hit anything during the accident. She became conscious as they were prying her foot from underneath the gas pedal. She was taken to the emergency room and a CT scan of the neck was performed. She was told nothing was broken, given a muscle relaxer, pain medication and then sent home. The total ER visit was only about four hours. She woke up the next morning with varied symptoms. When she followed up the next day with the doctor, he referred her to a neurologist because he felt she had a severe concussion and a possible stroke because she had lost function in the right side of her face and neck.
In the two and half years of seeing the neurologist, he had prescribed every kind of medicine for migraines which never worked. She felt she wasn't being heard, that the headaches were not vascular headaches. He prescribed narcotics, muscle relaxers, ultra sound, tens machine and physical therapy. He also prescribed Botox for the migraines.
She started seeing a chiropractor who performed adjustments, Dural unwinding, myofascial release and cranio-sacral therapy. The treatments never seemed to last. "I got more relief in the 30 minute demonstration than in the 29 months of medical care, physical therapy, chiropractic care and not to mention the $100,000 I have spent elsewhere," said Marianne.
By now I am sure you are wondering what on earth did I do so different than the other well intentioned skilled therapist and doctors? How did I know I had helped her? As a group, we looked at her range of motion of flexion, extension, side bending and rotation. Well, she had none. Yep, you heard me none. In order to drive, she turned her whole body. After two years, she literally had no motion to her cervical spine to look in any direction and she was forced to move through her thoracic spine. I was very nervous to work on her after she revealed her history and by observation her neck appeared to have permanent damage. The other thing that was odd, nothing showed up on the MRI to indicate such severe damage that would be contributing to this kind of loss of motion.
Addressing the group, I talked about changing muscle inhibition left over from an accident and how to approach the injury using isometrics for neuromuscular re-education of the mechano-receptors. The importance and value of taking the movement screen, also that I didn't have any preconceived notion that in 30 minutes what changes I could make. In other words, I was willing to fail.
I began doing the demonstration placing the cranial device under her T-spine, doing soft tissue work to the scalene muscles and trapezius. I then tried some very light isometrics with no post-isometric stretch to see if I could help re-set the mechano-receptors and encourage length to the scalene, SCM and trapezius muscle. I didn't stretch the neck because she grimaced every time I moved her neck in the slightest. The direction of lateral flexion with the isometric set off her pain pattern over the right eye. Since this elicited the pain pattern of the stroke, I didn't do any further cervical isometrics.
I continued the demonstration and used the cranial device to support the neck and let her doing some gentle rocking to her tolerance. The place I always go looking when someone has severe headaches is the first rib. Hers was very prominent and had no motion on springing. Leaving the cranial device at approximately T2-3, I explained that first rib dysfunction can give a lot of headaches and hers felt really elevated and fixed. I used the technique of positional release which uses the elbow and forearm to guide the humerus lateral to medial towards the spine to influence the first rib, asking the typical question of any pain or discomfort, and there was none. I then asked her to put her head in a slight rotation to the side of dysfunction and placed my left thumb over the rib head and asked her to make an isometric contraction of the forearm adducting to her side. I pulled the scapula out further with her head in the same position and asked her to contract again. I repeated the above about four to five times. I also rolled her onto her side just far enough to place the cranial device at the level of T3-4 along the rhomboids and middle trapezius using my fingers began a posterior to anterior push. I repeated the lateral to medial positional release into the spine and finished again with her on her back the cradle resting under her neck this time and repeated the downward adduction of the humerus into her side.
By now, they were flashing the lights at us to end the demonstration. She sat up carefully and I stopped the crowd that was trying to leave and said, wait we need to see what it is we accomplished. You assess in the beginning and at the end of every session don't you? I don't know who you could have picked up off the floor first, her or me. She flung her head back into extension; easily tossed her chin to chest into flexion without difficulty looked over her shoulder, and with some reservation accomplished about 20 degrees of side bending. She continued to take her head from flexion to extension because it was so exciting. It happened so fast, I grabbed her and said don't do that. I was so taken back by the amount of motion I was afraid she would hurt herself somehow or undo what I had done.
What had I done? I went to one of my resource reference books, An Osteopathic Approach to Diagnosis and Treatment, third edition. There, in chapter 78 Practical Applications and Case Histories of the Thoracic Cage, I found just what I was looking for. An explanation and a case history of something very similar to what I had experienced. I also called one of the author's to get her input into the somatic dysfunction of the first rib.
She explained that the first rib is probably the rib most commonly involved in somatic dysfunction of all the ribs. It is affected by trauma, stress and posture, as well as by the dysfunction of the C7-T1 complex. The patient may complain of "shoulder" pain, stiff neck, upper back or neck pain, and here it is an inability to turn the head while driving. The first rib can impinge the neurovascular bundle as it passes between it and the clavicle through the costoclavicular space. Since the anterior and middle scalene muscles assist in raising the first rib, they can also compress the brachial plexus when they are in spasm and result in thoracic outlet syndrome symptoms.
What I had accomplished was helping a first rib dysfunction that was hung up on the C7-T1 vertebra. The whiplash injury with the head turned to look in the back seat created an eccentric load to the scalene and trapezius. The force was so great that it displaced the first rib. I used the cranial tool at approximately the C7-T1 vertebra in a posterior to anterior position and I was able to use isometrics and positional release lateral to medial resulting in a release of the first rib.
I encouraged Marianne to continue to get body work done to the scalene's, trapezius, rhomboids and SCM to decrease the hyper tonicity. This will help to encourage the first rib to have better motion. Massage therapy is not an exact science that is why we have so many modalities to choose from. I wasn't sure I would be able to help, but I was willing to be vulnerable and fail. Marianne is eternally grateful I tried.
Click here for more information about Debbie Roberts, LMT.
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