resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
March, 2016, Vol. 16, Issue 03
Make a Difference in Clients who Suffer from Traumatic Brain Injury
By Don McCann, MA, LMT, LMHC, CSETT
There are manual cranial therapies for massage therapists that can make a significant difference for clients who have had brain injuries. Unfortunately, many massage therapists are unaware of the positive effect they can have with their brain injured clients.
Recent medical research has actually verified systems in the brain that were previously unrecognized. There are three that are of significant importance for manual therapy. The first is that they now recognize that the cranial motion exists with a subtle movement of the cranial bones. For years, medical schools have been teaching that the cranial bones do not move. The second was a breakthrough study at the University of Rochester Medical Center that discovered the glymphatic system. This discovery was only possible because of advances in technology that allowed them to study living brains.
The glymphatic system is a pressurized system that shadows the blood vessels of the brain and is now recognized as the principle waste removal process for the most sensitive of organs, the human brain. The third was a "stunning" discovery at the University of Virginia that overturns decades of textbook teaching that shows the brain is directly connected to the immune system by lymph vessels previously thought not to exist. While it has always been recognized that there were some lymph vessels in the brain, they were thought to be minimal and not of great significance. The new findings show that the brain has a complex and sophisticated immune system based on this newly discovered and extensive lymph system. Again, this only makes sense as the most sensitive organ of the body would need this.
In the past, when some of the treatable brain injuries occurred, massage therapists were seldom included in the treatment process. If we look at the systems mentioned above, we can see this was a major oversight by the medical community because, once the danger of further hemorrhage or damage to the brain was no longer an issue, massage therapists trained in specialized cranial techniques could have provided one of the primary forms of treatment. This is a bold statement which I now am going to back up.
First, we will look at what happens to the above mentioned systems when a traumatic brain injury takes place. When the cranial motion is examined after traumatic brain injury, it is dramatically diminished. The injury itself can jam sutures even to the point of causing them to become calcified. In addition, there is soft tissue damage. This can be from the surface layers of fascia just under the skin through the reciprocal tension membrane where it passes through the sutures, and inside the lining of the cranium into the tentorium that supports and holds the brain. This can dramatically disrupt the cranial motion and block neurological function as this tissue thickens into scar tissue.
In the acute stages of brain injury, a restriction of the cranial motion can cause a backup of fluids in almost any part of the brain. This backup of fluid causes pressure and swelling on the brain and inhibits brain function. Restoring cranial motion allows the systems of the brain to work normally and release the swelling. In addition, restoring the cranial motion can often result in a balancing of the temporal lobes which often dramatically reduces vertigo, and the inability to concentrate.
Case study #1
Robin, a 30-year-old real estate agent, had a brain injury from an auto accident. For three months she was unable to drive, had significant headaches, could not concentrate, could not stand bright lights, and was on medication for vertigo. She came for treatment because she also had a cervical flexion/extension soft tissue injury. Using kinesiology to evaluate her cranium, it was revealed that she had minimal cranial motion and almost no cranial motion of the left temporal bone. In addition, the relationship of the occiput/atlas/axis was jammed with no motion. The cranial/structural core distortion release, a complete unwinding of the restrictions of the cranial motion, was applied which restored full motion to the cranium. Additional synchronizing of the temporal bones and a mobilization of C1 were applied. By the time Robin got off the table, she felt her concentration was nearly 100%, her headache that had been present since the injury was gone, the lights in the room were no longer affecting her, and her vertigo had disappeared. Additional sessions further normalized and expanded her cranial motion and also treated the soft tissue injuries in her neck. Within three sessions, Robin felt that her brain injury was healed and that she could return to her real estate practice. This was a very good example of how the restrictions of the cranial motion which also jammed C1, had prevented her brain injury from healing. The timely application of cranial/structural techniques produced rapid and long lasting improvement.
Cranial motion is involved in both the glymphatic and lymphatic systems of the brain. However, each deserves special attention beyond just the restoring of the cranial motion. The glymphatic system is the principle waste removal system for cleansing the brain, and a brain injury damages the glymphatic vessels often collapsing or even breaking them. This is especially obvious when there have been broken blood vessels and hemorrhaging as the glymphatic system shadows the circulatory system. The first symptom of damage to the glymphatic system is swelling. Cerebral spinal fluid and blood will back up or leak out in an area that is damaged. The second is additional inflammation because waste products of the brain accumulate and cause constant irritation which also results in swelling. The third, and this takes place over time when the glymphatic system has not been restored back to full function, is brain degeneration due to lack of waste removal and a buildup of protein and amyloid beta. This may not be evident for a number of years after the injury, and is a major contributing factor to the early onset of dementia or Alzheimer's for those who have had multiple concussions.
In an acute brain injury, once danger of hemorrhage and additional damage has passed, treatment of the glymphatic system can dramatically speed up recovery. The glymphatic system pumps along with the cranial motion, but to engage it fully it is necessary to compress it. A specialized cranial/structural technique, the frontal/occipital decompression, will compress this system and then work it in a pumping motion. This will push fluid through collapsed glymphatic vessels and pump accumulations of fluid out of the brain. In addition, this pressurized pumping of the glymphatic system will dramatically increase the removal of waste products and inflamation. This will help to restore the glymphatic system back to full function. Many clients report immediate relief from concussion symptoms.
Case Study #2
Cindy, a college basketball player, had three major concussions in three years and, six months after the third one, hadn't shown any improvement in her ability to concentrate and attend school. She was also lethargic and had constant headaches. The physicians had said it was just going to take time and there could be some permanent damage.
At Cindy's first session, the cranial/structural core distortion release was applied to release the restrictions in her cranial motion. After the cranial motion had been restored the frontal/occipital decompression was applied to pump out the excess fluid and waste products and reduce inflammation in her brain. By the time the session was over, Cindy was not as lethargic and was starting to show more interest in her environment. This technique was applied four more times on a weekly basis with steady progress in her ability to concentrate, memory retention, and energy levels. Her headaches had also disappeared. By her fourth session, Cindy was back in school and able to handle her full load. This was after six months of not being able to read or concentrate enough to go to class. A CAT scan also showed a clearing in the areas that had previously been inflamed and swollen.
The lymphatic system also responds well to compression and decompression and is also treated with the frontal/occipital decompression. Consequently, there are two systems at work when treating inflammation and swelling with the frontal/occipital decompression. Both dramatically help in the recovery from treatable brain injuries.
Another effect of brain injuries, is leaving the client's brain susceptible to further neurological diseases and degeneration because of the damage to the lymphatic system which is the major component of the brain's immune system. Restoring the lymphatic system and lymph drainage can prevent the development of other neurological diseases such as MS, ALS and Alzheimer's.
As you can see, massage therapists can make a significant and long lasting therapeutic difference when treating clients who have had treatable traumatic brain injuries. Hopefully, this has expanded your awareness of the exciting possibilities that are available for successfully treating clients who have sustained treatable brain injuries. These techniques are not available through the medical community.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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