resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
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.
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.