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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
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.
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.
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.
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.
March, 2016, Vol. 16, Issue 03
Restore and Prevent Tender Feet
By Linda LePelley, RN, NMT
Massage therapists see many clients with a variety of foot problems such as bunions, plantar fasciitis, tarsal tunnel syndrome, neuromas, etc. Usually, they have already been to their physician, followed by a podiatrist. When (if the exercises, shots, braces and inserts have failed to relieve their pain) they come to see me about one or more of these conditions, they are usually at their desperate wits end to find relief. But this article isn't about those types of foot problems and pain.
Over the years, I have come to notice a pattern of certain clients who suffer from mild pain and tenderness on the bottoms of their feet, yet they rarely mention it of their own accord. For example, a 68-year-old client had been coming regularly for carpal tunnel treatment and pain surrounding a knee replacement. He made the statement, "Now that my hand and knee are good, the only thing I even notice are my tender feet, and I can sure live with those!" When I asked him why he would want to live with it, he said he had been putting up with it for decades. He said that it was just old age and nothing could be done about it.
A 65-year-old woman mentioned that it was getting harder to find shoes soft enough to walk in. When I questioned her about it, I found that she couldn't walk bare foot in her own house because if she stepped on the edge of a carpet or threshold, it felt bad. She said it had gotten to where standing on the tiles in her shower was uncomfortable. I asked why she hadn't mentioned it before and she told me that, "Nothing can be done about it, my mother had it too, so it's hereditary. It's not bad enough to go to the doctor. Besides, no one can do anything about boney feet, and mine just keep getting bonier, like my mother's."
Perhaps it is because I specialize in pain relief massage, that these and other clients of mine may believe that the tenderness in their feet is not serious enough to complain about. They have told me that what they are experiencing is not bad enough to call it "pain," nor is it as bad as the severe pain they have known others to be in, that it is just a nuisance, that it is just old age, and that everyone should expect to have discomfort such as this.
In my twenty years of experience as a massage therapist and nurse, I've found many people believe that chronic, low grade discomfort is a natural phenomenon which they expect and accept; allowing it to become a part of their everyday lives, making good days a little bleaker, and difficult ones a little bit harder to bear. Many of the serious pain issues I deal with started out as small nuisance irritations which, having been ignored for many years, end up being the source of chronic pain.
Tender Foot Restoration
While this is not intended for advanced foot conditions such as those listed above, which can take three or more visits to achieve desired results, this treatment will not injure or aggravate any of them, and might provide them some relief as well. Start with a warm foot bath if available, otherwise wrap feet in warm towels. Ensure that your work area is warm and free of drafts, as working over a warm heating pad is ideal.
Massage the bottoms of the feet and toes, having your client indicate the places that are most sensitive. You will note that these areas may feel like they are quite boney. Keep in mind that even if some of these tissues have atrophied, they are still alive and can be plumped and restored to normal. You can do that by massaging them until the circulation has softened those hardened areas. Follow the principles of Tissue Density Restoration (TDR) massage ("The Seven Principles of TDR Massage," Massage Today, July, 2015).
It is important that you spend at least 45 minutes on each foot, keep them warm, and do not elicit pain greater than a 2 or 3 on the 1/10 pain scale. You will know you are doing it right as you feel hardened areas soften, smooth out, and become pliable. At the same time, your client will be stating that they never thought their foot could feel so much better. You may be tempted to spend less time on each foot once the client states that it no longer hurts when pressed into, but the best, longest lasting results come from rubbing out every tender spot, and taking the time to do it thoroughly. As the tissues on the bottom of the foot respond and the tenderness eases, manipulate the entire foot and ankle, gently, to encourage and improve circulation to the foot, while continuing to work the affected tissues, until they are uniformly softer and without pain.
Both of my clients whose discomfort I described above, and many others with similar conditions, have experienced complete relief of their tender foot discomfort. For my clients who can reach their feet easily, I encourage them to give them a good massage during a bath, or when applying lotion, at least once a month to maintain the cushioning properties. Otherwise, they should schedule a bi-monthly maintenance foot massage.
Click here for previous articles by Linda LePelley, RN, NMT.
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