resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
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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