resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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?
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?'
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.
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.
July, 2014, Vol. 14, Issue 07
The Evolution of Releasing the Core Distortion
By Don McCann, MA, LMT, LMHC, CSETT
All my previous articles in Massage Today have included information about the core distortion found in the body. I want to explain how the term "core distortion" evolved and why other medical professionals have not described it in these terms.There is evidence that it exists and a process of discovery that led to effective treatment of a client's musculoskeletal pain by releasing this functional structural core distortion pattern.
It is understood in the medical establishment that 90% of musculoskeletal pain comes from distortions in the structure. In other words, structural imbalance creates pain and dysfunction and structural balance creates pain free function. In 39 years of practicing, I evaluated the structural alignment of my clients from a standing posture. I then used both applied and functional kinesiology to further evaluate and verify the standing postural observations. What emerged was a consistent pattern from the head to the feet that showed a spiraling twist going around and through the body. What became apparent as I viewed the body from the anterior, posterior and both sides, was the consistent anterior rotation of the left ilium and posterior rotation of the right ilium. This was verified 100% using functional and applied kinesiology. I have not found any terminology describing this full body distortion in any literature or in research, yet almost everyone recognizes major parts of it. Consequently, to help clarify the concept I chose to name it the "core distortion" since it involved the legs, pelvis, spine, thorax and cranium – the core of every client.
The Whole Body
Some of the professionals who have read the articles about the core distortion have questioned why the medical establishment has not recognized it. The fact is they do recognize portions of it, but have not looked at the whole body in its standing posture. In reviewing physical medicine and chiropractic research, there has been confusion about what exactly the ilium/sacrum relationships actually are. From my reading of their research, it appears that the discrepancies about the rotations of the iliums, the resulting long leg/short leg relationships and the tipping of the sacrum are more a matter of description and interpretation than disagreement. An example of this is some professionals view the anteriorly rotated ilium as producing or being produced by the short leg, where others view the placement of the acetabulum which is lower due to the anterior rotation, as creating a functional longer leg. There are many other examples where people have examined the same structure and drawn different conclusions based on their point of view and their interpretations of what the rotated iliums produce.
Functional kinesiology has been 100% accurate in my assessment of the core distortion in the bodies of my clients and has been very useful in the development of my protocols to restore weight bearing support and minimize structural distortions leading to long-term rehabilitation from pain and return to function. I have mentioned in previous articles that the core distortion is observable in 16-week-old fetuses. Unfortunately, there has not been a radiological study to either confirm or disprove this observation. However, if we look in Essentials of Skeletal Radiology, Vol. 1, 2nd ed. by Dr. Terry R.Yochum and Dr. Lindsay J. Rowe (the text book used in many medical, osteopathic and chiropractic schools), we find on pages 175-176 recorded measurements of normal acetabula angles of infants 0 to 3 months and 3 months to one year that show an average of 20 degrees difference between the right and left ilium with the left being anteriorly rotated and the right being posteriorly rotated. On page 176 in table 227, normal iliac angles are charted in babies from 0 to 3 months and 3 to 12 months, again absolutely verifying the difference in the angles of the iliums to be significant in normal children congruent with the core distortion. Thus, it is clear that normal children are born in the core distortion creating imbalances and weakness throughout the body. Injuries, stresses and developmental patterns that occur throughout their lives result in further collapse creating musculoskeletal problems.
A Different Paradigm
Thirty-nine years ago, I started practicing a myofascial restructuring therapy based on Structural Integration. I was quickly frustrated when my clients came in with pains and dysfunction in areas that weren't the focus of the first four to five sessions. Often, clients would feel that I was not paying attention to their area of complaint and would not want to continue their sessions. I began looking for a different paradigm that would incorporate the deep myofascial body restructuring techniques, but would allow me to bring the initial area of complaint into balance first, and then bring the rest of the body into balance to support the changes in the area of client complaint. To do this, I viewed the core distortion as it related to the entire structure as well as to the client's area of complaint, and incorporated applied and functional kinesiology for verification with great success.
Now, I could be confident that I understood how the area of pain and dysfunction was related to the core distortion and design a myofascial release protocol that would release the core distortion in this area. I also discovered that I could work not only the surface layers of the fascia, but also the deepest layers in the initial sessions by using slower directed myofascial unwinding strokes, followed by more specific individual myofascial fiber releases at deeper levels in the same session. This was stepping outside the concept of working just the surface layers of the fascia first and then the deeper layers in subsequent sessions. Because I was working within the parameters of releasing the core distortion, many of the changes were able to be maintained and actually affected other areas of the core distortion that were not actually being treated. However, if the area of complaint was in the upper body I found that within the first three sessions it was necessary to work with the soft tissue affecting the pelvis to start releasing the anterior/posterior ilium and sacrum rotations, even if the pelvis and low back were not an area of complaint. So, not only was I treating the area of client complaint early in the sessions even at deep levels, I was also releasing the sacrum/ilium rotation and imbalance in the early sessions which was key for longer term results. Clients immediately began experiencing relief of their symptoms and structural improvements. However, like the chiropractors and physical therapists, bringing the sacrum/ilium relationship into long term weight bearing support was seldom completely achieved.
The big breakthrough occurred when the relationship of the cranial motion and the rotation of the iliums was fully understood. The wings of the sphenoid relate directly to the ASIS of the iliums with the same distortion pattern as the rotation of the iliums. The ridge of the occiput relates directly to the PSIS of the iliums with the same distortion pattern as the rotation of the iliums. Thus when the torsion was released from the cranial motion, the rotation of the iliums was diminished resulting in weight bearing support of the sacrum and the leg length was equalized. The hip complex would now provide long-term weight bearing support and balance. With the sacrum more level, there was support for the spine and thoracic ribcage. Now, whenever a soft tissue myofascial protocol was applied after the cranial/structural correction the changes would be supported long term.
Another benefit also showed up as the body's alignment improved throughout the entire structure. Muscular weakness that had been the effect of the imbalance was immediately strengthened. The end result was long term rehabilitation from pain and dysfunction and increased muscle strength and flexibility, joint stability and increased physical potential in sports and life in general. Many serious joint and spine issues were so dramatically improved that surgery was no longer necessary. This is the answer for long term rehabilitation of 90% of musculoskeletal pain and a great tool for massage therapists to maximize their healing potential.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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