resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Pediatric Massage: Approach for Congenital Muscular Torticollis
Torticollis comes from the Latin words tortus, which means "twisted" and collum, meaning "neck." Congenital muscular torticollis (CMT) is also sometimes referred to as wry-neck, stiff-neck, crooked-neck and twisted-neck. It was first defined in 1912 as "a deformity, congenital or acquired in origin, characterized by lateral inclination of the head to shoulder, with torsion of the neck and deviation of the face." Between 0.3% and 2% of newborns present with congenital muscular torticollis (CMT) which is thought to be a painless condition caused by the unilateral shortening of the sternocleidomastoid muscle (SCM.) The shortening of SCM gives an ipsilateral head tilt and contralateral rotation of the face and chin on the involved side. If diagnosed early enough it can be managed easily, seldom requiring surgery with the best outcomes seen in children between 1 and 4 years of age.
The origin of CMT is still up for debate, wile the most popular theories behind the impairment include intrauterine crowding, muscle trauma during a difficult delivery, soft-tissue compression leading to compartment syndrome and congenital abnormalities of soft-tissue differentiation within the SCM muscle. Histologic studies of resected surgical specimens have demonstrated edema, degeneration of SCM muscle fibers and fibrosis.
There are different presentations of children with CMT, the most common is an obvious head tilt toward the affected side with the chin pointing to the contralateral side. Plagiocephaly, flattening of an infant's head or face, is reported in up to 90% of cases with CMT. Treatment is required to stop unilateral weight bearing which causes deformity of the skull base and cranium which can continue into adulthood.
Assessment of this condition can begin during the pediatric massage intake process of asking parents if their child often tilts their head in one direction, prefers looking over one shoulder instead of turning the head to follow with eyes, difficulty breastfeeding in one position, and displays frustration when attempting to turn their head in one direction. These are possible signs and symptoms of infants, or young children, with torticollis.
As discussed in Nilesh's 2013 article, "Congenital Muscular Torticollis", currently there are three classification groups for children with CMT. Group 1 is the sternocleidomastoid tumor group, which consists of torticollis with a palpable pseudotumor or swelling in the body of SCM. This is a hard, movable mass within the substance of the SCM noted at birth. This mass is usually located in the middle to lower third of the sternal portion of SCM. The pseudotumor usually becomes large after its first noted and then slowly resolves over a period of 5-21 months. This is the most common presentation and contributes to 28.2% to 47.2% of diagnosed cases of CMT in infants. Group 2, known as muscular torticollis, consists of torticollis with tightness of the SCM, but no palpable tumor. The last group, Group 3 (also known as POST), is a postural torticollis without a mass or tightness of the SCM. In an alternative system of classification, pseudotumor of infancy and CMT are described as a separate diagnosis.
Treatment of torticollis is dependent on the age of infant, the severity of torticollis, the diagnosis of plagiocephaly and the possible presence of associated neuromuscular or orthopedic impairment. About 50% to 70% of SCM tumors resolve spontaneously during the first year of life with little to no lifelong symptoms. Physical therapy and the use of massage is often strongly recommended.
Before massage treatment begins, it is important to have the child completely diagnosed by a medical professional. The amount of additional conditions that are associated with torticollis demand a full evaluation and treatment involving extra care. As mentioned earlier in this article, the SCM is most often the muscle that is affected with torticollis. It originates on the medial end of the clavicle and attaches behind the ear. The sternocleidomastoid muscle has the function of both turning the head and assists in tilting from side to side.
With the child in safe position, the pediatric massage therapist, or trained parent, may apply gentle stroking techniques to the lateral, posterior and anterior areas of the unaffected side prior to addressing the affected side. This approach is often helpful is reducing spasms.
Unlike with adult clients, we do not recommend an ivolved stretching protocol with children. Rather, it is best to soften the tissue and use a favorite toy or engagement item to help the children track and turn their own head to follow. This gentle motion will help to monitor comfort level of the client and prevent overstretching the soft tissue.
Incorporate child friendly approaches to engage the child to turn their head from side to side, bring their head to chest and orient to midline. When the child is prone, resting comfortably on their abdomen, encourage the child to lift their head to increase orientation and strength.
Per the American Academy of Pediatrics (AAP) recommendations for sleeping, many parents place their baby on their back to sleep for prevention of SIDS. However, it is just as important that parents incorporate supervised "tummy time." Tummy time or prone to play enable normal developmental progression and can help build muscle in the neck and upper back.
With CMT occurring in one of every 300 live births, it is essential to know simple, natural ways of dealing with this condition. Massage provides an excellent way to gently lengthen affected muscles while encouraging growth and development in children. Additionally, if taught to parents at home, it can provide an excellent was for parent and child to bond.