Integrating CMT’s July 2014. Facilitated by Deanna Straub CMT, with guest practitioner Ray Wilbur D.C. of The Integrative Medical Clinic of Santa Rosa. The group was dynamic and the participation was thoughtful and full of energy. I am happy to say that after two hours and forty five minutes I had to blink the lights to get the group to conclude! Ray Wilbur D.C. was highly informative, positive and fun! He began hands on care as a licensed massage therapist and polarity therapist and therefore has some real understanding of the work massage therapists do. As a chiropractor, his fundamental premise for treatment is to get to the root of the problem, correct it and encourage self-care to self-manage one’s health. Ray will often refer his patients for massage, movement, exercise or nutritional therapies. This integrative approach is often a key factor in helping the patient meet their health care goals. The group demographics included Casey, a massage student from Davis Ca., Lori P. a CMT from Santa Rosa Ca with 19 years’ experience, Monica C. from Santa Rosa Ca. with seven years’ experience, and me, practicing since 1989. Two others were registered but were unable to attend. The Case Story questionnaire was an effective tool in presenting a whole case persons story.The presenter filled out a three page questionnaire relevant to the case they chose to present. Feedback on the questionnaire:
- The questionnaire made the presentation process straight forward, it flowed nicely.
- I didn’t have to decide what information to include.
- It gave me some really good ideas on what to add to my intake forms.
- I can see clearly now the relevance of getting detailed information of ADLs (activities of daily living) as it really is part of the tapestry of movement, function and pain.
- Using the questionnaire helped me better connect the information I gathered through intake, I began to see a bigger picture and formulate a broader plan of care.
- I don’t have experience in presenting a case for integrative collaboration but now feel confident I can do so.
THE CASE PRESENTED Lori presented on Carpal Tunnel Syndrome and her success in helping her client avoid surgery. Lori’s person, a professional musician with a bay area symphony, presented with diagnosed CTS and was preparing for surgery. The years of repetitive holding of postures during practice, rehearsal and performance created dysfunctional muscle and connective tissue pattering. The soft tissues were trained to shorten and hold postures and over time they began to sustain these new short and contracted patterns, ultimately compressing the median nerve bringing on forearm numbness, shooting pain in the wrists, grip weakness and visible vascular changes and swelling in the forearm, wrists and hands. The client was told surgery was the only option which was a devastating prospect but was getting ready to proceed when a friend referred this person to Lori. Her approach of care included assessment of posture and ROM’s and a detailed health history intake. She integrated myofascial release, trigger point therapy, stretching and verbal feedback. The therapy was applied to the soft tissues of the cervical spine releasing and decompressing any possible soft tissue caused impingement at the nerve root of C5 – 7 and T1, the soft tissues of the shoulder and thoracic spine including the pectoral group and the subscapularis muscle; addressing compressive factors on the brachial plexus sub – pectoral and the upper arm, forearm and hands, thereby releasing the contractive forces on the median nerve. This approach combined with a disciplined self-care regimen of movement and gentle stretch to interrupt and reorganize the perpetuating factors allowed her client to avoid surgery altogether. FEEDBACK AND QUESTIONS Ray: “what a great presentation”. Ray included his approach as a DC might include an evaluation and treatment of dysfunctional spinal segments C-L, extremities and to evaluate any possible compensations brought on by SI joint instability, the base of the spine. Also validating the need to look closely at the perpetuating factors and implement a personalized self-care regimen. Casey was happy and inspired to see a chiropractor and massage therapists integrating information on care because her perception has been these two professional groups can be clash. The group then discussed personal experiences of repetitive pattering issues in the work we do and the relevance of self- care for longevity. The Wrap Up – again I was so delighted there was such energy and enthusiasm to share information and integrate how we all think through care. Spread the Word – This workshop is intended to be inclusive of all levels of Massage Therapists. It is my hope that as we work this process, we promote building an alliance within the field of Massage Therapy and a sharing of information and colleague based support. I have been working this process with multidisciplinary health care teams since 1991 and still find it invaluable to my practice.