Massage & Bodywork

November/December 2012

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best practices BUSINESS SIDE | Q & ART | TABLE LESSONS | SAVVY SELF-CARE While she was seated, I palpated her tissue for further clarification. "How about this muscle?" I asked, pressing on her masseter. "I think so," she said. "And this?" I asked while exploring her temporalis. "There, too, I think," she answered. Given the presentation of her pain, When the Pieces Don't Fit both of these muscles were prime suspects. I measured her interincisal range of motion with three successive readings: 41, 44, and 47 millimeters respectively. For B.K.'s petite size, these readings were not indicative of notable restriction. In addition, the readings improved each time, something that research endeavors have told us is a good sign. If the masseter and/or the temporalis are involved, why is the range of motion so unremarkable? Thinking about this more, I remembered other presentations where muscle length tests out fine, but contraction reveals the problem. "Do you have trouble with sustained Finding Appropriate Providers is Critical By Douglas Nelson I have always enjoyed seeing my client B.K. She possesses the perfect combination of compassion, insight, and intelligence, all of which make her a very successful psychotherapist and a delight to be around. This session was to address orofacial pain on the left side. "Show me where you are feeling pain," I began. B.K. pointed to the left side of her face in a rather broad sweeping motion, so broad I couldn't really tell what she was pointing to. This made me wonder if she was unaware of the exact source, or if the pain presentation was that diffuse. chewing of foods, such as a bagel or a piece of steak?" I asked. "Do you find your jaw tired or painful afterward?" "No, I can't say that I do. I chew gum occasionally, and that never bothers me. I have never noticed the pain in my jaw or face being worse after chewing, but maybe I am just not paying enough attention to when it happens." Somehow, deep inside, I found her answer to be unsatisfying. Perplexed, I had her lie supine on my table and proceeded to explore the orofacial musculature. I began with the fanlike temporalis, carefully palpating every millimeter. Starting first with the posterior section, I soon found areas where the tissue felt restricted. "That's pretty tender," B.K. remarked. See what benefits await you. 37

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