Dive into the world of manual therapy with our comprehensive guide to Dermoneuromodulation (DNM). Learn about the groundbreaking techniques pioneered by Diane Jacobs and continued by practitioners like Michael Reoch, and uncover how DNM leverages the nervous system and skin to modulate pain perception. Discover the evolution of manual therapy, the importance of understanding the sensory nervous system, and practical insights into implementing DNM in your practice. Whether you're a seasoned therapist or new to the field, this blog post provides valuable insights into the future of pain relief through innovative manual therapy approaches.
Read Morehealth tips
News about Well+Able and massage therapy, pregnancy, running, and health
COVID-19 CLOSURES
To our patient community,
We would like to thank you for choosing Marcy and Mike at Well+Able as your RMTs and we remain committed to ensuring that we continue to keep all of you front of mind in our decisions. Because of the unprecedented and unforeseeable COVID-19 global pandemic that is putting you, your loved ones, and our own health at risk, we are unable to provide our role in your care and maintain social distance. It is for this reason that we have no choice but to close our clinic effective at 9 pm Thursday, March 19 until we are legislated to go back to work. We do not take this situation lightly as we understand the impact that this can have on your healthcare. Please email us directly at michael@wellandable.ca or marcy.reoch@gmail.com if you have any comments or questions about future appointments.
Thank you for your understanding as we come together as a community to fight this virus pandemic.
Yours in health,
Marcy Reoch, RMT and Mike Reoch, RMT at Well+Able
Price Changes for 2019
Please be aware that the prices for RMT services starting January 15, 2019 will be changed to reflect our increased expenses and comply with our RMT fee schedule. Thank you for your understanding.
‣ 20 minutes massage Therapy $45.00 ‣ 30 minutes Massage Therapy $70.00 ‣ 45 minutes Massage Therapy $100.00 ‣ 60 minutes Massage Therapy $120.00 ‣ 90 minutes Massage Therapy $190.00 ‣ 120 minutes Massage Therapy $190.00
Podcast interview for Massage Therapy Now
Marcy and Mike Reoch run their own Registered Massage Therapy Clinic in Ladner, BC. In this episode we talk about the benefits and challenges of being a couple running a business together, how family values influence their business
Read MoreNeurocentric Approach to Massage Therapy
What I propose is an approach to these people’s painful conditions that puts the nervous system first. Specifically, I’m looking at pain that originates from a mechanical deformation of nerve tissue and that can change with position or movement.
Read MoreWhat to expect with your first Massage Therapy visit
A short video by the RMTBC on what to expect from a Massage Therapy visit with an RMT
What to expect from your RMT during your Massage Therapy visit
Photo by Moncherie/iStock / Getty Images
Are Tension-Type Headaches Treated by Massage Therapists?
Tension-Type Headaches: what can you expect?
According to the International Association of the Study of Pain (IASP), Tension type headaches (TTH) are:
“headache attacks with mild to moderate pain intensity and is often described as having a pressing or tightening (non-pulsating) quality that is not aggravated by routine physical activity, such as walking or climbing stairs. The pain lasts for at least several hours to days and is predominantly felt bilaterally.”
TTH originates from a combination of tissue sensitivities in the head and neck as well as how the nervous system interprets the signals from those tissues. Development from episodic to chronic TTH is thought to be accompanied by increasing Central Nervous System sensitivity to the tissue signals like a car alarm that is triggered by a loud truck. Diagnosis of TTH is based on a “featureless” headache and normally results in a neurological examination. Most commonly found are tender spots around the head and neck. Additional diagnostic workup by your doctor is important if you have additional symptoms other than headache. Chronic TTH is often associated with medication overuse.
Tension-type headache is the most common form of headache. It can be categorized into three subtypes according to the International Classification of Headache Disorders based on headache frequency:
(1) infrequent episodic TTH (<12 headache days/year), (2) frequent episodic TTH (12-180 days/year), and (3) chronic TTH (>180 days/year)
(2) frequent episodic TTH (12-180 days/year)
(3) chronic TTH (>180 days/year).
Stress seems to play a big role in Tension Headaches. Managing that stress can be beneficial in reducing frequency and duration of these headaches.
According to the International Association of the Study ofPain:
The lifetime prevalence of episodic TTH is almost 80%, and that of chronic TTH is 3%. Women are slightly more affected than men. The age of onset peaks between 35 and 40 years, and prevalence declines with age in both sexes
o Headaches are the most prevalent neurological disorders and among the most frequent symptoms seen in general practice.
o 50% of the general population have headaches during any given year, and more than 90% report a lifetime history of headache.
o The average lifetime prevalence of migraine is 18%, and the estimated average prevalence in the past year is 13%.
o The prevalence of migraine in children and adolescents is 7.7%.
o Tension-type headache is more common than migraine, with a lifetime prevalence of about 52%. However, only frequent or chronic tension-type headaches are disabling.
o 3% of the general population have chronic headache, i.e., a headache ≥15 days per month. They are the most severely disabled.
Clinically, this is the most easily and effective type of headache for an RMT to treat. In our experience, after an initial assessment and treatment, future treatments usually should be around 30 minutes 1-3x a week with a follow up in 1-2 weeks depending on severity and chronicity. After your first visit the normal course is of at least a 50-80% resolution of head pain around 30 minutes after the massage treatment. This relief should last from 3 days to 2 weeks and will increase with future treatment.
Make sure to ask for some home care such as exercises and or movements which will depend on the tissues and structures that are sensitized then work together with your Massage Therapist to create a plan of action that is effective and obtainable.
Our Aging Population: Mobility, Wellness and Independence
What a Great Weekend!
We are always looking at increasing our skills and knowledge to better serve our patients. On May 5th, Marcy and Mike attended the sold-out RMTBC symposium: Our Aging Population: Mobility, Wellness and Independence.
Registration at the beautiful Anvil Centre in New West
After a rousing First Nations welcome by Coastal Wolfpack, Isobel Mackenzie, B.C. Seniors Advocate started off the day with a fascinating, in depth look at the demographics and conditions of todays' seniors population. Her talk was a great start to the days theme that Massage Therapy can play a key role in keeping mobility and wellness in seniors thus helping you keep your independence as you age.
The first keynote address was Dr. Lorimer Moseley, one of the most respected pain researchers in the study of pain. Dr. Moseley is a fantastic presenter. He has been a strong promoter in giving people with persistent pain more tools to manage their pain.
The second Keynote was with Dr. Karim Khan who is a MD at UBC as well as the editor of the British Journal of Sports Medicine. He gave a great talk on how diet and exercise is very strong medicine in preventing illness. The day ended with an esteemed panel of Andrew Nemeth, Yvonne Poulin and Dr. John Sloan who provided tremendous information on their work with seniors.
simple lifestyle modulators: diet, exercise, avoidance of smoking and excess alcohol, together with moderate physical activity reduce colorectal cancer by 50%
- Karim Kahn
Dr. Karim Khan is a leader in sports medicine and rehabilitation, known for advancing evidence-based practices. As a physician and researcher, he has greatly contributed to injury prevention and recovery. Dr. Khan promotes holistic health, focusing on physical recovery and overall wellness. His approachable nature and expertise make him a trusted resource for athletes and individuals seeking optimal health. He inspires colleagues and patients, solidifying his role in enhancing the community's health and performance.
From left: Gordon MacDonald, Peter Behr RMT, Yvonne Poulin RMT, Dr. John Sloan,
Andrew Nemeth RMT.
Mike catching up with colleagues
We had a fun and informative Saturday! Thanks to the RMTBC who always put on a world class symposium every year. Also, I would like to thank them for some of the photos and content of this post.
What is DNM? By: Michael Reoch, RMT →
The term DNM Stands for Dermo (skin), Neuro (nervous system) Modulation (a change from one state to another). It is a method of manual therapy/massage therapy used to change the state of the nervous system from a painful, hyperactive state to a less painful and reactive one through the skin receptors. Diane Jacobs, a Canadian PT with 40 years of experience, developed DNM as a way to treat people with chronic and persistent pain better. I have had the pleasure of learning from and working directly with Diane over the last four years.
She explains the background of the method:
The nervous system is comprised of 72 km of nerves and a brain 5 times bigger than it needs to be to run a critter our size. Even with all this length, even with the giant brain, it's tiny, only 2% of the whole body. Still, because it's busy 24/7, even when we're asleep, and because it runs all operations, it sucks up an amazing 20% (!) of all available oxygen and glucose all the time at speeds of about 270 miles per hour, so it's a big energy suck. You are part of it. It's not part of 'you' how we usually think of our body parts. You are part of it. 'You' are the human bit in there, but most of it we have in common with all the other critters out there that have vertebrate nervous systems. It runs 'you'. It looks after 'you'. It keeps 'you' alive. It puts 'you' to sleep at night so it can do other things, but it keeps your heart beating and your lungs working, right? It's your survival machine and your threat detector. It wakes 'you' up in the morning because it needs you to get it something to eat. It never shuts off! It's your operating system. It's an old, evolved thing, and some parts are really old while other parts are quite new, and they're all hooked together, and sometimes it can get itself into a glitch. Usually, that's all that's the matter. So, we do a systems check and help it fix itself.
This unique nervous system goes all the way from the brain to the skin and back. There are Billions of sensors in our skin. On average sensors are one to two cells apart. These sensors tell our brain what is happening in the world around us, what is happening within us and what is happening to us. There are many different sensors and each have specific rolls. There are sensors for just heat others for just cold, there are sensors for just heavy pressure others for light pressure, ones for quick stretch others for slow stretch and so on...
DNM is a method of manual care that puts the patient and their needs first. Instead of operating a recipe treatment, the treatment is an interaction between the patient and the therapist. We work together to find the areas that need attention and remove the tenderness and pain felt in that area. The focus is on changing the signalling within the nervous system to decrease your pain. Pain does not happen in the muscles and other tissues but in the nervous system itself; therefore, whether or not the area of pain is damaged, we can reduce that pain with DNM.
The manual part of DNM involves changing the input signalling from some of these receptors to help the brain get a better picture of what is happening to/in the body. We want to show the Brain that the area where you feel pain is not under the threat that the brain perceives it to be in.
Some effects of an effective DNM treatment:
You will get sleepy
You will have less swelling/inflammation after
You will feel warming, an ease of movement, and a softening of hardened muscles
Your pain relief will continue throughout the day of the treatment and will usually peak 72 hours after the treatment.
See it in action
Pain BC Blog Talk Radio
Michael Reoch will be featured on the Pain Waves Radio Show Thursday February 6th, 2014 at noon-1pm. He will be talking about Massage Therapy for chronic pain. If you miss the show you can listen later at your convenience. If you do get the chance to listen live you can phone in and ask a question and Michael will do his best to answer.
How does stress make pain worse?
Do you ever have neck or back pain after a stressful day? Maybe a headache?
Why do you get tight muscles when something stresses you out?
Nerve receptors are involved in pain generation. Their job is to send a signal to the brain that they have been stimulated. The brain knows that a signal from these receptors in the body is usually a sign of danger and will usually then decide that the body is in pain, specifically in that area. In his talks, David Butler often mentions adrenaline-sensitive peripheral nerves and the amazing ion channel turnover. Specifically, this means that these nerve receptors can become extra sensitive to the chemical adrenaline, also called epinephrine. With this sensitivity, less stimulation is needed to send a danger signal to the brain. Think of a car alarm set to go off when someone breaks the window. When the alarm is hypersensitive, it may go off if a loud truck drives by. No damage happened to the car, but the alarm still went off. When we are stressed out, our bodies produce more adrenaline. This can be a good thing because it helps us to prepare for action. Unfortunately, if a nerve is damaged, stretched, or pressed on for too long, it will create "baskets" of adrenaline-sensitive fibres. As David says here:
"If a person has a highly adrenoreactive area of peripheral nerve and if they are in a state of persistent elevated stress then repeated firing into the CNS will occur. And if the person is stressed, central inhibitory controls will probably be lifted anyway, and a persistent neuropathic pain state may ensue."
What this means is that if someone has a nerve that is sensitive to adrenaline and is always stressed out, the danger signal to the brain will be almost constant. If that is the case, the Drug Cabinet in the brain will be lifted away, and persistent pain will likely develop. Not fun.
Fortunately, you have some control over this. The first line of defence is to reduce your stress level, thus reducing your adrenaline. Also, knowing that your pain is not from a damaged muscle but stress chemicals, your brain will be less likely to think of the signal as pain. Third, if you get out and move your body in a way that reduces any specific nerve perturbations you will have less chance of a future sensitivity. Most good Manual Therapists (RMT, Chiro, PT, etc) will know how to help you do this.
Most forms of massage therapy have good evidence behind their ability to reduce stress. Two of the modalities Michael implements, DNM and Simple Contact, work on a model that directly addresses pain and adrenal-sensitive nerves.
If you have any questions about this, feel free to contact us at well+able. We would love to help you out. It would also be beneficial to watch the previous stress video, the Drug Cabinet video, and the What is Pain video.
A short video on managing stress
Dr Mike Evens has set up a youtube channel with some great health tips. Here is his 11 minute video full of some fantastic ideas for managing stress
Welcome to Well+Able
After months of hard work getting the clinic up and running we now have a website. Please look around and check it out.