Medical Massage Therapy in Brentwood, TN

Medical Massage Therapy

Medical Massage Therapy by definition is a massage that is performed after an evaluation by a Licensed Physician who can diagnose your condition and develop a treatment plan.  The Massage Therapy can then be performed by the Physician or by a Licensed Massage Therapist under their direction.  The most common place to receive a Medical Massage is by a Chiropractor or a Physical Therapist both of which are allowed in their scope of practice to evaluate and diagnose a condition.  Medical Massages are directed at correcting musculoskeletal issues creating pain and disability.  The type of method used during a treatment vary but usually entail deep tissue, myofacial release, trigger point therapy, sports and myofacial stretching.  This type of massage is not what you would find in most massage settings.  The clinical nature of this type of massage separates the service from the spa industry.  While it is still considered massage therapy it is a diagnosis based treatment protocol with an outcome of measurable changes such as increasing range of motion.

What our Office Offers

Dr. Aiello has been performing Medical Massage Therapy for over 20 years.  He incorporates it at varying degrees in all of his treatment protocols.  With certain patients he recommends getting longer sessions than what he offers during a regular Chiropractic Session.  If postural imbalances are extreme enough he incorporates up to 60 minute sessions in his treatment protocol.  Many of patients have been living with muscle imbalance for so long that to attain relief they require a more detailed approach to multiple myofacial structural dysfunctions.  People who have had past history of major traumas, chronic repetitive work injuries, chronic poor posture, failed surgeries and extreme anxiety/stress develop muscular imbalances that overtime become so ingrained it leads to chronic pain.  These specialized massages will help people who have tried everything else with no results

Everything you need to know about getting an adjustment

What I need to know about getting an adjustment

If it is you first time getting an adjustment we will describe everything you need to know about getting an adjustment in this blog.  First Chiropractic Care is growing as people are becoming aware of the benefits and safety of this option versus what the medical profession has to offer.  Annually 22 million people visit a Chiropractor to receive spinal manipulative care.  The benefits for many common conditions have well been established.  35% of the 22 million are seeking care for low back pain, the rest are consulting a Chiropractor for care of other condition of the spine such as neck and middle back pain.  What many do not know is Chiropractic Care can benefit pain anywhere in the body.  I have many patients dealing with chronic pain in their extremities in conjunction with a spinal condition and are amazed that getting an adjustment in their spine gives them relief in other parts of the body.  Chiropractic is also an effective option for conditions such as asthma, irritable bowel syndrome, allergies, and anxiety.  Chiropractic has been a proven safe alternative to pain care and should be the first option when seeking relief from pain.


Getting Your First Adjustment

On the day of your first adjustment expect to have a physical exam to discover what your issues may be.  Sometimes an X-ray may be be necessary to evaluate more serious underlying causes of your pain.  After an exam is performed most Chiropractors will give an adjustment on the first day.  It is recommended that you wear appropriate attire that is loose fitting to make the treatment easier. It is very rare that a Chiropractic evaluation would require removal of clothes or wearing a gown. During a treatment you are on a specific chiropractic table which allows the Chiropractor to position you in different positions to perform the adjustments.  After an adjustment you should not be in more pain many people feel immediate decrease in their pain.  Many Chiropractors will also incorporate modalities such as contrast therapy, low back stretching, neck stretching, cold laser therapy, and massage therapy.   After your treatment depending on the severity of your condition you will be put on a corrective treatment plan.  Many people opt to continue care after their problem is resolved to enjoy the benefits of maintenance care.

1 Simple Change Will Help Your Posture

It may sound to good to be true that 1 simple change will help posture but it exists. It is quite simple make a routine of having your palms up.  This means when you are walking have your palms forward and when you are sitting rest your palms up. Practice this during the day take a break from working on the computer and rest your palms up on your desk, while sitting at home rest palms up, when you go for a walk spend some of the time walking with your palms forward, when you are driving alternate resting one hand on your thigh palm up.

During meditation many techniques recommend keeping your palms up.  The purpose of this simple posture change was used to open the chest for breathing and allow the heart to function optimally. Restriction of the muscles in the front of the chest and neck will not allow our rib cage to move freely and holds the upper ribs in a depressed state.  When we breath our rib cage is elevated allowing air to enter our lungs via negative pressure.  When these muscles are tense we don not inhale fully with each breath.  When we inhale with our upper ribs it opens the thoracic cavity freeing the heart up to beat optimally.  When we turn our palms up it causes us to rotate our shoulders back opening up the chest wall.  A very similar technique is used by runners after a race by putting their hands on top of their head allowing the chest to open.

Anatomy of the Rib Cage

Rib Cage anatomy

The rib cage is made up of 7 true ribs, 3 false ribs, and 2 floating ribs.  The 7 true ribs which individually attach directly to the sternum thru cartilage, 3 false ribs which have a common single joined cartilage attachment to the sternum and 2 floating ribs which do not attach to the sternum.

When we breathing correctly three components are coordinated:

  1. The true ribs elevate increasing the front to back diameter of the upper thoracic cavity.
  2. The false ribs elevate and widen increasing the side to side diameter of the lower thoracic cavity.
  3. The diagram lowers opening the up and down size of the entire thoracic cavity

The combination of these 3 motions create a negative pressure in the thoracic cavity allowing air to flow into the lungs.  You can feel these motions on your self by putting one hand on the front of the upper part of your chest (over your heart) while the other hand is on the side of the lower part of your chest and take in a deep breath.  You can feel the distinct first 2 components of breathing.  To feel the third put your hand over your belly button and inhale deeply to feel the third.

Postural Effect on Breathing

Poor posture of the neck and shoulders is the result of tightness of the deep chest and neck muscles which attach to the true ribs.  Poor posture is forward head posture and rolled forward shoulders which is a stress related adaption we develop.  It is reinforced by by working on computers, driving, and cell phone use.  The tight muscles causing this posture are the Scalene Muscles in the neck and the Pectoralis Minor and Serratus Anterior originating from the shoulder blades. Tightness of these muscles will decrease the free movement of the 7 true ribs limiting our chest expansion.  These muscles are also commonly involved in pain syndromes of the neck, shoulder, and upper extremity in Western Medicine. In Traditional Chinese and Ayurvedic Medicine they are also correlated to diseases of respiration/circulation.  The physiologic fact is they are related to both.  When these muscles are tight they lead to pain syndromes and shallow breathing.

Practicing the palm up technique will help you relax the tight muscles in the chest and neck and activate the weak muscles in the back of the neck and upper back. This method trains your body to hold a better posture.  While practicing this technique pay attention to how you breath and how your posture changes.  Incorporate this posture during your meditative technique and set your focus on the three components of breathing. Be mindful of the three components during your meditative focus and use it as a tool during the day with the palm up technique to rapidly ease stress and pain.



8 Stretches to Correct Poor Posture

Causes of Poor Posture

Poor posture is so common I see some degree in every patient who walks through my door. Upon completion of care I routinely teach the the 8 stretches to correct poor posture. The upright posture of human beings is a delicate balance of many muscles resisting gravity.  When we develop bad habits in posture it puts excessive strain on muscles as they work at a disadvantage against gravity.  The causes that lead to poor posture are vast and range from prolonged positions at work to our emotional states.  In this article we will discuss the most common issues in the upper body because they result in more presentations into my office as pain.

Starting at the top Anterior Head Carriage is when someone is holding their head to far forward.  The average weight of the human head is 8 pounds and as we move our head forward out of our center of gravity the new lever arm on the muscles greatly increases.  This excessive work on the muscles in the back of our neck and upper middle back leads to chronic fatigue and development of trigger points in the muscles. This leads to neck pain upper shoulder and middle back pain. Also as a result of carrying our head forward it results in the muscles at the base of our skull overworking to tilt our head up to see forward.  Trigger points in these sub-occipital muscles can lead to tension headaches.  In this posture the muscles in the front of the neck shorten and become tight which can result in nerve compressions such Scalene Syndrome.

As the head carries forward we simultaneously start rolling our shoulders forward.  The forward rolling of the shoulders occur as the chest muscles shorten and pull the shoulder blade forward.  The muscles that oppose the chest muscles in the middle back get lengthened and fatigue faster.  The fatigue leads to trigger points and pain in the middle back and upper shoulder area.  The tightness in the chest can cause nerve compression leading to Thoracic Outlet Syndrome.

In combination with the above muscles imbalances we also start to develop an increased curvature of the Thoracic spine.  This excessive curvature is called Hyper Kyphosis.  Hyper Kyphosis is most likely due to prolonged head posture.  Hyper Kyphosis leads to middle back pain along the spine as the muscles get trigger points from overwork caused by carrying the head forward.

8 Stretches to Correct Poor Posture

  1. Snow Angels.  Lay on the floor on your back, with palms up at your sides slowly make snow angels with your arms while keeping your hands on the floor. It is best to perform this exercise with a foam roller.  Lay on the foam roller so that is is running along your spine with your head resting on it.
  2. Kyphosis Stretch:  Using the foam roller perpendicular to your spine, lay your back on top of the foam roller in the center of your middle back with your arms overhead.  Slowly roll downward until you get to the start of your low back.  Never use the foam roller on the low back.  Begin again by starting at the base of the neck and roll all the way down to the start of low back.  Once at low back roll slowly back up to base of the neck. Repeat 5-10 times depending on how tight you are.
  3. Head hanging off Foam Roller:  Lay on the foam roller with it running up your spine like in Snow Angels.  Scoot your body up so your head is not resting on the foam roller.  Let your head hang off the edge.  Hold the stretch until you feel a release and then scoot a little higher and repeat.  when your head easily touches the floor you have scooted high enough.
  4. Chin Tucks. While seated look straight ahead and bring your chin straight back slightly causing your head to tilt forward.
  5. Cervical Flexion and Extension stretch.  While seated tilt your head as far forward as you can bringing your chin to your chest. Then alternate the opposite direction by looking up. Hold each position several seconds.
  6. Cervical Curve Support. Roll up a towel and place under your neck while laying on your back. Just lay still and relax allowing head the rest back as towel supports you neck curve.
  7. Standing reach back:  While standing reach arms overhead as far as you can.  Then bring them back as far as you can while arching back and looking up.  Hold as long is as comfortable.
  8. Standing Rotation:  Stand with arms lifted to 90 degrees at your side like you are making a T.  While reaching back with arm turn as far as you can to right in a twisting motion following with your head and gaze.  Then in one motion turn to the left as far as you can making sure your head and gaze follow.  This motion is moderately fast and smooth.  Each time try to twist and look further.  Repeat 5-10 times.  Be careful the first few attempts to make sure you do not get to dizzy.

What is Spinal Decompression?

Spinal Decompression


Spinal decompression therapy is an excellent nonsurgical option for the treatment nerve impingement.  A study in 1998 showed a 71% success rate on the 778 participants in the study. Nerve impingement related to a disc herniation or degenerative stenosis can safely be treated with this therapy.  Nerve impingements related to muscular causes will not respond and may even be exacerbated by this type of care.  It is very important to have a physician evaluate the body as a whole and not rely on just an MRI finding to differentiate the cause of your nerve impingement.

Spinal decompression can be performed in many ways in a Chiropractic Physicians office setting and even at home.  The theory behind spinal decompression is very simple, traction is performed to the spine to separate the bones and open up the disc space.  When the disc spaces are opened it creates a vacuum effect within the disc increasing blood flow to the area.  The separation also results in decreased pressure on the pinched nerve and more importantly allows impinged veins and lymphatic’s to drain swelling in the area.  During a session in a physicians office the decompression will be intermittent so you also get a pumping effect further decreasing inflammation.  With repeated visits the goal is not to suck the herniated disc back into place but to increase fluid within the disc resulting in more height and separation between the vertebrae. Recent studies are suggesting that disc herniation’s have been showed to get smaller after repeated sessions but no large studies have proven this yet. Repeated visits will also decrease the swelling around the irritated segment of the spine.

Decompression therapy can be done on the lumbar and cervical spine but in this article we will focus on methods for the lumbar spine.  Cervical methods are very similar and different tables are incorporated in the care of cervical spine therapy.  Studies on cervical decompression are much fewer and honestly I have little experience with using any table assisted methods.  I prefer using my hands for cervical decompression and home care with neck hammocks.

3 Types of Tables

  1. Cable and Pulley: Cable and pulley units have the patient lying on a table with a belt wrapped around the waste.  The patient can be lying on the their back with or without their legs being elevated. At the foot of the table a machine pulls the cable which is attached to the belt on a preprogrammed therapy.  The machine will slowly traction the back to programmed tension and then slowly release the tension. This is a mechanical traction method.
  2. Separating Table: This method has the patient lying on their back with their legs elevated.  The body is strapped to one section of the table and pelvic restraints are used hold the desired position.  The table then has separates section to create decompression of the lumbar spine. This is a mechanical method.
  3. Flexion Distraction Table: This type of table can be mechanical or manual.  This type of traction has the patient lying face down with a strap around their ankles.  The bottom section of the table tilts downward at the foot during treatment.  This motion of the table creates the traction by flexing the spine.  During a manual treatment the physician controls the downward motion with one hand and uses the other hand to apply pressure to the vertebrae above the treated area.  During a mechanical treatment the table moves the lower section based on preprogrammed  parameters.

All three of the above methods are very safe and comfortable.  They are all highly effective at accomplishing decompression and have research behind them.  I prefer to use the manual flexion distraction model in my office.  This method is most controlled by the Physician with a hands on approach.  The only downside of this type of table is it relies on the skill of the Physician to apply the needed to be effective.  The other methods are protocols that can be reproduced by a computer program.

2 Types of Homecare Decompression

  1. Straight Leg Table: This type of table the person attaches their ankles to the table while standing and then lays back.  The table the allows them rotate the table backwards to invert. The person is able to control how far back they invert themselves to apply traction to their back.  During this type of treatment the entire spine undergoes spinal decompression in a general manner.
  2. Bent Leg Table: This type of table the patient stands up against a pelvic support and they lean forward into the table bending their knee around a cushion behind their knees.  During this type of inversion the legs are supported and holding the user inverted.

I endorse the bent leg approach for one very important reason.  When the hips are flexed the low back muscle will relax and allow decompression to occur.  The straight leg tables keep the low back curved and the muscles tense preventing a an optimal decompression.

You Tube Video: 5 Stretches For Low Back Pain

Stretches For Low Back Pain

I recommend 5 stretches for low back pain to all of my patients presenting with low back issues.  These stretches are advised for any low back condition I treat.  If tolerated I recommend doing these stretches every morning for 10-15 minutes preferably before going on a morning walk.  The purpose of these stretches are to loosen the tight muscles in our spine, hips, and legs.  These stretches will also put the lumbar spine into the 2 functional movements of flexion and extension.  These stretches are based on yoga poses which I find to be the most effective method of stretching.  I highly encourage all my patients to eventually add a yoga class to their wellbeing strategy.

5 Yoga Stretches

  1. Childs Pose
  2. Upward Dog Pose
  3. Downward Dog Pose
  4. Pigeon Pose
  5. Leg Up Wall Pose

The following video we will demonstrate these poses.

You Tube Video: Energetic Theory of Allergies

Energetic Theory

Dr. Aiello explains the energetic theory of allergies in this video.  This theory is the basis of Allergy Desensitization Treatments offered in his clinic.  Techniques such have NAET have been used for the last 30 years to help people overcome allergies in a quick and noninvasive protocol.  In our clinic we have refined some testing  aspects of the older homeopathic techniques and found we can help a wider spectrum of allergies.  Homeopathic techniques relied on kits for samples. These kits did not contain the actual allergens but instead had homeopathic preparations that mimicked the allergen. In our clinic we have produced a large kit of the actual allergens in a whole state.  We test dog hair using dog hair and when we test foods we have actual food samples. All samples are in glass vials and we never contact the patient directly with the sample. After we test and determine the allergy we use energy reflex points with lasers to reverse many allergies in a single visit.  We have had success eliminating symptoms of allergies to food, pets, pollen, molds, and even electrical sensitivities.