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Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
Happenings in Our Evolving Profession
Good things seem to be happening for our profession and recent developments show we are all on board. Talking about being on board, this September The Veterans Express-Purple Heart Tour is expected to make its way out of the station.
What They Don't Say Could Hurt You
I have written previously regarding the difficulties of drawing information from patients who are poor historians, forgetful or just plain uncooperative. The thought to revisit the topic occurred recently during preparation for an upcoming seminar.
Are They Finally Fixing Medicare Reimbursement?
Even with federal sequestration cuts taking effect in March, including a 2 percent reduction in Medicare reimbursement to health care providers, hope may be on the horizon in the form of a much-anticipated, perpetually suggested overhaul of Medicare's Sustainable Growth Rate formula, which serves as the basis for determining physician reimbursement.
Correcting Kid Logic in Health Care and Research Design
A recent broadcast on public radio described a fascinating phenomenon known as kid logic.
The Potter's Wheel: Reflections on Practicing in a Technology-Driven World
In my very early years of practice, an older patient named Cora would call me at home, usually late Sunday night after she had consumed an unknown quantity of beer.
Have a Heart: Say No to Soda
It's not enough that soft drinks and other sugar-sweetened beverages have been linked to cavities and weight gain, among other negative health consequences.
Chiropractic: The Right Choice for Relieving LBP
"Low back pain (LBP) is a common threat to medicine and a reasonable threat to all national health care systems. ... Reducing ineffective treatments is necessary to decrease the LBP associated costs."
Remembering Joe Weider (1920-2013)
With the death of Joe Weider, the world's most famous body-building visionary, crusader, fitness magazine publisher and icon, on March 23, 2013, chiropractic has lost one of its greatest friends and supporters.
Going Shoeless: The Pros & Cons of Barefoot Running
With the subculture of barefoot runners and the products catering to them growing daily, just about every chiropractor has been asked at one point or another about their opinion regarding barefoot running.
We Get Letters & E-Mail
Patient Perception and the Farce of "Fast Relief"; A Fly in the Ointment; Persecuted for Choosing to Practice Chiropractic.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
Why You Should Get to Know the National Vaccine Information Center
Barbara Loe Fisher has been a diligent advocate for providing parents with the information necessary to make informed decisions regarding the usage of vaccinations for their children.
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
Some Thoughts on the TMJ
The temporomandibular joint is an interesting and dynamic articulation that can cause a lot of problems.
What the Science Says About Magnesium Stearate
It's often been said that scientific studies can be used to support just about anything. But discoveries are never made one study at a time.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
News in Brief
Controversial Florida PIP Law Under Review; D'Youville Chiro. Students Learning Art of Co-Managing; And the Award Goes To...; F4CP Recognizes Major Contribution by ChiroTouch.
Side Effects From Big Pharma: Wellbutrin – Dangerous for You and Your Baby
Are some of your pregnant patients taking Wellbutrin? If so, it could be a danger to them and their baby. This drug is extremely popular, but it has a serious history.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
SOAP Notes: It's Time for a Cleaning
I have been planning for some time to write an article about how traditional SOAP notes do not fit chiropractic practice, and the unfairness of holding DCs to a model clearly created for and primarily applicable to medical physicians.
A Building Block of Healthy Aging
Coenzyme Q10 has gained enormous attention in recent years, and with good reason —it's the Energizer Bunny of the cellular world.
Medicine Presents: A Great Opportunity
The changing nature of health care presents both opportunities and challenges. While we tend to focus on our profession, we can sometimes forget the impact other health care professions can have on us.
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
Research Abstracts From the Journal of Manipulative & Physiological Therapeutics
Effect of Pain Relief on Lumbar Muscle Function and Activation; Effects of Thrust Amplitude and Duration of HVLA Spinal Manipulation; Immediate Effects of Upper Thoracic Manipulation on Cardiovascular Response.
March, 2012, Vol. 12, Issue 03
A New Method for Dealing with Hip Rotators
By Shari Auth, MA, Lac., LMT, NCBTMB
Remember "Piece Goods Often Go On Quilts" or as my anatomy teacher taught us, "Pirformis and the Go-Go Queens?" Both are memorization tools for recalling the names of the six deep lateral rotators of the hip.The first letter of both phrases corresponds to the first letter of one of the rotators (i.e. piriformis, gemellus superior, obtuator internus, etc.) Left-brain knowledge crammed in during massage school all to be forgotten later, with the exception of the fashionable piriformis. We may have forgotten the names, but in clinical practice, hip rotators are hard to forget. Tight hip rotators contribute to lumbago, sciatica, turn-out in the legs and feet, and just plain old hip pain in people who travel, sit or clench too much.
Clients hip rotators can be contracted and short for a long time before prompting them to see a massage therapist. For the average person, yogis and dancers aside, this is one of those hard-to-reach, hard-to-stretch and overall unconscious places.
The Auth Method is a system of massage that makes the health and well-being of the practitioner's body the priority, without sacrificing results. The method was developed with the belief that with the right tools, technique and body mechanics, performing massage can be effortless. In the Auth Method, the forearms are the preferred massage tool for the majority of massage work for a few reasons. The forearms are more durable massage tools than the hands, fingers or thumbs, so you can work longer on your clients with less wear and tear on your body. When it comes to hip rotators, this durability provides a strong tool for getting into the deep muscles of the pelvis. Let's face it, the hands, fingers and thumbs are no match for the large muscles of the hips.
Massaging the hip rotators with the fingers or thumbs can be pokey and uncomfortable for the client. When using the forearms, you have a broad surface area of contact, so the sensation is smooth and not pokey. This broad contact is ideal for working larger muscles groups because you can massage more of your clients in less time. Finally, the forearms are perfect for leaning into. I recommend using body weight instead of muscular force when massaging. Using muscular force is exhausting and runs the risk of working too deep. By using body weight, you'll naturally sink to the first layer of tight tissue; as that layer releases, you'll sink to the next layer of tight tissue. Work patiently, layer by layer, to create a deep tissue massage experience that is painless for your client and effortless for you.
Stretch and Release
Placing a muscle in a stretched position while performing massage is a wonderful tool for a massage therapist, because it intensifies the massage without further taxing the massage therapist. Extra effort by the therapist isn't needed for the recipient to receive deeper work. This comes in handy when you're working on a large or muscular client. Taking a muscle off the stretch softens the muscle and allows the practitioner to sink deeper into the muscle. Alternating between putting a muscle on and off the stretch while massaging is an effective technique for releasing a muscle. It incorporates all the benefits of stretching with massage, coupled with the benefits of taking a muscle off the stretch.
First Things First: Warming Up the Hip
Because the hip rotators are deep to the gluteus maximus, it is necessary to first massage the gluteus maximus. After the gluteus maximus has released, it is easier to contact and work with the deep rotators. With your client in prone position, undrape their hip. Tuck the drape securely under either leg. The drape should cover the client's midline. Effleurage the hip and leg, sufficiently spreading oil throughout. Stand alongside the table at the level of your client's anterior superior iliac spine facing down the table toward their feet. Spread your legs a legs-length apart with either leg in front. If the leg closest to the table is in front, try leaning your hip against the table for comfort. Rest your forearm closest to your client just below the iliac crest with your elbow skimming the lateral border of the sacrum. Be mindful to use your upper forearm versus your middle of lower forearm. Using the upper forearm provides you with more leverage.
Rest your other hand on your client's leg. (Image 1) Gradually lean your body weight onto your forearm and sink into your client's hip muscles. The massage table should be low enough that you can comfortably drop your body weight onto your client and high enough that your back is straight. Glide down your client's hips, tracing the border of the sacrum with the edge of your forearm and ending the stroke at the ischial tuberosity. Keep your forearm parallel with the massage table so you have a broad base of contact, this will ensure that your massage stroke isn't too pokey. (Image 2) Repeat the stroke as needed to warm up the hip and release the gluteus maximus.
Deep Hip Rotators
To massage the hip rotators with a stretch, pick up your client's ankle and bend their knee to 90 degrees. (Image 3) Repeat the same hip stroke with the knee bent; when you reach the vicinity of the rotators, about halfway down the sacrum, move their ankle and lower leg laterally. (Image 4) This will put the hip rotators on a stretch. You will feel the rotators become taut as they are being stretched. This taut quality will increase the intensity of the massage for your client, so be mindful not to overstretch or apply too much body weight onto the area. You may only have to move the ankle a couple of inches until the rotators have an adequate stretch — proceed slowly. By massaging the hip rotators in the stretched position, you are able to release tight hip rotators as well as lengthen short hip rotators.
Slowly bring the ankle back so it's hovering over the knee, releasing the stretch in the rotators, softening the tissue and allowing you to sink in deeper on the rotators. Repeat this stretch and release over the entire region of the rotators, increasing the stretch as necessary, moving slow and steady. This is a deep and often tight area for our clients. Encourage your clients to breath into their hips during this work. This will relax them and promote circulation in the area.
Releasing tight rotators can reduce turn-out in the legs, changing the alignment through your client's lower body. I have noticed that my clients are more grounded, centered and relaxed after receiving deep bodywork in the hips. Check in with your own body when massaging. Be conscious of keeping your shoulders relaxed, back straight and legs active. Remember, this is your time, too. At the end of the massage, if our clients are more relaxed but we are more tense, we have only succeeded in transferring tension rather than reducing it. Massage, even in deep areas of the body, can and should be easy on your body.
Shari Auth, MA, Lac., LMT, NCBTMB, is a licensed massage therapist and acupuncturist, and is certified in the Rolf method of structural integra-tion. She is the creator of the Auth Method and has a full-time practice in New York City. Auth teaches continuing education workshops and has a DVD, Auth Method of Therapeutic Massage: A Guide to Using the Forearms. For more information, visit www.authmethod.com or www.shariauth.com.
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