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News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
June, 2014, Vol. 14, Issue 06
Treating the Symptoms vs. Rehabilitating the Causes of Pain and Dysfunction
By Don McCann, MA, LMT, LMHC, CSETT
There is no shortage of clients in pain from musculoskeletal problems. All one has to do is look at the number of over-the-counter medication, chiropractors, physiatrists, orthopedic surgeons and neurologists to understand how great the need is for long-term solutions for musculoskeletal problems.This raises the biggest challenge for massage therapists - how to achieve long-term rehabilitation from pain for their clients so they can resume their normal life activities pain free? If successful in achieving this, massage therapy can become the overall treatment of choice for those with musculoskeletal problems.
Finding the Cause
When clients come for massage treatment, much of their pain is a symptom of an underlying cause. If massage therapists spend most of their time treating the symptoms and not addressing the cause, they are likely to either create a client who is dependent on constant treatments just to stay out of pain or, as most clients do, eventually look elsewhere into more invasive and costly treatments from the medical profession that lead to even worse problems. So, our challenge is to first understand the origins of musculoskeletal pain and then to treat it by rehabilitating the causes of the pain. This leads to long-term resolution of the client's musculoskeletal problems. When massage therapists do this, they will be constantly in demand and could possibly earn the respect of the rest of the medical profession.
Within the musculoskeletal field, structural imbalance results in pain and dysfunction, whereas structural balance equates to pain free function. Therefore, the origins of musculoskeletal pain and dysfunction are actually easily observed in every client who seeks treatment for pain. This is usually the core distortion. Babies are born with it. The rotation of the iliums and the hip complex in infants and children is well documented by Dr. Terry R. Yochum and Dr. Lindsay J. Rowe in their description and images of normal acetabula angles in children from birth to three months and three to twelve months.
The left ilium is rotated anteriorly resulting in a functional long leg. The right ilium is rotated posteriorly resulting in a functional short leg. This imbalance of the iliums and sacrum collapses further into rotation with life experiences until symptoms of pain become prominent. It is very easy when doing structural evaluation of a client to notice the twist in a standing client's body. There are many differences of opinion as to these actual rotations due to the methods of evaluation and interpretations of what is observed. If, however, you use functional kinesiology, the client is supine and asked to raise the right leg about 10 inches off the table. When the right leg is pressed down toward the table, there is significant strength. The same test done with the left leg will show significant weakness. "The rectus femoris is a powerful extensor of the knee, but is weak when the hip is flexed," along with the hip flexors. The anterior rotation of the left ilium (flexion) prevents the rectus femoris and hip flexors from being functionally strong. This is a consistent finding over 38 years of evaluation of clients with the core distortion and is just one of the many functional tests that verify the imbalances in the pelvis that is a major part of the core distortion found in the body.
Finding a Release
The discovery of the core distortion in the cranial motion reveals that the wings of the sphenoid are restricted in a pattern identical to the ASIS of the iliums, and that the ridge of the occiput is restricted in a pattern identical to that of the PSIS of the iliums. Working with the cranium to release the imbalances in the cranial motion as described previously, results in a balancing of the rotations of the iliums, an equalizing of the leg length and a leveling of the sacrum reducing curvatures of the spine. This is accomplished by releasing the soft tissue restrictions responsible for the imbalances in the cranial motion. Amazingly, this has been the missing link to restoring the balance and weight bearing support to the hip complex which includes the sacrum, ilium and SI joints.
The core distortion is involved in the entire musculoskeletal system including the cranium and its specific imbalances relating to TMJ imbalance and dysfunction. Therefore, if we start looking beyond just the areas of pain and look at the overall balance and function in the body, we find the source of most clients' pain. This covers TMJ, headaches, the entire spine and appendages into the feet such as plantar fasciitis and compartmental syndrome. As you can see, it involves the entire musculoskeletal system. With the imbalance of the iliums and sacrum, we get exaggerated curvatures of the spine putting excessive stress on the edges of the discs leading to early degeneration, thinning and even herniations and ruptures of the discs.
When evaluating the muscles and soft tissue using functional kinesiology, 50% of the muscles are operating at a 50% or less efficiency due to this imbalance, leaving them susceptible to injuries such as strain, tearing, adhesion and scar tissue build up. In addition, the shortening and over contraction of some of the muscles directly result in compression along the nerve pathways and many types of nerve pain.
The body in core distortion is also much more susceptible to injuries at the joints. The imbalance of the core distortion results in a dysfunction at the joints since at least half the muscles at the joints are severely weakened and cannot support the stabilization and balance under strain. No matter how effective your soft tissue therapy is, if the weaknesses at the joints due to the core distortion are not brought back to strength, then the causes for the injury or pain are still present and full rehabilitation has not been achieved. However, if the core distortion is released, the structure is brought back into balance including the joints and the soft tissue is brought back to full functional strength. This will produce long-term improvements. The symptoms of pain will disappear. The importance of releasing the core distortion back into balance and function to reduce and rehabilitate the conditions resulting in pain cannot be stressed enough. This is a long-term solution to the structural imbalance resulting in pain and dysfunction of at least 90% of musculoskeletal problems.
It is amazing that most of the medical field has not looked at the imbalances in the entire structure, but rather focuses on individual areas. Consequently, there is no awareness of the overall pattern of imbalance found with the core distortion. There are some chiropractic and osteopathic treatment models that do include working with the entire structure, but mainly by adjusting the joints and vertebrae. While the chiropractors adjust joints and bones, when the soft tissue is engaged in movement and structural stabilization, it moves the bones back into the patterns governed by the tension and weakness of the soft tissue. Whenever structural drawings are made of the musculoskeletal system, the imbalances of the core distortion are obvious. Massage therapists have an advantage as the soft tissue governs the organization alignment and function of the musculoskeletal system. It is possible to stand our clients up for full structural evaluation and see how the core distortion relates directly to their musculoskeletal pain. It is then possible to work with specialized soft tissue protocols to bring the core distortion back into balance, not only in the area of the symptoms (pain), but also throughout the structure so every part of the structure supports function and balance.
Consequently, the reoccurrence of the old dysfunction and pain is prevented. This is most effectively accomplished when the cranial imbalances caused by soft tissue restrictions of the cranium are released first, which bring the hip complex back into weight bearing support balancing the sacrum and equalizing the leg length. This creates a balanced weight bearing foundation for the spine reducing spinal curvatures and excessive pressures on the disc. The improved structural balance is seen at every joint and restores strength to the weakened muscles surrounding each joint.
Once a foundation for rehabilitation of the musculoskeletal system has been achieved by releasing the core distortion cranially, the body is trying to balance, there is weight bearing support at the hip complex and there is restored strength to the musculature governing every joint. At this point, further soft tissue work to release ischemia and trigger points, old myofascial holding patterns, adhesions, scar tissue and nerve compressions will be working with the body which is already moving into optimal balance and function. When this happens, structural balance results in pain free function. Even old injuries, damaged joints and discs can heal. Clients really are able to resume their normal life activities pain free.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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