resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
July, 2014, Vol. 14, Issue 07
Following the Body's Clues
How 29 minutes of massage therapy changed a life.
By Debbie Roberts, LMT
There was a higher power at work when I helped Marianne. You know as a therapist when you jump right in and try to help someone and all your efforts work, but you are not entirely sure why.Then your mind is reeling in the possibilities of what just happened, followed by you can't wait to get your nose into a text book to further investigate how exactly you made those dramatic changes. A twenty-nine minute demonstration at a massage therapy conference using a gross cervical movement screen, a piece of equipment that allows firm pressure and my hands led the way to an incredible, life changing event for my volunteer, Marianne.
On January 5, 2012, Marianne and five of her children were in their minivan stopped about 10 cars away from a red light. She was one and a half car lengths away from the car in front of her. Her two-year-old had just woken up and they all had turned around to give the child attention, when they were hit from behind and then shoved forward to hit the car in front of them. The driver was texting while driving and the approximate speed was 55 miles per hour on impact. She was knocked unconscious from the whiplash as her head did not hit anything during the accident. She became conscious as they were prying her foot from underneath the gas pedal. She was taken to the emergency room and a CT scan of the neck was performed. She was told nothing was broken, given a muscle relaxer, pain medication and then sent home. The total ER visit was only about four hours. She woke up the next morning with varied symptoms. When she followed up the next day with the doctor, he referred her to a neurologist because he felt she had a severe concussion and a possible stroke because she had lost function in the right side of her face and neck.
In the two and half years of seeing the neurologist, he had prescribed every kind of medicine for migraines which never worked. She felt she wasn't being heard, that the headaches were not vascular headaches. He prescribed narcotics, muscle relaxers, ultra sound, tens machine and physical therapy. He also prescribed Botox for the migraines.
She started seeing a chiropractor who performed adjustments, Dural unwinding, myofascial release and cranio-sacral therapy. The treatments never seemed to last. "I got more relief in the 30 minute demonstration than in the 29 months of medical care, physical therapy, chiropractic care and not to mention the $100,000 I have spent elsewhere," said Marianne.
By now I am sure you are wondering what on earth did I do so different than the other well intentioned skilled therapist and doctors? How did I know I had helped her? As a group, we looked at her range of motion of flexion, extension, side bending and rotation. Well, she had none. Yep, you heard me none. In order to drive, she turned her whole body. After two years, she literally had no motion to her cervical spine to look in any direction and she was forced to move through her thoracic spine. I was very nervous to work on her after she revealed her history and by observation her neck appeared to have permanent damage. The other thing that was odd, nothing showed up on the MRI to indicate such severe damage that would be contributing to this kind of loss of motion.
Addressing the group, I talked about changing muscle inhibition left over from an accident and how to approach the injury using isometrics for neuromuscular re-education of the mechano-receptors. The importance and value of taking the movement screen, also that I didn't have any preconceived notion that in 30 minutes what changes I could make. In other words, I was willing to fail.
I began doing the demonstration placing the cranial device under her T-spine, doing soft tissue work to the scalene muscles and trapezius. I then tried some very light isometrics with no post-isometric stretch to see if I could help re-set the mechano-receptors and encourage length to the scalene, SCM and trapezius muscle. I didn't stretch the neck because she grimaced every time I moved her neck in the slightest. The direction of lateral flexion with the isometric set off her pain pattern over the right eye. Since this elicited the pain pattern of the stroke, I didn't do any further cervical isometrics.
I continued the demonstration and used the cranial device to support the neck and let her doing some gentle rocking to her tolerance. The place I always go looking when someone has severe headaches is the first rib. Hers was very prominent and had no motion on springing. Leaving the cranial device at approximately T2-3, I explained that first rib dysfunction can give a lot of headaches and hers felt really elevated and fixed. I used the technique of positional release which uses the elbow and forearm to guide the humerus lateral to medial towards the spine to influence the first rib, asking the typical question of any pain or discomfort, and there was none. I then asked her to put her head in a slight rotation to the side of dysfunction and placed my left thumb over the rib head and asked her to make an isometric contraction of the forearm adducting to her side. I pulled the scapula out further with her head in the same position and asked her to contract again. I repeated the above about four to five times. I also rolled her onto her side just far enough to place the cranial device at the level of T3-4 along the rhomboids and middle trapezius using my fingers began a posterior to anterior push. I repeated the lateral to medial positional release into the spine and finished again with her on her back the cradle resting under her neck this time and repeated the downward adduction of the humerus into her side.
By now, they were flashing the lights at us to end the demonstration. She sat up carefully and I stopped the crowd that was trying to leave and said, wait we need to see what it is we accomplished. You assess in the beginning and at the end of every session don't you? I don't know who you could have picked up off the floor first, her or me. She flung her head back into extension; easily tossed her chin to chest into flexion without difficulty looked over her shoulder, and with some reservation accomplished about 20 degrees of side bending. She continued to take her head from flexion to extension because it was so exciting. It happened so fast, I grabbed her and said don't do that. I was so taken back by the amount of motion I was afraid she would hurt herself somehow or undo what I had done.
What had I done? I went to one of my resource reference books, An Osteopathic Approach to Diagnosis and Treatment, third edition. There, in chapter 78 Practical Applications and Case Histories of the Thoracic Cage, I found just what I was looking for. An explanation and a case history of something very similar to what I had experienced. I also called one of the author's to get her input into the somatic dysfunction of the first rib.
She explained that the first rib is probably the rib most commonly involved in somatic dysfunction of all the ribs. It is affected by trauma, stress and posture, as well as by the dysfunction of the C7-T1 complex. The patient may complain of "shoulder" pain, stiff neck, upper back or neck pain, and here it is an inability to turn the head while driving. The first rib can impinge the neurovascular bundle as it passes between it and the clavicle through the costoclavicular space. Since the anterior and middle scalene muscles assist in raising the first rib, they can also compress the brachial plexus when they are in spasm and result in thoracic outlet syndrome symptoms.
What I had accomplished was helping a first rib dysfunction that was hung up on the C7-T1 vertebra. The whiplash injury with the head turned to look in the back seat created an eccentric load to the scalene and trapezius. The force was so great that it displaced the first rib. I used the cranial tool at approximately the C7-T1 vertebra in a posterior to anterior position and I was able to use isometrics and positional release lateral to medial resulting in a release of the first rib.
I encouraged Marianne to continue to get body work done to the scalene's, trapezius, rhomboids and SCM to decrease the hyper tonicity. This will help to encourage the first rib to have better motion. Massage therapy is not an exact science that is why we have so many modalities to choose from. I wasn't sure I would be able to help, but I was willing to be vulnerable and fail. Marianne is eternally grateful I tried.
Click here for more information about Debbie Roberts, LMT.
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