resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
"Turn, Turn, Turn"
Many people are credited with saying, "If you remember the '60s, you really weren't there." Given the fact I didn't become a teenager until 1970, I actually do remember the '60s (or at least part of it). And as a child of the '60s, I was, of course, influenced by the music.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
The McGill Approach to the Lower Back (Part 1)
Stuart McGill, PhD, brings a unique combination of tools to the table. He is a scientist who also functions as a clinician. He describes himself as a medical consultant who is referred challenging patients. He is both evidence based and practical.
The Bottom Line ... From a Surgeon Who Knows
Regardless of individual relationships between providers, there continues to be a type of Hatfield-McCoy feud between the philosophies of medicine and chiropractic, particularly when it comes to musculoskeletal ailments.
Giving Chiropractic Some Much-Needed PR
Public relations has not always been the chiropractic profession's strong suit, a shortcoming that has subjected the profession to countless attacks on its legitimacy and seemingly perpetual confusion among the public and the health care world as to the skills and services doctors of chiropractic provide.
Correcting Dysfunctional Movement Patterns – Is Local Treatment Enough?
It is widely believed that mechanical, non-traumatic back pain is largely related to dysfunctional or compensatory movement patterns the body has adopted over time.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
News in Brief
Foundation for Chiropractic Progress Enrolls Second Group Member; Focus on Chiropractic Education at WFC-ACC Conference in Miami; Are You Ready for Another "Have-a-Heart" Campaign?
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Drug War Rages in Wisconsin
Based on its actions over the past 15 years (review the sidebar in the app version of this article), controversy and the Wisconsin Chiropractic Association seem to go hand in hand.
Alcohol Consumption Strongly Linked to Risk of Colorectal Cancer
Alcohol intake is one of the primary risk factors for many human cancers, and is strongly associated with cancers of the oral cavity, pharynx, larynx, esophagus, liver, breast, and notably, the colon and rectum.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Little Muscles Can Create Big Pain
Sometimes it is the smallest of muscles that can create the most servere types of pain. Some clients come in to the clinic and report that hip and leg pain is so severe it caused them to visit an emergency room, a walk-in clinic or their primary care physician. Various tests were performed and x-rays taken.
Medications and therapy were prescribed. The symptoms persisted, specialists were seen, more tests and imaging were ordered. Ultimately they are still in pain and seeking relief. While the above symptoms could have numerous origins, let's take a look at the gluteus minimus muscle, its myofascial trigger point patterns, a few manual therapy techniques and self-care tips.
The symptoms produced from myofascial trigger points in the gluteus minimus muscle can be terrifying to clients. Some report the symptoms are new and presented quickly, while others state the symptoms increased over time. Frequently, clients report experiencing "low back" or "hip pain" as they point deep in the gluteal region, down the lateral and posterior thigh and leg. They may also mention the pain is more intense when walking and standing up straight after sitting or sleeping.
The gluteus minimus is the deepest of the three gluteal muscles, the smallest in length and lightest in weight. It attaches proximally to the external surface of the ilium and distally to the anterior surface of the greater trochanter of the femur (Photo 1A). The muscle fibers of gluteus minimus and gluteus medius run in the same direction and produce the same action, however, the trigger point patterns of these muscles are very different.
When the lower extremity is free to move and all fibers of the gluteus minimus contract, they produce abduction of the thigh. When the anterior fibers of gluteus minimus contract, and the lower extremity is free to move, they produce medial rotation of the thigh. When the lower extremity is in a fixed position, as during the weight bearing phase of gait or when balancing on one leg, the gluteus minimus, along with the gluteus medius, and tensor fascia lata, keep the pelvis level when the opposite limb is raised off the ground. These same muscles can tilt the pelvis when the lower extremity is in a fixed position.
To make your practice stand out from the competition, use the camera and video recorder built into a smartphone or tablet to assess and educate clients, while documenting your objective findings. We all know the saying a picture is worth a thousand words. It takes seconds to capture a few postural analysis photos. A lateral view allows the client to see their forward head, rounded shoulder or rotated pelvic posture. An anterior view makes it easy to spot when the shoulders or pelvis are not level. Point out when the head or torso is held more to one side from midline. Record video to document restricted range-of-motion and gait.
Muscular, skeletal, postural analysis and trigger point charts are excellent for client education. Be sure to explain how to read the charts, for example in photos 1B and 1C, "X" indicates the common location of trigger points. Solid red areas indicate essential pain zones or the regions of referred pain that is present in nearly every person with active trigger points. The dotted red regions indicate spillover pain zones or the regions of referred pain on some, but not all, patients with active trigger points.
Also, note in photo 1B the trigger points (TrPs) in the anterior fibers of gluteus minimus refer into the lower buttock and down the lateral aspect of the thigh into the fibular region of the leg. Rarely do the referrals cross the ankle, but on occasion will refer into the dorsum of the foot. While in photo 1C, the trigger points in the posterior fibers, tend to refer pain more medial into the lower buttock, posterior thigh and proximal calf.
Prior to treatment, as appropriate, use moist heat, stretching and any other techniques you like. As discussed in this article, the client is positioned prone during treatment, however, you can use side lying or other positions as necessary.
Boney landmarks are used for precise hand positioning to isolate and treat the deep gluteus minimus muscle. You will be able to treat through the superficial gluteus maximus, medius and tensor fascia latae. The piriformis muscle is positioned adjacent to the gluteus minimus muscle.
The client is positioned prone. The therapist is standing at the level of the thigh facing the hip. Palpate the iliac crest, anterior superior iliac spine (ASIS) and the posterior superior iliac spine (PSIS). Next palpate the greater trochanter by placing the flat fingers of one hand in the region of the greater trochanter, apply and maintain pressure. With the other hand, flex the knee 90 degrees, then move the leg medial and lateral to internally and externally rotate the thigh. (Photo 2)
This step will isolate the superficial gluteus maximus muscle. First, shorten the muscle by externally rotating the femur. Use pincer compression to lift the gluteus maximus muscle while moving the thumbs and finger tips in opposite directions. Reposition your hands at different locations and angles to isolate the entire muscle. (Photo 3)
Now we will treat the muscle bellies and attachments on the posterior surface of the ilium. Remain standing at the level of the thigh and keep the thigh externally rotated. Start at the lateral aspect of the ASIS and treat an area on the posterior ilium, to the lateral border of the sacrum and continue to the sacrotuberous ligament. Using thumbs or fingers, check for sensitivity by applying static pressure. Next, while applying more pressure in one direction, move the skin in a with-fiber direction. Repeat treating the area in a cross-fiber direction. (Photo 4)
Reposition your hands and treat as above the area mid point between the iliac crest and greater trochanter. Reference your trigger point charts throughout the treatment session.
The olcecranon process (elbow) can be used as an optional treatment instrument. To maintain control of the movement, place one hand palm down on the treatment region. Place your oleconon process in the space between the thumb and fingers. Pressure is controlled by the treating olecranon process. (Photo 5)
Stand at the level of the clients shoulder, facing their feet. Use with-fiber then cross-fiber movements, treat the attachments around the superior border of the greater trochanter and trochanteric notch. (Photo 6)
Clients will ask for advice pertaining to self-care. Identify any perpetuating factors that negatively influence the client's condition and recommend cost effective self-care tips. For example, when standing, do they place their weight on the same leg all the time? When sitting, do they always cross the same leg over the other? Explain the effects on muscles, the pelvis and spine. Do they keep a wallet, tools or a large set of keys in their back pocket? If the answer is yes, recommend removal immediately. Do they sit immobilized for long periods working on the computer, reading, watching a movie, etc.? Suggest a timer be set to ring every fifteen minutes as a reminder to stand up and stretch. Do they drive for long distances? Plan additional time for more frequent stops to stand up, move and stretch. Do they sleep in a fetal position? Then a pillow placed between the knees and in front of the chest will be helpful. Simple actions can quickly improve symptoms.
Clients become raving fans when you teach them simple cost effective self-care tips. They feel empowered having the knowledge to care for themselves between sessions. Review their daily activities and discuss proper ergonomics. Show them stretches and other self-treatment tips. I recommend clients use professional self-care equipment verses something like a basic tennis ball. Professional materials can heated, stay warm and are available in various sizes. Show clients how to lengthen and strengthen their muscles with exercise balls and resistance bands to create structural balance.
Topical analgesics are also beneficial for relieving pain. Apply some during therapy and educate your clients on its use. Give samples for clients to try between treatments. Selling products like topical analgesics, hot/cold packs and other self-care aids can generate a tremendous amount of additional income.
Pain is scary to clients and they fear it will never go away. The pain starts affecting every area of the client's life: physically, emotionally, spiritually, financially, relationships at home and work, etc. They scheduled a treatment with you looking for answers and relief. Take the time to assess and educate clients before, during and at the end of the therapy session. Clients want to know what caused the pain, how you can help and if there is anything they can do to prevent it in the future. While the client's symptoms could have numerous origins, remember the gluteus minimus is a little muscle that creates big pain.