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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.
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.
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.
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.
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.
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Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
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.
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.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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?
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.
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.
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.
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.
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 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.
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.
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.
Educating Massage Clients: What's Appropriate and What's Not
All massage therapy experiences should be provided in a safe, comfortable and trusting environment. No one should ever do anything to your body that you have not given permission for. A therapist should never be sexual in any way with a client. That includes sexual touching, sexually explicit comments to or any sexual act whatsoever. Every well-trained massage therapist understands – or should understand – the guidelines that follow.
After initially greeting a new client, the therapist and client agree on the type of session, if it was not clearly prescribed when booking the appointment. In a spa or wellness setting, a client may have selected a particular type of treatment and this should be clear without discussion. However, the therapist always asks if there are any areas you particularly want worked on or completely avoided.
The extent of the history-taking depends on why the client is there. If they are coming for a relaxation massage, the therapist will ask certain questions to make sure the treatment is safe. At a minimum, the therapist should ask about any surgeries, medical conditions, medication, injuries, pain, skin conditions, allergies to anything the therapist may be using and any sensitive areas. A woman should be asked if she is pregnant.
Who's In Charge?
The client is always in charge. If a therapist of any kind ever does anything that makes a client emotionally or sexually uncomfortable, the client should speak up immediately or just tell the therapist they want to terminate the session and leave. Clients see a massage therapist for many reasons. Some come for a relaxing massage, postsurgical or post-cancer treatment, or for pain or injury treatment. In some types of massage and bodywork, there may be some physical discomfort. Be sure that you and your client have agreed on how much discomfort is okay and how much is too much. For example, if treating for an injury, there may be some discomfort, which is part of the treatment process. If a client comes for some myofascial or Rolfing work, inform them that this kind of treatment, which is very different from massage, can be quite painful.
Nudity and Draping
Every client should undress and dress in private; the state of undress is up to the client. Some clients remain fully clothed except for their shoes. Others wear a hospital-type gown, leave their underwear on or are nude. A client should always be securely covered or draped with a sheet or towel, which should be tucked in or draped in such a way that it will not easily move.
The entire session is about the client and what they need to have in this particular session. How much pressure is used, where the therapist works and doesn't work, and if you talk or remain quiet is all up to the client. It's not about the therapist's needs.
There is a power differential between practitioner and client. The power differential is inherent in any therapeutic relationship. There is an implicit acknowledgment that the practitioner has more knowledge in this area than the client. The power differential exists for the purpose of bringing benefit to the more vulnerable individual. In healthcare, the power differential is amplified by the physical aspects of practice. The client is usually lying down and unclothed, which has the psychological effect of increasing the imbalance of power. Maintaining professional boundaries is the responsibility of the practitioner, even if the client requests or instructs the practitioner to behave otherwise. The practitioner also has a duty to stay aware of how the power differential may affect the client's ability to raise concerns.
Appropriate and Not
A massage therapist should never touch the genital area of the client. This is either sexual abuse or prostitution. In most parts of the U.S., massage of the breast is off limits. In the few states where it is legal, there must be written consent by the client. In other countries (for example, in certain provinces of Canada), where the training is much more extensive, breast massage is part of massage therapy training and is permitted where appropriate. There are cases where breast massage may be indicated. For example, if a nursing mother has a blocked milk duct, breast massage is sometimes indicated. Or if there is a painful post-surgical scar, certain types of massage therapy may be helpful. However, it is never appropriate to perform massage on or touch a woman's nipples.
The area of the upper inner thigh, either in front or back, is an area that is rarely touched. More specifically, the therapist never works within two to three inches of the genital at the inner thigh. It can evoke sexual stimulation, fear or both. It is a private area that is left to intimate partners. The only exception to this guideline is when there is an injury to the muscles or tendons in this area. In this case, the client has come to the therapist to work on this issue and has explicitly agreed to be treated in this area. When this is done respectfully and with draping, it is not a problem. The therapist carefully and securely drapes the client's upper inner thigh with a sheet or towel before working.
The buttock area is generally included in a massage therapy session but doesn't have to be if this is not an area you want worked on. Work on or very close to the anus or motions that clearly open the cheeks of the buttock should never happen.
Reporting an incident: If the client feels their boundaries have been crossed or violated, they should say something immediately. some people freeze physically, emotionally and verbally when they have experienced posttraumatic stress disorder at some time in their life and this could be a problem. Inappropriate actions by therapists can be reported to the police, the Massage Therapy Board of Registration and/or the District Attorney's office. These types of actions cannot be tolerated and do great harm to those in our profession who do an admirable job in helping people live more pain free lives. Make sure your clients are educated as to appropriate behavor for them and for you, so there is no miscommunication or misunderstandings and your practice can continue to thrive.