resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Additional Stealth Factors in Chronic Somatic Dysfunction
For all massage therapists who treat clients with chronic somatic dysfunctions and pain, I invite you to consider sub clinical infections as a possible contributor to the perpetuation and persistence of their long term condition. Until one understands that such a category of possibility exists, it doesn't. Here are a few examples from my 35 years of private practice to highlight the idea:
These are but a few of the situations that have presented themselves in my clinical practice. One tip-off that this may be a relevant variable is to ask prospective clients if they have ever had a serious infection. Serious, meaning that they were hospitalized or stayed home for more than a week. For so many, infections can take months to overcome. Yes, those which occurred during their childhood still do matter even decades later.
My premise is that once a person has had a serious infection, their probability of contracting another is much more likely. And, my corollary premise is that all micro-organisms, in their never ending evolution to survive themselves, figure out ways to "hide" and eventually re-build their population(s).
Wikipedia defines sub clinical infections as "an infection that is nearly or completely asymptomatic (no signs or symptoms). Since sub clinical infections often occur without eventual overt sign, their existence is only identified by microbiological culture, electromagnetic frequency detection or DNA techniques such as polymerase chain reaction."1 Further, Wikipedia lumps microbes, parasites and viruses under this same heading as we would be wise to consider doing so as well in our thinking when dealing with clients presenting with stubbornly chronic somatic profiles. I would also include fungi which is mentioned yet, downplayed in most medical texts, especially as it relates to potential stealth urinary tract and kidney infections.2
All too often, it is not even a consideration that musculoskeletal problems can be an expression of the immune system's efforts to contain bacteria, viruses, fungi, and parasites. I am here to shout from the mountain top that this is an important category for us to consider as practitioners when addressing clients with chronic profiles.
The human nervous system often uses the joints and their associated soft tissues as "back door communication channels" via the spinal cord to get our attention that something is amiss internally. The viscero-somatic reflex arcs are the biological communication system for such expressions of internal distress. These reflex arcs are neural circuitries shared between organs, joints, and their soft tissues.3 Everything is connected to everything.4
The notion of attending to the possibility of sub clinical infections emerged over many years as my "hands-on work" with clients would reduce the number of their somatic complaints only for them then to report other significant, perhaps even debilitating, non-somatic symptoms. Or, having gone to their doctor as I encouraged, they discovered that they did indeed have an infection that had been flying under the surface of their chronic troubles. Or, encouraging them to request that their physicians prescribe an extended run of antibiotics or, to consider treating them for suspected parasites ... their chronic somatic symptoms resolved.
How could this be?
My conjecture, as previously stated, is that bacteria, viruses, parasites, and fungi have learned to "hide." It's a simple idea. I also propose that the immune system often has so many "fires to put out" that its attention is distracted by other more immediate and threatening assaults.
As humans we prioritize activities where we expend energy and resources in our lives, we space out, we ignore, we go into subconscious and conscious states of denial. We wish for this not to happen internally but my clinical experience increasingly leads me to consider that this continuum of external behavior reflects how our immune system works ... a possible manifestation of the principle "As within, so without."5
The importance of developing "hands on skill sets" that facilitate an awareness of a communication within the nervous system from the brain and spinal cord to the internal organs, and an ability to amplify this voice so it may be heard clearly by the Central Nervous System is our highest privilege and challenge.
Let us remember that the internal viscera have, on average, only 25% of the sensory neurons of the musculoskeletal system and the skin.6 The voice of the viscera is a quiet one. Easily, dysfunction and pain of the musculoskeletal system and those of our skin drowns out the muffled cry of the viscera that evolution gave a reduced capacity to signal distress.
I propose that we are in a transition phase of our collective evolution where we have the opportunity to decipher the elegance of our human design given our present extended longevity. When the human nervous system locked in its current functioning our ancestors were still on the menu of many predators. Individual survival and the collective preservation of our human species made the task of passing on our genes the ultimate priority. And, survival in that environment required the ability to flee, fight, or neither ... that is, to freeze.
Who could forget the scene in the movie Jurassic Park where the T. Rex searches for the young protagonists standing silently still right in front of him. Freezing once served a survival purpose, literally. To my perception, hiding is our modern version of this survival strategy both physically and psychologically. And, cooperation, so needed now, is construct of consciousness and choice. It is the new kid on the block within our nervous system.
I perceive these seeds exist in all of us yet, they are less hard-wired and require love and compassion of self and others to find their way to consistent expression. Let us remember that we are born without an instructional manual to show us how the human body really works. We are actively creating theories and practices which potentially reveal how our body systems interactively function as an integrated whole.
Let us consider that the coherence within us is established to use the musculoskeletal system both to distribute the strain of internal distress and as a communication device to point the way back to its source(s). We are Atlantis embodied, endeavoring to remember all that we once understood. Or, perhaps we never did possess this understanding and are having to sort it out through trial and error by resourcing the discoveries of our progenitors and the technological advances of our present time.
This notion of distribution of strain is inferred by the generally accepted referral pathways for pain that is found in most medical text books. The notion of the connection between organs, joints, soft tissues and fairly specific levels of the spinal cord are further validated by more than 150 years of their daily use. Both the professions of osteopathy and chiropractic rely upon these in guiding their treatments using manual therapy means.3 Surgeons also use these relationships in making differential diagnostic decisions.7
It has been my clinical experience however, that once the distribution of strain influences have been normalized using manual therapy, the voice of the organs and that of the immune system become more easily interpreted in more classic medical symptom profiles. It is similar to the orthopedic notion of centralization wherein as spinal nerve pressure is released, radicular pain symptoms into the extremities subside, while the more central area which is still afflicted becomes the remaining and more obvious symptom.8
The most common sub clinical infections I have encountered over my 35 years of professional practice include those related to the brain and spinal cord, periodontal troubles, the sinuses, ears and throat, the lungs, the stomach and duodenum, the gall bladder, liver and pancreas, the urinary bladder, kidneys, the small and large bowel, the uterus and ovaries and the prostate gland. Apparently, all organs and tissue structures have a vulnerability to infection.
The immediate take-away is that when a client makes progress only to then regress in their improvement without apparent cause, then the presence of one these factors needs to be considered and a referral to their physician encouraged.
One last example to highlight how quickly the immune system can respond to treatment: a pregnant woman came to me with internal left abdominal pain that would get worse after eating. She responded quite well to the first session reporting that her symptoms had gone away when I called to follow-up a few days later. However, when she arrived for her second session, 10 days later, there was obvious swelling and heat in the area where her symptoms had been. It was clearly an abscess. She was not happy when I said that she needed to see her physician before I could work with her again. When the culture came back, it was diagnosed as an E. Coli infection. Again, it is so important for us to refer our clients to physicians when we suspect internal difficulties or infections.
Since beginning to expand my awareness of the many possible influences that perpetuate chronic musculoskeletal dysfunction and pain, my ability to assist my clients has improved steadily. May it also be so for you.