Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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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?"
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."
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.
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.
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.
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.
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.
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?
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
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.
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.
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?
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."
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
April, 2006, Vol. 06, Issue 04
A Reflexogenic Relationship: The Muscle/Joint Battle, Part 1
By Erik Dalton, PhD
Reflexogenic - Producing or increasing reflex actions between muscles and joints.
Myoskeletal - All soft tissues forming from the mesoderm including muscles, ligaments, joint capsules, discs, fascia and bones.
Surprisingly, the "key" that unlocked the door to this muscle/joint mystery initially was revealed in a presentation to the American Back Association by the legendary osteopath Dr. Philip Greenman when he stated, "In the presence of vertebral dysfunction, palpable fourth-layer muscle hypertonicity will always be found." The fourth-layer transversospinalis muscles include the rotatores, multifidus, levator costalis and intertransversarii (Fig. 1). These phylogenetically old laminar-groove muscles are the first structures neurologically stressed by joint blockage, and often are the very same tissues that prolong the dysfunction.
Working with the understanding contained in Greenman's statement, the massage therapist can maximize therapeutic outcomes by:
Under normal conditions, the superior vertebra of each joint smoothly flexes, extends, sidebends and rotates on its inferior neighbor. Too often, however, hypertonically short spinal muscles bind one side of a joint altering its axis of rotation and center of gravity (Fig. 2). When therapists continually palpate lumpy, stringy or wiry fourth-layer intrinsic muscles session after session, underlying joint dysfunction is present and must be addressed.
According to John Mennell, MD, all of the body's synovial joints must have at least 1/8 inch of movement not controlled by voluntary muscle contraction. The term "joint play" was coined to describe this essential principle of normal, pain-free, non-restricted vertebral movement. Deep-tissue myoskeletal techniques focus on restoring joint play and stopping the reflexogenic battle between muscles and joints.
This article offers an overview of current theories and myoskeletal strategies for preventing and correcting "catch 22" pain/spasm/pain cycles perpetuated by abnormal muscle/joint reflex actions.
Fourth-Layer Spinal Muscles
Working through the bulky paravertebral muscles and fascia, bodyworkers' sensitive fingers frequently encounter small, hard and sometimes tender knots in the deep transversospinalis muscles of the erector spinae group. These highly innervated tissues located in the medial groove adjacent to the spinous processes contribute to rotation, sidebending and extension in each spinal segment. According to Greenman, "Fourth-layer muscles are dense in spindles and function more as proprioceptors than prime movers. When dysfunctional, they alter joint mechanics locally and alter the behavior of the larger muscles of the erector spinae group." Therefore, muscles such as the multifidus and rotatores (and suboccipitals) are perceived as dynamic ligaments designed to stabilize the spine. Acting as supporting, information-gathering ligaments, they allow the brain to coordinate more gross movements of the vertebral column via longer-lever muscles that have greater leverage and mechanical advantage.
The power generated by short fourth-layer spinal muscles is easily underestimated. These highly innervated little critters readily pack enough punch to lock spinal joints open or closed with their strong torsional forces (Fig. 3). Holding a telephone with the shoulder to one ear is a perfect example in which prolonged cervicothoracic sidebending unilaterally compresses joint surfaces, creating reflex transversospinalis and erector spinae spasm. This predictable neurological firing pattern represents the beginning of many functional scoliotic cases seen in the clinic. However, specially designed deep-tissue massage techniques can be very effective in releasing hypertonic myofascia and recovering joint play to fixated facets. Regrettably, some of the tightest transversospinalis muscles are buried deep to more superficial groove muscles such as the multifidus and spinalis, making it difficult and sometimes impossible to mobilize them with fingers and thumbs (Fig. 4). So, how can massage therapists access and release short, concealed spinal muscles that bind joints and perpetuate aberrant pain and posture problems? In part two of the "Reflexogenic Relationship" series, I will demonstrate innovative soft tissue techniques for creating joint-play in fixated facets.
Editor's Note: Part two of Erik Dalton's article, along with a complete list of references, will appear in the May 2006 issue of Massage Today.
Click here for previous articles by Erik Dalton, PhD.
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