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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.
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.
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Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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 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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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.
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.
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?
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.
January, 2001, Vol. 01, Issue 01
By Kate Jordan, NCTMB
Many massage therapists are confused and uncertain about the appropriateness of accepting pregnant clients who are in high-risk pregnancies. Who can be harmed? Can massage therapy and bodywork be useful and beneficial in a high-risk pregnancy? Are there techniques to avoid?
A high-risk pregnancy is one in which the mother or baby has a greater chance of injury or death.About 5-10% of all pregnancies in the U.S. fit in this category.
Prenatal care for women in this situation may include more extensive testing, more frequent prenatal visits, medications, and bed rest.
A woman may be identified as high risk because of her age (under 15 or over 35), family history, medical condition, or complications that develop in her pregnancy. Therapists should include a question about risk status in intake forms for pregnant clients, or in initial phone contacts. If a client indicates that she is considered to be high risk, it is essential to communicate with, and secure a release from, her prenatal health care provider, who will be a doctor, nurse-midwife, or lay midwife. Such a release asks the health care provider to approve massage therapy, and also list any precautions or limitations in massage procedures. I find it easiest to fax a release form to the doctor's office, or ask my client to hand-deliver it on her next prenatal visit.
When working with a high-risk pregnant client, it becomes even more important to observe basic precautions and contraindications for bodywork in pregnancy. Some clients may have been restricted by their health care providers in the positions they are allowed to take. This can include no sitting or prone or supine positioning, or lying on either the left or right sides. When no specific restrictions have been given, side-lying positioning is the safest, offers the greatest comfort, and increases blood flow to the heart. Side-lying is also the most common position a high-risk client on bed rest will be asked to assume.
Therapists should also modify bodywork modalities used on the legs in pregnancy. Fibrinolytic changes in pregnant women's blood makes blood clots more likely to develop. These clots can develop in both superficial and deep veins in the legs, and are not always detected by common tests. Therapists should avoid using techniques that involve deep pressure and friction on the legs. This includes, but is not limited to, deep acupressure, shiatsu, cross-fiber friction, deep tissue massage, and all percussive movement. In addition, all techniques on the legs, except for the lightest effleurage, should be directed toward the heart, since hormonal changes in pregnancy weaken the valves in veins.
Therapists should restrict abdominal massage with high-risk pregnancies to light touch, and should avoid touching the abdomen entirely in the first trimester. Since 80% of miscarriages occur in the first trimester (1-13 weeks), it is wise for a therapist to avoid even the appearance of possible contribution to the loss of a baby.
When a mother knows that her pregnancy is high risk, or develops a complication that puts her in that category, she may experience anxiety, fear, and guilt. This increased stress can further endanger the successful outcome of her pregnancy.
Massage therapy is especially appropriate for the high-risk mother, since it promotes relaxation, reduces anxiety, supports the physiology of the pregnancy, and can relieve the discomfort and muscle strain that develop when a mother is placed on bed rest. Recent research has shown that massage in pregnancy decreases the incidence of prematurity or other complications in labor.
When in doubt about the appropriateness of specific techniques for a high-risk pregnancy, therapists should consult experts in that modality, or err on the side of caution. Observing guidelines on client positioning and use of modalities will enable the therapist to provide the high-risk pregnancy client with a safe, enjoyable, and therapeutic bodywork experience.
There is a need to understand and address the unique health concerns of women. This column will continue to explore issues of particular interest in massage therapy and bodywork for women, including reproductive health, sexuality, body image and eating disorders, pain syndromes, osteoporosis, and aging.
Click here for previous articles by Kate Jordan, NCTMB.
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