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Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
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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