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Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
February, 2001, Vol. 01, Issue 02
You Know It Like the Back of Your Hand
By Neal Cross, PhD, NCTMB
While it is unfortunate that many of you may not have access to human cadavera, the amount of anatomy that may be learned and reviewed on one's own body parts is quite amazing! We often go to the books (two dimensional) first, even when we have a 3-D anatomy right in front of us.It seems to me that when we do not take advantage of reviewing anatomy on ourselves or on another living person, we are truly missing out on a wonderful opportunity.
There is a level of disconnect in going from cadaveric anatomy in the lab to that warm, pliable tissue we feel on our clients. This disconnect goes away when we study living anatomy. It also makes our hands better educated when exploring bodies. And better-educated hands make for more accurate assessments.
Let's try a simple exercise. I am sitting in a jet somewhere over New York, headed to Chicago, then to Miami. I place my left hand on my left knee, palm down. I observe that the hair pattern changes from dense to sparse as I look distally. The transverse creases on each digit indicate the underlying MCP, PIP and DIP joints. These abbreviations refer to rather cumbersome names: metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints, respectively. A nail covers each digit distally. I see the dorsal carpal venous rete and the origins of the basilic and cephalic veins medially and laterally, respectively. If I extend each digit, I clearly see its extensor tendon move just beneath the skin. I also observe that when I extend any of my fingers, its tendon and an adjacent tendon move.
All this lets me know that I have connecting tendons between the extensor tendons of digits two through five. The pattern of these intertendons varies widely from person to person. I can palpate these tendons. If I palpate carefully, I find that digits two and five each have a pair of tendons. One is from the common digital extensor (extensor communis); the other is from a muscle named for that digit. These are the extensor digit minimi and extensor indicis. I do not have the additional tendons to digits three and four, as some people do. These tendons are from the muscle extensores digiti tertii et quarti. I also note that all of these tendons "disappear" proximally under the extensor retinaculum.
If I abduct a finger against resistance, I can readily palpate a dorsal interosseous. I also know that the four dorsal interossei attach only to digits two, three and four. The third digit has two dorsal interossei, as its midline is the reference for finger movements. If I abduct the thumb and little finger against resistance, I can palpate their abductors one for digit five and two for digit one. When I hyperextend my thumb against resistance, a prominent depression appears proximally to the thumb's base. This is the anatomical snuffbox, bounded by the tendons of the short and long extensors of the thumb and the long abductor. Exploring the distal attachments of these, I can readily palpate more than one tendon associated with two of these muscles.
This is a very common phenomenon, even though it is not mentioned in many standard textbooks. I know of no significant functional consequence, other than perhaps driving a few of my medical students to some level of madness. I can readily palpate the pulse of a branch of the radila artery in the floor of the snuffbox. If I press harder and discover point tenderness, it may be indicative of a scaphoid fracture. This is arelatively common injury caused by falling backward onto a hyperextended wrist.
I can readily palpate all of my phalanges and metacarpals. I can also distinguish the major landmarks on each. If I carefully examine the range of motion of each of the joints in each digit, I note several things. In digits two through five, the range of motion is generous about one axis, but extremely limited about the other two axes. When examining the metacar-pophalgeal joint of the thumb, I notice it has generous motion about two axes and very limited motion about the third. I also discover that the ranges of motion differ if I utilize passive rather than active movements.
So, while sitting here on the plane, I have reviewed most of the salient anatomy of the dorsum of my hand. I have considered what is normal (i.e., usual) and compared my hand anatomy to "textbook" hand anatomy. In this way, I am reminded of the great wealth of variety in the human anatomy. This variation is an easily overlooked feature, yet it is so very important to understanding human form and function. As clinicians, we should strive to learn as much as we about this variation.
Some aspects of our anatomy indicate something especially unique to the individual being examined. Unique to the back of my hand are two scars. One is about two centimeters long, lying transversely at the base of the thumb. This resulted from the errant path of a knife while I was filleting a fish a few years back. The second is a very faint, perfectly rectangular scar overlying the midline of my extensor retinaculum. This was created by a burn from a popcorn popper at a Cub Scout meeting in 1958. I hadn't thought about that in decades.
So as you can see, the human hand is a marvelous instrument far more interesting than peering out the window at the top of the clouds.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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