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Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
February, 2001, Vol. 01, Issue 02
Let's Talk About Palpation
By Ben Benjamin, PhD
Question: True or false: Palpation is an excellent assessment method for locating injured structures.
Palpation is generally a poor and inaccurate method of locating injured structures.Just finding tender areas in the body without the use of clinical testing procedures usually leads to confusion and inaccurate conclusions. Many individuals have tender spots throughout their entire bodies. Experienced therapists can find tender or painful areas on most people in dozens of places. Finding a tender area that verifies a practitioner's hunch about where an injury is located is easy to do, because so many structures are often tender when not injured. For instance, the occipital muscles may be tender or painful when palpated because of chronic muscle tension, not because the occipital muscles are injured.
Palpation can be an important verifying factor after anatomical testing procedures have discovered the injured tissue(s). Skilled touch can also help the practitioner more precisely locate the injured tissue, once the structure has been clearly identified. For example, if anatomical testing identifies an injured hamstring muscle tendon unit, a skilled practitioner can use palpation to locate the exact site of the damage along the muscle tendon unit.
Without first identifying the source of the pain, palpation may lead to inaccurate conclusions. For example, what appears to be a hamstring injury is frequently referred pain from a low back injury.
To verify your assessment, it is generally important to compare tenderness on the right and left sides of the body, because the individual may be tender in many places as described above. If the individual is tender on the injured side and not tender on the uninjured side, this gives the practitioner a piece of corroborating evidence that the assessment is correct. On the other hand, if the uninjured side is just as tender as the injured side, the practitioner must look for further verification.
For example, the extensor carpi radialis brevis tendon (of tennis elbow fame) may be quite tender on palpation in many individuals, without being injured. But if resisted extension of the wrist is weak and painful at the lateral elbow on the right side, and resisted extension of the left wrist is strong and not painful, then tennis elbow on the right is very likely to be present, regardless of the tenderness on palpation.
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