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Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
March, 2001, Vol. 01, Issue 03
Manual Resistive Tests
By Whitney Lowe, LMT
Many practitioners learned how to perform simple assessment procedures, such as active or passive range-of-motion, in their basic training. However, despite their exposure to these concepts, many massage practitioners don't realize the tremendous amount of information that can be derived from these simple procedures when they are performed correctly.In this article, let us focus our attention on the manual resistive test (MRT) and the valuable information we can derive from this procedure.
The MRT may also be referred to as a resisted isometric contraction, or simply as muscle testing. The primary purpose of this procedure is to investigate the nature of problems with muscles and tendons, those tissues that are actively involved in the contraction process. A MRT is performed by having the client attempt to engage in a muscle contraction against some resistance (usually offered by the practitioner). Figure 1 shows an example of a MRT for abduction of the shoulder. The practitioner offers resistance to the client's attempt to abduct the shoulder. This is accomplished by placing a hand near the client's elbow and preventing the client from abducting any farther.
The most valuable information in MRTs comes from combining information derived from the test with that derived from the other procedures. For example, if a client has pain during active motion and no pain during passive motion, you might suspect a problem with the muscle tendon unit. We can validate our suspicion with a MRT. It is likely that the client will have the same pain when a MRT is done, because it is also using the muscle tendon unit. Since a MRT consists of restricting motion at the joint, it is unlikely that the pain is originating from a joint pathology that involves tissues such as the joint capsule, ligaments, bursa, or any of the other inert tissues of the joint. An inert tissue is one that does not actively cause a contraction, such as the joint capsule or nerve.
Often a client will describe a motion that hurts, such as lifting the arm out to the side of the body while carrying a weight. For example, the client may describe that carrying a heavy briefcase causes shoulder pain. In an effort to hold the briefcase away from the legs, the shoulder is attempting to abduct slightly. When you perform an active range of motion in abduction, the client reports that it does not hurt. When you perform a passive motion in abduction, the client also reports that it doesn't hurt. This seems puzzling.
Why does it hurt when the client attempts to abduct the arm with the briefcase, but not in your office during the evaluation? The difference is the absence of weight (resistance) in the arm. The briefcase is acting as an additional resistance when the client is holding it away from the body. This is a perfect chance to use a manual resistive test to validate your suspicions. If you have this client attempt to abduct the arm against resistance, the client will describe the same pain as when lifting the briefcase.
What we see here is a common pattern. The muscle injury is not severe enough to be perceived when the client is only lifting up the weight of the arm. However, when overcoming additional resistance (applied by the therapist or the briefcase), the pain is evident. This indicates a lower level of injury to the muscle tendon unit. The pain can be felt when there is greater demand on the muscle fibers, but not when the demand is low, such as lifting the arm by itself.
Another factor that is very important to consider when using MRTs is what the information from the test actually means. For example, what might be the problem if your client reports pain during a manual resistive test? A frequent error of many practitioners is misinterpreting the results of a MRT. If there is pain during a manual resistive test, it is likely that there is a problem with the muscle tendon unit. However, the nature of that problem still needs to be identified. Practitioners like massage therapists who spend a great deal of time dealing with myofascial trigger points and muscular tension may jump to the conclusion that a myofascial trigger point is the cause of pain during a MRT. Myofascial trigger points often do not cause pain with a MRT. They are much more likely to be painful when you press directly on the trigger point itself.
The primary causes of pain with a MRT usually involve a disruption in the fibers of a muscle-tendon unit, such as a muscle strain, tendinitis, or tenosynovitis. Information that is derived during the client history and palpation of the primary region of pain will help verify suspicions as to the cause of the pain. While the manual resistive test is a simple procedure to perform, its value in identifying numerous musculoskeletal problems should not be underestimated.
Click here for more information about Whitney Lowe, LMT.
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