resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
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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