resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.