resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
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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