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An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
April, 2001, Vol. 01, Issue 04
By Neal Cross, PhD, NCTMB
On several occasions in the past 10 years or so, students and practitioners have asked me about the existence of a new muscle they had recently heard or read about. As an anatomist with over 30 years experience, I immediately questioned such claims.The human body exhibits a very rich structural variability. As this variation is beyond the scope of most anatomical textbooks, it is, unfortunately, not fully appreciated by many clinicians. On the other hand, experienced gross anatomists and surgeons encounter this variation on a daily basis.
The most recent "new muscle" to be brought to my attention was a muscle that has been called the sphenomandibularis. It was described in a few journals in the mid-to-late 1990's as a heretofore-unknown muscle of mastication. It was also implicated in the etiology of certain types of headaches -- especially trigeminal pain. Ybarra and Bauer recently published a clear, concise rebuttal and explanation of this "new muscle" in the journal Clinical Anatomy.1
The temporalis muscle is a much more complex structurally than textbooks would have us believe. This structural complexity often reflects an underlying functional complexity as well. The first detailed description of the medial portion of the temporalis occurred in the early 1800's. Ybarra and Bauer discuss several other early descriptions of this portion of the temporalis in their article. After dissecting several specimens and giving an exquisitely detailed description of the complex origin and insertion of the medial head of temporalis, these anatomists discuss the possible clinical relevance of its dysfunction. They paid particular attention to the complexity of this portion of the temporalis muscle's attachment to the sphenoid. The authors describe the possible entrapment of the lateral portion of the maxillary division of the trigeminal nerve (V2) in relation to facial pain. They describe the differences in pteryogopalatine fossa anatomy as a possible factor associated with specific pain patterns. These musculoskeletal-based pain patterns may be confused with CNS based pain patterns. Even though the various authors may disagree on the definition of the medial portion of the temporalis (whether should be considered a separate muscle or not), they all agree that it may be involved in certain cases of headache.
The specific muscles associated with headache may be much more complex than we now know. Travell and Simons2 have described many of the muscles commonly (and not so commonly) associated with headache. We also need to consider specific parts of muscles that may be involved in the etiology of headache.
The point is this: the muscular system is quite variable in nature, and some of this variation may be related to complaints of pain. These variants may confuse the practitioner, or worse, may lead to a missed assessment or a clinical mistake. For example, one of the most common muscle variations in the human body is the absence of the palmaris longus. This muscle is absent 10 -15% of the time. Its absence leads to the median nerve being less protected, just proximal to its entering the carpal tunnel. You can easily test to see if you have a palmaris longus by isometrically contracting your wrist flexors against resistance (for example, place your supine hand under the edge of a desk and attempt to flex your wrist). If you have a palmaris longus, it will be seen protruding anteriorly as it passes over the carpal tunnel.
Other common muscle variants, such as the presence or absence of the peroneus (fibularis) tertius, have little or no known (at least to this author) functional or clinical significance. Another type of muscle variation can be considered hypertrophy. In this case, I am referring to the intentional or habitual overdevelopment of part or all of a muscle. One very interesting example of this kind of "functional" variation can be seen in the pronator teres in some fast-pitch softball pitchers. One common method of throwing a drop ball [i.e., a "sinker"] requires strengthening the pronators of the forearm. The resulting hypertrophy of this muscle can put pressure on the median nerve, which travels into the forearm between the two proximal heads of the pronator teres. The resulting complaint can mimic carpal tunnel syndrome, yet have nothing to do with the median nerve at the carpal tunnel. All efforts to correct the problem at the tunnel will result in no diminution of symptoms.
These are but a few examples of muscle variations. This information is definitely something to keep in mind when a patient presents with any very unusual pain pattern. It also points to the need for continuous refreshing of our anatomical knowledge and advanced anatomic study.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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