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The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
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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