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The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
May, 2001, Vol. 01, Issue 05
By Ben Benjamin, PhD
Question: Do muscles, tendons and ligaments regularly refer pain down the arms and legs in ways that appear similar to a nerve compression injury (often referred to as a nerve root compression, radiculopathy or pinched nerve)?
Muscles, tendons and ligaments often refer pain down the arms and legs in ways that are similar to nerve compression injuries.For instance, a ligament sprain in the low back will often cause referred pain down the lateral leg to the area of the lateral gastrocnemius. A torn gluteus medius muscle in the buttock will often refer pain down the leg to the lateral calf. Nerve compression to the L5 nerve root may similarly cause pain in the lateral thigh and calf.
Another instance in which confusion arises is when there is a strain in one or several of the rotator cuff tendons, or a nerve root compression at the C5 level in the neck. For instance, a severe injury to the supraspinatus tendon will often refer pain down the arm to the wrist. This same pattern of referred pain will often be similar to the pain felt from pressure on the C5 nerve root.
Because pain patterns from nerve root compressions may overlap the areas to which muscles, tendons and ligaments refer pain, these injuries often confuse experienced and inexperienced practitioners alike. It may be easy at such a point to throw up your hands and say, "It's too complicated and difficult to figure this out, and it isn't going to change my treatment, anyway." In my experience, this is a mistake. Various types of massage and other hands-on therapy techniques can be very helpful for muscle, tendon and ligament injuries, but they are useless for a nerve compression injury. However, having the knowledge and skills needed to differentiate these different types of injuries is useful and vital to the therapist interested in working with clients who suffer from pain and injury problems.
Let's say a client comes in with a history of three to four months of pain in an area indicative of a potential muscle, tendon or ligament injury, or a nerve compression problem. Assessing the client with specific active, passive and resisted tests will help you identify a soft tissue injury. However, if you see that the involved muscles have atrophied, and the client reports a feeling of pins and needles and numb or numb-like sensations in patches of skin, you may suspect a compression injury of a nerve. In such a case, your soft-tissue techniques will not help this client; you need to refer him/her to a health care provider or other specialist. Referred pain to the arm from suprapinatus injury or C5 nerve root injury.
It's worth the effort to learn when to refer clients out because they have an injury you cannot help, and when to treat them for something you can help. It makes your work more effective because you can work primarily on the people and the pain problems you can actually help. Obtaining the skills to differentiate these confusing injuries makes you a better therapist, and adds enormous confidence to yourself and your work.
Remember, it is always wise to have a physician check a client who has a serious pain or injury problem.
Click here for more information about Ben Benjamin, PhD.
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