Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
May, 2001, Vol. 01, Issue 05
Snap, Crackle and Pop, Part I
By Neal Cross, PhD, NCTMB
The human temporomandibular joint (TMJ) is involved in the etiology of several clinical complaints, including jaw pain, tongue pain and headache. Although small, this joint has a rather complex structure and function.By placing your middle finger over the TMJ (just inferior and slightly anterior to the external auditory meatus) and slowly opening and closing your mandible, you should feel a nice smooth motion bilaterally. This motion will start as a jaw opening (depression); at the end of the movement ( at the point just prior to fully opening the jaw), you should feel the joint glide anteriorly. Some will feel one side move out of synch with the other; others may feel one or both sides suddenly "snap" anteriorly. A few may feel a "crackle" (crepitus) on one or both sides; still others may feel and/or hear a "pop" as the articular disc releases.
Let's consider some of the underlying anatomical and functional aspects of the TMJ. The TMJ is formed by parts of two bones: the temporal bone and the mandible. More specifically, the condyloid process of the mandibular ramus fits into the mandibular (glenoid) fossa of the zygomatic process of the temporal bone. This mandibular fossa is bounded posteriorly by the retroarticular process and anteriorly by the articular tubercle. There is a well-defined articular disc within the joint cavity and an articular capsule enveloping the joint. (Author's note: For more information, please refer to one of the atlas pictures listed below.) Interestingly, the disc separates the joint cavity into two functionally separate compartments: one inferior and one superior. Another unique feature of this joint is that the articular surfaces are covered by dense fibrous connective tissue instead of hyaline cartilage, as is usual in synovial joints. This type of connective tissue allows for joint remodeling. The disc attaches to bone medially, laterally and posteriorly, but blends with the articular capsule anteriorly. The articular capsule and the lateral ligament further stabilize this joint. Medially, the sphenomandibular ligament assists in TMJ stabilization. Posteriorly, the stylomandibular ligament assists in joint stabilization.
The TMJ is considered a compound joint, because it operates as two separate but related functional units. The articular disc and the mandibular condyle form the first functional unit. These two act together in most hinge-type movements. This is when the jaw is depressed. The condyle and the disc together move (glide) on the articular eminence for full mandibular opening. The jaw may also be protracted (protruding the mandible) or retracted. In addition, there is lateral displacement about the TMJ. The primary muscles producing these mandibular movements are: depression-lateral pterygoids with help from the digastric, mylohyoid and geniohyoid muscles; elevation-masseter, temporalis and medial pterygoids; retraction-posterior temporalis; protraction-lateral pterygoids; and lateral displacement-contralateral lateral pterygoid. Earlier descriptions of a separate "superior pterygoid" muscle acting solely upon the articular disc seem to have been unfounded.1
The innervation of the TMJ is derived from branches of the mandibular division of the trigeminal nerve; specifically, the masseteric and auriculotemporal branches. The blood supply is derived from the superficial temporal and maxillary branches of the external carotid artery. Lymphatic drainage is primarily into the deep cervical nodes.
Next month, I will discuss various TMJ dysfunctions as they relate specifically to the underlying anatomical features. It will then become clear why so many clinicians of various types treat TMJ dysfunction.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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