resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Fish Oil: A Key Component of 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?
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.