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Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
June, 2001, Vol. 01, Issue 06
How Do You Say "No" When Your Client Says "Yes"?
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Heads up, readers: we have some work to do! Put yourselves in the place of these bodyworkers:
What do you do? What do you say? How do you handle it when your client says, "yes," but your instinct says, "no, no, NO"?
Massage therapists are better trained in contraindications today than we've ever been, and I'm proud to be part of that movement. Our clients depend on us to make informed decisions about whether Swedish massage or other types of bodywork are the best choices for their needs. Still, it is inevitable that some people who may be at risk may seek massage - and the responsibility for causing any harm rests squarely on the massage therapist. All of the scenarios described above are based on real-life situations in which clients could be injured or have their condition dangerously neglected. It could happen to any of us, at any time - in some instances, it already has.
I believe that getting good training in pathology in the context of massage and bodywork is the first step in being able to work with clients who aren't perfectly healthy. We must develop critical-thinking skills so that we can make wise choices about different types of bodywork in different situations. But the next step, often the harder step, is taking action on those choices when they may not be in agreement with our clients' wishes.
How do you do that? How do you say, "No, we can't do this today, because if we do you could end up in the hospital"?
So many obstacles are in our way: staying within our scope of practice; not wanting to lose clients; not wanting to make a mistake or overreact; not wanting to get sued; but above all, not wanting to inadvertently hurt someone!
I have some ideas about how to frame these difficult conversations with our clients (which I will share in my next column), but I work in a bit of a vacuum. I am not in a full-time practice, and I don't work in a setting in which I see a lot of people who may be ill. Instead, I spend the bulk of my professional hours teaching and writing. This is a topic that needs to be addressed by the people who are really doing it - that's you!
So here is your invitation - no, here is your assignment:
Think about the last time you had to change your plans with a client to adapt to his or her health situation. Maybe you couldn't do Swedish massage, but had to switch to something else. Maybe you had to avoid an area the client hoping to have worked on. Maybe you had to reschedule your appointment altogether. How did you do it? Did your client object? How did you handle it? Would you do it differently next time?
Send me a description of your experience. It doesn't have to be eloquent or fancy; it just has to be real. I'll edit it, and change the names to protect the innocent. I'll clear my final draft with you, and then it will appear in Massage Today so that we can all learn from your experience.
This column is meant to be a forum to share our success stories and, maybe more importantly, our mistakes for the benefit of all massage therapists. Be brave. Let us know how you handle this delicate issue. Allow us to learn from each other.
I'm looking forward to hearing from you. Until then, good health and happiness...
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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