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Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
September, 2001, Vol. 01, Issue 09
Miles, Myths and Musings
By Keith Eric Grant, PhD, NCTMB
Last Sunday was one of those idyllic summer days on which the inland temperatures were moderated by a gentle inflow over the hills from the San Francisco Bay. I found myself sitting with friends at a table outside of a coffeehouse in the early afternoon, pouring over maps and charts spread out before us. What had brought us together was the common purpose of running a 199-mile relay from Calistoga to Santa Cruz.
The preamble to this meeting for me has been a spring and summer reckoned by a week-to-week increase in my running. It has meant a return to some familiar places and routes, after several years of letting my distances dwindle amid the pulls of professional and parental responsibilities. In an interesting synchronicity, I had started increasing my running about six weeks before I was asked to join the relay team. It was a reminder for me that, when we set ourselves to a goal, things often occur around us to aid and further motivate us. As I've spent time running up ridges and over hills, I've had opportunities to muse on the physiology and psychology of training.
Challenging Our Lactate Threshold
There is a persistent myth that massage relieves muscle soreness by flushing out lactic acid. In truth, lactic acid, which dissociates in solution into lactate and hydrogen ions, is only present in excess during and immediately following high-intensity exercise. It is metabolized within 30-60 minutes after such exercise ceases. Moreover, lactate is not a toxic end-product; it is an efficient energy-storage and transportation medium.
As we increase the pace of exercise, our bodies produce pyruvate, the end product of glycolysis, faster than it can be processed. To keep us moving, our bodies perform a metabolic "trick" of sorts, shuttling the pyruvate to lactate. The lactate formed from pyruvate can slip quickly and quietly out of cells and into surrounding tissues and blood, where it can be picked up and used as an energy source by less active muscles . As long as our exercise intensity is only producing lactate within our body's ability to process it, blood lactate limits will only rise slightly, then stabilize. If we exceed this level of exercise intensity, the lactate levels in our blood will increase dramatically - we have passed through our lactate threshold (LT). The good news is that by designing our training to regularly challenge our LT for short intervals, our LT will increase. In running, LT is one of the best predictors of race performance.
Delayed Onset Muscle Soreness (DOMS)
Soreness occurring 24-72 hours after exercise is termed Delayed Onset Muscle Soreness (DOMS). The exact mechanisms involved in DOMS are uncertain, but researchers believe they involve micro-trauma to individual muscle fibers resulting in calcium ion leakage and a cycle of inflammation response. Most DOMS is experienced following suddenly increased workouts, particularly those resulting in eccentric contractions - muscles being lengthened while resisting against the lengthening, as in walking down stairs or running downhill. Increasing eccentric exercise gradually conditions our muscles and avoids the soreness.
Musings on Exercise and Massage
Eliminating lactic acid removal as the focus of post-exercise massage, we are left with a therapy that sports experience shows to be effective, yet lacks a clear mechanism for such effectiveness. Research indicates that the simple post-exercise administration of effleurage does not result in a increase in local blood flow or in accelerated recovery. Other research indicates that massage, combined with an active cool-down, increases the rate of recovery during short breaks between maximal efforts.
One difficulty in interpreting such results comes from the early 20th century tendency to view the body as a simple machine. We mistakenly look for massage to have direct mechanical effects. What seems more likely is that massage acts as a new input to a system with a memory. In my observation, fatigued muscles tend to remain hypertonic and shortened. When we cajole specific muscles to relax and lengthen via mechanical and neurological input, we reduce their metabolic activity and the compression they exert on surrounding tissue. In my opinion, it is not the direct action of massage, but the action of massage to create a new homeostasis, that allows the natural process of recovery to occur more efficiently.
When I run intensely, I notice results beyond the obvious. Running involves not just my legs, but the core muscles of my trunk, the stabilizers of my hips and ankles, and the coordinated movement of my arms. It requires training my determination and mental focus to challenge my muscles and breath when going up hills, and the speed and efficiency of my neuromuscular motion patterns when going down hills. At times, the fatigue and soreness bring an increased sense of vulnerability and the need for nurturing human contact - another role that massage can fill for athletes.
As I finish writing this article, I'm preparing for a backpack trip into the eastern escarpment of the Sierras -- a journey with a loaded pack along a creek, from the sagebrush-covered hillsides of the trailhead, through the miles and several thousand feet of climbing, to a high alpine lake nestled at the foot of an even higher pass. It strikes me as the perfect preamble for a massage.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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