resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
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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