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Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
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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