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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.
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.
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.
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.
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.
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.
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.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
September, 2001, Vol. 01, Issue 09
Healing in the Presence of Motion
By Ben Benjamin, PhD
Question: Is it best to immobilize a body part during the healing of a musculoskeletal injury?
When a body part is immobilized, it is more likely to form adhesive scar tissue, making effective healing much more difficult.Adhesive scar tissue can form in two ways: internal to the injury and/or external to the injury. Internal scar tissue occurs between the fibers within an injured ligament, muscle or tendon. External scar tissue refers to adhesions that form between the damaged-but-healing structure and adjacent tissues, such as nearby fascia, bone, muscle, ligament, etc. When a body part is immobilized after injury, considerable scar tissue of both types may form, making complete healing and successful treatment more difficult.
Question: Why is healing more effective and complete in the presence of full range of motion?
Answer: It allows healing to occur with a minimum of adhesive scar tissue.
Healing in the presence of full range of motion is a basic healing principle. When healing occurs without full range of movement, adhesive scar tissue forms in inappropriate places, often turning an acute injury into a chronic one. Internal and external scar tissue help perpetuate stubborn injuries and resulting pain. People restrict their movement and activities for months or years because they know if they look up too high or for too long, bend from the waist to lift even a pencil off the floor, or kneel down on their bad knee, they will suffer many weeks of pain.
When we heal in the presence of full range of motion, damaged tissue is replaced by a small-but- appropriate amount of scar tissue, in a discrete and defined area within the originally injured structure. There is no strain on the internal fibers due to adhesions; there are no external adhesions to adjacent structures; and the surrounding muscles and other structures maintain their strength and flexibility.
For instance, if an ankle is sprained and the individual immobilizes the ankle, it is likely that scar tissue will form within the sprained ligament(s), and possibly between the inflamed ligament and nearby structures such as bones and fascia. If the same individual moves the ankle joint as soon as possible within the maximum pain-free range of motion without bearing weight, then moves the ankle with weight bearing as soon as can be accomplished without excessive discomfort, adhesive scar tissue is much less likely to occur.
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