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Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
November, 2001, Vol. 01, Issue 11
What Is the "End Feel"?
By Whitney Lowe, LMT
Some of the most valuable assessment information is derived from relatively simple procedures such as passive range-of-motion tests. While many massage practitioners have been exposed to the fundamental concepts of active and passive range-of-motion testing, most have not learned how to use this information effectively in a clinical environment.In this article, we will focus particular attention on the "end feel" that is evaluated during passive range-of-motion testing. Valuable information can be derived from thorough examination of the end feel.
To perform a passive movement evaluation, the practitioner instructs the client to relax as much as possible preceding the movement. It is important to have the greatest degree of muscular relaxation prior to beginning the movement, to improve the accuracy of the evaluation and eliminate muscular effort as the cause of any pain that is felt.
One of the most important factors to investigate with passive range-of-motion testing is the end feel. The end feel is the quality of movement perceived by the practitioner at the very end of the available range of motion. The end feel can reveal a great deal about the nature of various pathologies. James Cyriax, the British orthopedic physician who developed one of the most commonly used systems for physical examination, specified six different end feels when he first described them in his writings.1
Bone to bone - This is the sensation when motion is stopped by two bones contacting one another. An example is the end feel for extension of the elbow.
Muscle spasm - When muscles are in spasm, they may abruptly halt motion prior to what should be the normal range of motion. It is likely that pain will be felt at the end of this range, because the muscle in spasm will be stretched.
Capsular - This is the end feel described for range of motion limited at the end by the joint capsule. The sensation often described is a "leathery" feel to the end of the motion, such as in external rotation of the shoulder. A true capsular end feel occurs when the joint capsule is the primary limitation to the end range of motion. Some authors have called this end feel the "tissue stretch" end feel and extended it to other tissues, such as muscles, that may stretch normally at the end of their range of motion. An example of the tissue stretch with muscles would be hip flexion with the knee held in extension, in which motion is stopped by the hamstrings.
Springy block - This end feel is the sensation of motion stopping short of where it should, accompanied by a rubbery or springy sensation at the end. It occurs most often in joints in which a piece of loose cartilage (like the meniscus in the knee) may be blocking full motion and causing the limbs to "bounce back" a bit.
Tissue approximation - This is the end feel in which motion is stopped by two masses of soft tissue pressing on one another. An example is in flexion of the elbow, in which the elbow flexors and wrist flexors press on each other to limit further motion.
Empty - This end feel has no mechanical limitation to the end of the range, but the client will not let you go any farther because of excessive pain. An example would be in shoulder impingement, in which pain from the supraspinatus tendon being compressed will limit how far the arm can be abducted. Mechanically there is no further restriction, but the pain will prevent the individual from allowing further motion.
The end feel for a particular joint may be the joint's normal end feel, or it may be pathological in nature. For example, in elbow extension, the normal end feel would be bone to bone as the olecranon process contacts the posterior aspect of the olecranon fossa. If you were performing a passive range-of-motion evaluation with your client and you got a tissue stretch end feel for the elbow in extension, it would most likely indicate some form of restricted range of motion that should be treated.
On the other hand, if you were evaluating medial rotation of the shoulder, you would expect a tissue stretch end feel, and that would be normal for medial rotation. If you performed medial rotation and got a bone- to-bone end feel, it would be abnormal for that joint and would certainly indicate a more serious joint pathology requiring evaluation by another health professional.
Passive range-of-motion evaluation can provide a great deal more information than just how far an individual can move his/her joint. When you know what kind of end feel should be apparent with each joint, you can effectively evaluate and analyze pathological limitations to motion.
Click here for more information about Whitney Lowe, LMT.
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