Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
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.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
February, 2002, Vol. 02, Issue 02
The Tuina Treatment of Tennis Elbow
By Bob Flaws, LAc, FNAAOM (USA), FRCHM (UK)
In 1982, I was studying acupuncture at the Shanghai College of Chinese Medicine and working as an intern in the acupuncture department at the Long Hua Chinese Medical Hospital. Sometimes, during the heat of the summer, there were not that many patients to see in the acupuncture ward, so I would wander through the hospital to see what else I might learn.As a graduate of what was then the Boulder School of Massage Therapy (BSMT), I had practiced massage for several years prior to studying acupuncture. Thus, I was immediately fascinated by what I saw when I discovered the tuina, or Chinese medical massage, ward.
The movements I witnessed were unlike anything I had learned at BSMT. I was especially enamored with the idea of specific protocols lasting 15-30 minutes for the remedial treatment of specific conditions. Therefore, I arranged to study tuina the following year and to work as a tuina intern at the Yue Yang Chinese Medical Hospital, also in Shanghai. Eighteen years later, I am still as enthusiastic about tuina as I was then.
Below is the tuina protocol I learned for the treatment of tennis elbow. It is based on the rolling school (guan fa pai) of tuina popular in Shanghai founded by my personal teacher, Ding Ji-feng.1 Dr. Ding had been practicing this method for over 50 years when he taught it to me.
Western Medicine and Tennis Elbow
Lateral epicondylitis, also called tenosynovitis (and more colloquially, tennis elbow), consists of inflammation of the tendons attached to the lateral side of the elbow at the epicondyle of the humerus. Patients with tennis elbow experience pain in the lateral aspect of the elbow, which may radiate into the forearm, and occasionally into the hand. The pain occurs with grasping activities and may be accompanied by a sense of weakness. An achy discomfort may also be present at rest or at night after activity. This inflammation may be caused by a sudden violent injury, repetitive strain or microtrauma. Tennis elbow occurs equally in men and women and is most commonly seen in patients between the ages of 35-50. Tennis elbow is found not only in tennis players, but in baseball players; swimmers; carpenters; plumbers; meat cutters; musicians; or anyone who repeats an arm motion over and over.
The Western medical diagnosis of lateral epicondylitis mainly consists of physical examination of the affected area eliciting abnormal tenderness to palpation over the lateral epicondyle. X-rays may show calcium deposits on the lateral epicondyle but are not typically required to make this diagnosis. Bone spurs only occur in 20% of tennis elbow patients. The Western medical treatment of tennis elbow mainly consists of rest, anti-inflammatory medication and the application of ice. This is supplemented by stretching and strengthening exercises; straps; wrist braces; and cortisone shots. Surgery is indicated in approximately 5% of cases when all of the above measures have failed over a course of several months and pain continues to prevent activity. The success of tennis elbow surgery is generally 85-95% excellent relief of pain.2 However, patients typically require 3-6 weeks of recuperation before returning to work, and several months before returning to sports or heavy use of the arm.
Chinese Medicine and Tennis Elbow
Chinese disease categorization: Tennis elbow is called zhou lao (elbow taxation); zhou tong (elbow pain); and shang jin (damaged sinews) in Chinese medicine.
Chinese disease causes: Taxation detriment with possible contraction of wind cold evils.
Chinese disease mechanisms: Overwork taxation causes detriment and damage to the sinews and vessels of the elbow. On the one hand, there is insufficient blood to nourish the sinews; on the other hand, there is blood stasis obstructing the free flow of the vessels. This may be complicated by external contraction of wind cold evils due to defensive qi vacuity.
Treatment principles: Soothe the sinews and free the flow of the network vessels; quicken the blood and transform stasis; regulate the qi in the channels and vessels.
Other adjunctive measures may include the use of moxibustion locally on the elbow (either indirect, roll moxa or direct, non-scarring, "grain of rice" or thread moxa), or warming with a TDP heat lamp.3 Internal administration of Chinese medicinals based on the patient's individual pattern discrimination is also quite helpful.4
To get a satisfactory result with tennis elbow, the patient needs to refrain from all activities, be they work or play, that aggravate the condition. Until or unless the patient is willing to allow the inflammation of their lateral epicondyle to heal, no amount of tuina or Chinese medicinals is going to get a satisfactory effect. If the cause of this inflammation is work-related, the patient should be advised to modify their equipment or work habits. This may mean using a lighter hammer or tennis racket or seeking professional advice from an ergonomic specialist or kinesiologist.
While ice is indicated within Chinese medicine for recent traumatic injuries and acute inflammations with redness, swelling and palpable heat, it is usually contraindicated for tennis elbow. Even though Western medicine defines lateral epicondylitis as a species of inflammation, it does not usually present heat signs and symptoms according to Chinese pattern discrimination. In fact, given the common age range of patients with tennis elbow and its Chinese name, elbow taxation, this condition is usually a vacuity condition complicated by cold and/or blood stasis, all of which may be worsened by the application of cold. This is why the external application of warmth is usually so important for the treatment of this condition.
In my experience, both in China and the U.S., tuina is definitely an effective therapy for the remedial treatment of tennis elbow.
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