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Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
February, 2002, Vol. 02, Issue 02
CranioSacral Dissection Sheds New Light on Effects of Palpation
By John Upledger, DO, OMM
In early April 1999, a small group of us had the privilege of working with a human cadaver that had been neither embalmed nor frozen. It had only been kept in a cooler to inhibit the deteriorative processes.It was the body of an 80-year-old male who had died only 34 hours earlier. The cause of death was lung cancer.
This particular dissection echoed back to others I had participated. By studying unembalmed cadaveric skull samples - skulls that had not been calcified from the effects of chemical agents - we were able to demonstrate the potential for movement between cranial bones. That fact that would become the underlying basis for what I would later name CranioSacral Therapy. Now, some 20 years later, this new round of cadaver dissections would allow us to understand the effects of this therapy in ways we could only have imagined.
To preserve the intracranial membrane system, we performed a parietal window dissection. Carefully, we removed brain tissue with no instruments but our gloved fingers. We also fully exposed the spinal dura mater to explore the interrelationships of the intracranial and spinal dural membranes, as well as their effects upon each other.
Those interactions in such a fresh cadaver were remarkable. We could see and feel the tensions developed in the falx and tentorium as we gently tractioned the dural tube from points between the occiput and the sacrococcygeal complex. The reverse, we found, was also true. As we lifted the frontal, parietal or sphenoid bones, we could see and feel the effects upon the spinal dura mater. It was all very exciting.
Now I'd like to describe our findings as we explored the effects of various activities upon the palatine bones. As you may know, a "stuck" palatine bone can be very difficult to release. It can also cause major problems, from severe headaches to visual disturbances and even seizures.
First we evaluated the resistance of motions induced by our fingertips on the palatine bones. The resistance was quite high - it required a push of at least half an ounce (15 grams +/-) to move either palatine in a cephalad direction. Pressing on the eyeball did not cause any movement in an inferior direction. This wasn't surprising, considering there was no "life" in this body. (We questioned the concept of "life," however, when we noticed the dural membrane stretched at about five grams of traction, yet eemed to contract against us as we increased the traction.)
We then dissected the right eyeball and its surrounding fat pads, which were copious even though the cadaver was lean and muscular. The fat pads clearly occupied at least 40 to 50% of the volumetric space in the orbit. We exposed the superior aspect of the vertical pillar of the right palatine bone. We were careful not to disrupt the fascial lining of the orbit, so we couldn't be accused of liberating fascial restrictions attached to the intraorbital aspect of the palatine bone.
We proceeded to induce palatine bone motion, with one finger upon its orbital surface and another finger upon its horizontal contribution to the hard palate in the mouth. The vertical and transverse mobilities of the palatine bone were still quite restricted. That's when another therapist placed a finger in the mouth, contacting the internal aspect of the right zygoma. The zygoma was decompressed laterally. This technique broadened the floor of the orbit and dramatically freed the palatine bone so that its responses to even slight finger-induced motions were extremely smooth and easy.
I had been using this technique on my patients for some time, based on the theory that a stuck palatine bone might often result from abnormal medial compression of the zygoma. It seemed effective to move the zygoma laterally to release the bone. It was most gratifying to see and feel how well the technique worked from the inside. The principle is simply to widen the floor of the orbit using the zygoma as your "handle." As the floor widens transversely, the trapped palatine bone is released and can move vertically up or down. Usually it's caught in a cephalad (upward) position.
Having witnessed the amount of fat in this orbit and the small area the palatine bone contributes to the intraorbital surface, it would seem to take an inordinate amount of pressure upon the eyeball to significantly facilitate palatine motion in a caudad (downward) direction. I much prefer to use the zygoma bone as the recipient of my force. After all, the eyeball is a delicate and intricately designed bag of fluid with subcompartments that can be much more easily damaged than the zygomatic bone.
Even with my level of experience in dissection and treatment, I found this type of dissection both enlightening and confirming. Since then we have continued to conduct similar dissection classes on a regular basis through the Institute. These classes focus on fresh, unembalmed cadavers, highlighting functional explorations rather than static observations. After all, no matter what anyone teaches you, there's nothing like discovering it with your own hands.
Click here for previous articles by John Upledger, DO, OMM.
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