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Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
March, 2002, Vol. 02, Issue 03
Body Mechanics and Continuing Education
By Sandy Fritz
Editor's note: Sandy Fritz, a practicing massage therapist for over 20 years, is the author of Mosby's Fundamentals of Therapeutic Massage and co-author of Mosby's Basic Science for Soft Tissue and Movement Therapies and other massage textbooks such as Mosby's Massage Therapy Review.She is the owner and director of the Health Enrichment Center, Inc., School of Therapeutic Massage in Michigan, and maintains a private practice for professional football players. Sandy also provides consultation to many massage schools in development. I've spent many hours pondering how I could encourage practicing massage therapists to improve their body mechanics. Because proper use of body mechanics can enhance the longevity and success of your career, continuing education regarding body mechanics should be stressed to all massage therapists.
Most research in ergonomics had focused on elements of lifting and motion. Massage application is more about the application of compressive force. Adaptation of biomechanics for those who lift and move is counterproductive for massage application. Over and over, I hear clients ask for more pressure without being poked and jabbed. The major goal for massage is to apply an appropriate broad-based compressive force to soft tissue, using the least amount of physical effort.
Massage has become a system unto itself. The historical basis for massage was as more of an integrated system utilizing movement, exercise and massage. Seldom was massage applied for a full hour. Now the one-hour massage is the expected standard for massage professionals. Five massage sessions per day is necessary for most to achieve financial stability in a typical workweek. No wonder that a recent study by Watson (reported by Gerry Pyves in the Journal of Bodywork and Movement Therapies, vol. 5, no. 3, July 2001) showed that 78% of massage professionals have experienced a work-related injury. Something must be done to help our profession. A change in paradigm about how massage is delivered is necessary. The idea that the hand is the primary delivery tool is outdated. The forearm, the flat space below the knee and the foot are better suited for sustaining the abnormal loading of the joints and repetitive movement strain on the joints and soft tissue required when giving massage.
Compressive force is applied 90 degrees in relationship to the body contact. This means that the client needs to be positioned so that you can lean against an upward slope on the body and maintain about a 45-degree angle at the shoulder. When the knee and foot are used, a 90-degree angle against the tissue can be achieved easily.
The joints need to be stacked and stable; the gliding motion should be provided by moving the feet in a forward position, instead of leaning at the waist and reaching forward. Avoid petrissage or kneading movements. The same effect can be achieved by applying compression to the tissues, then moving the adjacent joint actively or passively.
Are you asking yourself, "What can I do to improve my body mechanics?" First, be aware that there could be a problem, and the problem may not be apparent to you. Just because you have your education under your belt and practice massage does not mean you are using your body in the most efficient way.
There are many objects to consider when discussing body mechanics, including the massage table, floor mats, stools and chairs.
Is your table the proper height? As a general rule, your fingertips or first knuckle should reach the top of the table when your arms are hanging at your sides. This varies depending on if you have a long or short torso, legs or arms. If your table is a little short, you will be able to accommodate by widening your stance, but will often end up bending at the waist and developing low back fatigue. A table that is too tall will cause you to use upper muscle strength instead of leaning and using leverage to apply the compressive forces. Test your table. Are you thinking it's too tall or too short? If so, experiment to see if it feels more comfortable set at the suggested height. If it was too tall and you adjusted it, at the end of a day of practice you may feel less lethargic because you used less upper body strength. If it was too short, your back will ache. More often than not, raising the table a bit helps.
One way to notice incorrect body mechanics (besides the pain you may be feeling by the middle or end of your day) is by using a mirror to check yourself frequently in different positions:
If you were unable to notice incorrect uses of your body mechanics and think you are doing just fine, wouldn't you rather be safe than sorry? Ask a few other massage therapists to get together so you can evaluate each other. Watching each other will provide more objective feedback. If you are only doing two or three massage sessions per week, you may be able to get by with bad body mechanic habits, but if your are doing two or more massage sessions per day to total 10 massage sessions or more per week, injury will likely result.
Here are some ways to do a self-test:
You should have answered yes to the above questions. If these tips don't help, check out continuing education providers that offer classes in body mechanics or related classes. Choose your course carefully. You do not want to replace one set of bad habits for another. One place you can locate classes is on NCBTMB's website: www.ncbtmb.com. You can also call (800) 296-0664 to find CEU providers in your area.
Remember that the human body is designed for movement and range of motion, not for the compressive forces required when giving a massage. Appropriate body mechanics must be maintained to provide adequate pressure throughout the massage. Body mechanics systems that are based on movement, such as dance and martial arts systems, are not designed for the delivery of compressive force required for massage. Learning to effectively use your knees and feet while working on a mat as part of your massage applications can allow you to rest your arms and hands. Some applications of shiatsu and Chinese massage systems incorporate these applications of pressure delivery.
A well-trained massage professional should be able to effectively provide five to six massage sessions a day, five days per week, without excessive fatigue or pain. If you are unable to maintain this type of work pace, your body mechanics is the most likely cause. Take action now so that you can have the career you desire.
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