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The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
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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