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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.
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.
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.
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.
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.
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.
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:
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.
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.
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.
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.
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.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
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.
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.
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.
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.
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.
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."
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.
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?"
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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