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Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
March, 2002, Vol. 02, Issue 03
The Korean Four Constitutional Types, Part I
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
Most students and practitioners love looking at the different constitutional types in Chinese medicine and find it very useful in their practice. People who have studied Asian bodywork are familiar with the Five Element constitutional types.Many also know the European Six Division way of assessing fundamental characteristics, as popularized by Yves Requena. But unless your teacher was Korean or you had the good fortune of studying with Alex Tiberi at the Pacific College of Oriental Medicine, you probably are not familiar with the Korean constitutional types. Most of this information grew from seminars with Alex. I am sure you will find it useful in understanding more about your clients' nature and selecting which meridians on which to focus. I will talk about taiyin and taiyang (greater yin and yang) constitutional types in part one and then shaoyin and shaoyang (lesser yin and yang) in the following issue.
Taiyang -- Greater Yang -- Small Intestine /Bladder
When we think of taiyang, we consider our most external structure and protective framework. This is created by the Small Intestine and Bladder meridians, on the back of the shoulders and down the back. Strong musculature in this area of the body forms our armor, our protection. It's also the framework that creates our upright position and propels us forward. So that is what we consider in assessing whether an individual is taiyang or not -- strong structure and forward movement.
People who are taiyang are large and muscular. They are stocky and appear strong and sturdy. Their complexion is usually reddish or ruddy, appearing "thick-skinned." Their movement is always forward, allowing nothing to get in their way or distract them. For this reason, they are great people for starting companies. You will find that often they are ambitious entrepreneurs. They love to be in charge and noticed, and often display aggressive and outgoing personalities. Nothing is ever a problem for them, except for minute details that they will quickly glaze over as unimportant. Taiyang people never get sick or goes to a doctor. When they do get sick, it is usually sudden and serious. They'll be going along and then "blam"; they get hit with a heart attack or stroke that kills them. But we don't see them in our clinics often because they never admit to anything ever being wrong. They may be totally stressed out, but they just don't feel the impact like most people do.
Sometimes their partner will drag them into your office. (They won't come on their own because they always "feel fine!") You will give them a medical history to fill out, and they'll check nothing: name, address, signature at the bottom, that's it. So when you do the interview, you ask again, "any problems?" and of course they'll say no, even though the girlfriend who made the appointment said that he passed out from a bleeding stomach ulcer and is living on Tagamet. When you ask about it, they'll say, "Oh that? That's nothing." Treatment for taiyangs must include deep, strong work on the SI and Bl meridians. They will absolutely love it for one reason: it helps to relax the taiyang structure that has been propelling them forward their entire lives! You will find that Nuad Bo Rarn (Thai bodywork) is very effective for taiyang folks, as well as barefoot shiatsu. Taigyang people feel so good afterward, they often say that they didn't realize that they were not relaxed. Book another appointment right then and there, before they get back into their taiyang routine. You'll find that after a thorough assessment, they may have imbalances with the Kidney or Heart meridians, which after treatment will bring more long-lasting results.
Gradually suggesting lifestyle changes also will increase the efficacy of your treatments. Suggest that they take time off without their cell phones or laptops. Could they possibly find another favorite vegetable other than French fries? If they eat meat three times a day, maybe they could cut down to two? The more you work with them, the more likely they will trust and follow your advice.
Taiyin -- Greater Yin -- Spleen and Lung
The taiyin meridians, Spleen and Lung, both help regulate the water/fluids in the body. Remembering that for this type of person, these meridians are their greatest strength as well as their greatest weakness. You will notice that a taiyin person tends to have water buildup. Combine that with the extreme qualities of a "Spleeny Weeny" Earth person: one that ruminates obsessively and that of a stuck Metal element person with the inability to let go, and you have the classic taiyin constitutional type.
Taiyin people are large, like taiyang, but not as firm. They tend to be soft and flabby, kind of like big phlegmy yin balls. Their complexion is yellowish and their flesh feels mushy when you work on them.
Both taiyin and taiyang have "greater" in their name; they are people with "large" conditions. But whereas the taiyang person is excess in yang: motion - activity - energy, the taiyin person has excess of yin substance and stagnation. Taiyin people tend to have accumulations and blockages, such as cysts and tumors. They not only have stagnation in their bodies, they also have it in their lives. They will stick with a job as long as it takes to get it done, no matter how boring it is. They are great people to have working for you, because they are loyal and pay attention to details. But they get stuck in jobs that they hate, relationships that they hate, and living situations they hate for years and years. They always have a million excuses for why they couldn't possibly change! That is classic taiyin: the inability to let go, with the tendency to stagnate.
Interestingly enough, after receiving shiatsu for a few sessions with a focus on the taiyin meridians, they will start to shift. It will still usually take more work, but as you strengthen the Spleen and move through some of their phlegm, they will be able to see the possibility of change in their lives. Diet-wise, they probably need to cut down on sugar and dairy. Walking would be an appropriate form of exercise to suggest.
The Korean constitutional types are one paradigm among many! I always utilize it in combination with a more detailed assessment, using the tongue and pulse. I love the imagery used in this system; it's so easy to see parts of others and ourselves in these classic types. Enjoy!
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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