resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
April, 2002, Vol. 02, Issue 04
Anatomy of an Inversion Sprain
By Neal Cross, PhD, NCTMB
Ankle inversion sprains make up the greatest majority of ankle sprains (Snider, 1997). The anatomical damage subsequent to this biomechanical event goes beyond the ankle and its adnexa.The principle structures stressed during forced hyperinversion of the ankle are the three components of the lateral collateral ligament (LCL) of the ankle: the anterior and posterior talofibular ligaments and the calcaneofibular ligament.
The anterior talofibular (ATF) ligament attaches to the anterior margin of the lateral malleolus and runs distally to attach to the anterior aspect of the talus. It is readily palpable, especially at its proximal end, and is the first structure stretched or torn following an inversion sprain. The calcaneofibular (CF) ligament attaches to the distal tip of the lateral malleolus and runs inferiorly to attach to the lateral aspect of the calcaneous. You can easily palpate this ligament at its proximal portion. In the sequence of events following an inversion sprain, this is the second ligament to be compromised. The posterior talofibular (PTF) ligament is not readily palpable, as its runs from the posterior margin of the lateral malleolus to the posterior aspect of the talus. Damage to the PTF usually occurs only following severe sprains. In fact, the severity of inversion ankle sprains is often defined by the damage to these three ligaments making up the ankle LCL. For example, Anderson and Hall, 1995 note that 1st , 2nd and 3rd degree sprains are associated with the ATF; ATF+CF; and ATF, ATF+CF, ATF+CF+PTF, respectively.
The LCL is not the only structure on or near the lateral aspect of the ankle that is liable to injury following an inversion sprain. The peroneus (fibularis) longus and brevis muscles run from the lateral aspect of the leg and have their distal tendons running in a groove (peroneal groove) on the posterior aspect of the lateral malleolus, on their way to the distal attachments on the foot. These tendons are held in place by two (superior and inferior) retinacula. Following an extreme acute sprain or a series of milder inversion sprains, these two structures may be stretched or torn. Subsequently, when everting the foot (against resistance), the tendons of the peroneal muscles "pop out" from behind the lateral malleolus. Injuries to any of the above ligaments and retinacula may result in swelling, ecchymosis and tenderness over the lateral aspect of the ankle and foot. Pain may often be more severe over tissues experiencing the most damage. Bone injuries also can occur with severe inversion sprains and need to be ruled out by a physician.
The lateral malleolus comprises the distal end of the fibula. Since inversion sprains of the ankle negatively impact this end of the bone, it makes sense that it would have to impact the proximal end as well. In fact, a loss of fibular motion usually occurs following such a sprain. If you check yourself or a client, you can gently rock the fibular forward and backward ever so slightly. The fibula may become "stuck" following an inversion sprain -- this motion would cease. The sprain also would cause increased tension on the interosseus membrane between the fibula and tibia. The proximal part of the fibula (fibular head) is closely associated with the knee joint complex via the lateral collateral ligament of the knee. As a result, there may be significant forces running though the lateral aspect of the knee.
The entire lower limb wrapped in a thick fascial layer. In fact, in the thigh this layer is so dense it has a special name; the fascia lata. On the lateral aspect of the thigh, and continuing down to the proximal leg, this fascia lata is thickened further by the apposed tendon of the tensor fascia lata, which together form the IT band (iliotibial tract). The IT band runs from the anterolateral surface of the pelvis to a tubercle (Gerdy's tubercle) on the anterolateral aspect of the tibial condyle. Therefore, sometimes following an inversion ankle sprain the IT band is forced inferiorly, and this forces the pelvis to be pulled down forcibly on the affected side. The end result will be an "uneven" pelvic base to support the torso and rest of the body.
As massage therapists, we need to be aware of relationships among body parts that may impact the work we do on our clients following specific injuries. In many instances, soft tissues well-removed from the site of original insult are affected.
Click here for previous articles by Neal Cross, PhD, NCTMB.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.