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Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
June, 2002, Vol. 02, Issue 06
Symbol and Form
By Keith Eric Grant, PhD, NCTMB
Along the road to discovering how people learn to draw well, Betty Edwards began to realize that the problem was not primarily one of kinesthetic skill, but of seeing and perception. Students who learned to draw did so suddenly, not incrementally. One week, their drawings were stereotypic symbolic images, and the next week they were drawing proficiently. Then she found a new clue.
What Edwards concluded was that the brain hemisphere responsible for verbal-linguistic ability couldn't draw except in stereotypic symbols and that the hemisphere responsible for seeing in the way necessary for drawing was nonverbal. I am reminded of Edward's observation whenever I am demonstrating massage and attempting to describe my methods or am Scandinavian dancing and trying to converse. Kinesthetic/perceptual skills and verbal/linguistic skills simply come from different places. Doing both requires a lot of switching back and forth.
What has intrigued me further, however, are the differences Edwards noted between the detailed perceptions of shape and form needed for drawing and the simple symbolic caricatures offered up by the verbal-linguistic mind. There are other ways in which fixating on the symbol rather than switching our minds into the depths of the form can deceive us.
We often think of posture as if it had some independent existence. Yet, if we delve below the symbol, our posture is merely the relative positioning of parts of our body in the downward pulling field of gravity. If we simply lean forward slightly while standing, we can feel the posterior line of the muscles of our calves, hamstrings, and glutei tighten to keep us from falling forward. At the same time, our knees might lock in hyperextension while the intrinsic muscles of our toes contract to grip the ground.1 If we were to hold this posture habitually, the muscles of our posterior line and plantar foot would be working continually. At the same time, the mobility of our knees and ankles and their ability to absorb shock would be reduced. Over time, anterior line tissues would become shortened and weak, locking our bodies in this effort-filled position. From just this small example, we see how many clues to lengthening and releasing specific tissues we receive in going from the symbolic idea of posture to the specific dislocations that have occurred. Sometimes we talk about injuries to soft tissues as if they came in standard packages at the store. Yet again, in working with minor injuries we need to examine the specifics. What type of tissue was injured: muscle, tendon or ligament? What has been the effect of this injury in limiting tissue strength and restricting motion? Do we best create a change by applying compression, a lengthening stretch, or a broadening stroke across the tissue? All are useful but quite different techniques.5 How do we best position our client to facilitate access while keeping our own body mechanics effortless and efficient? Do we want our client to move a joint to enhance either tissue lengthening or broadening? Again, moving our focus from symbol to detail provides the clues.
It's easy to get stuck in the terminology we learn and miss the nuances of its application. In working with the shoulder and hip we learn words for position like flexion, extension, abduction, adduction, medial rotation, and lateral rotation. As we get into the specifics of assessing dysfunctions, however, we begin to realize that position isn't everything; that motion also is present.3 What can be confusing is that the words for position and motion are the same. We can have a motion of flexion in a position of flexion and a motion of flexion in a position of extension. We can also have a motion of extension in a position of extension or a motion of extension in a position of flexion. Similar combinations exist for abduction-adduction and medial rotation-lateral rotation. Again, it's in going beyond the terminology into the specific tracking of both position and motion that we begin to understand working with the shoulders and hips.
Beyond just shaping the work we do with our hands and hearts, the differences between symbol and form can shape our very perceptions of ourselves and of each other. People speak of having "high standards" for entry into practicing massage when what they mean is simply high requirements. In contrast, the Boston Marathon has clear entry standards based on a prior performance in another marathon. For the 18-34 age group, the required finishing times are: men - 3 hours 10 minutes; women - 3 hours 40 minutes. The conditions are measurable and unambiguous. They don't specify how many hours you have spent training, but they do specify what the result of that training must be. It is meaningless to talk about "high standards" apart from a specific context and a well-defined measure of attainment. Betty Edwards was right. The differences between symbol and form lie deep within the perceptions of our minds, and make all the difference in the world in how we draw our conclusions.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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