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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.
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?
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.
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.
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.
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
August, 2002, Vol. 02, Issue 08
Move Your Anatomy
By Keith Eric Grant, PhD, NCTMB
As midsummer's day approaches each year, it marks the reappearance of one of my favorite micro-communities. For one week in June, Scandinavian dancers and musicians gather in the redwood forests just inland from the Mendocino, California coast.Teachers of regional dances and fiddle tunes are brought in from Sweden and Norway, and other teachers and participants arrive from across the United States. It is a community marked by the respect and encouragement given to each student struggling with the nuance of a dance or tune, and by the ways in which all contribute to the week. Part of what I contribute are my skills with muscle and tissue, which help keep a number of my fellow participants more comfortably dancing and fiddling. Given the motions of what we are about, my fingers may work deep into the muscles of the anterior torso, hip, and gluteals of those asking for my help.
I stress these bodily areas for their great importance to movement and posture,1 and because, as I've discovered via a number of e-mail discussions, many massage schools apparently give only summary attention to these areas. In my mind, this is a very serious omission for those hoping to more than momentarily ameliorate the tensions and pains of their clients. It is not enough to simply move our work over painfully tight areas, because the pain and tightness can be secondary to the shortness and adhesions of another area.7 Consequently, it is important to understand the basic patterns by which maintained tension leads ultimately to dysfunction, and to work to relieve these patterns.
Vladimir Janda grouped muscles into postural and phasic muscles.2 Postural muscles are oriented toward static support and tend to shorten when stressed; phasic muscles are oriented toward movement and tend to weaken when stressed. These two types of muscles are key in understanding two common patterns of muscle dysfunction: upper-crossed syndrome and lower-crossed syndrome.2,3 In upper-crossed syndrome, the pectorals, upper trapezius, and levator scapula (postural muscles) become short, while the deep neck flexors, rhomboids, and serratus anterior (phasic muscles) become weak. In lower-crossed syndrome, the iliopsoas and erector spinae become short, while the abdominals and gluteals become weak. In both syndromes, weak muscles can be strenthened by exercise only after the shortened muscles have been released. While forward-pulled shoulders may result in weak, lengthened and taut rhomboids, habitual anterior flexion can compress the ribs and cause weak and short abdominals. Thus, relieving back pain may require releasing and lengthening the entire anterior torso, as well as releasing shortened posterior muscles.
Dance kinesiologist Sally Sevey Fitt notes the extent to which our cultural habits affect our muscles and body.4
Bodyworker Erik Dalton similarly calls us a "society of flexion addicts."3 Fitt further discusses the symptoms resulting from tightness of the anterior torso muscles pectoralis minor and serratus anterior.4
From the perspective of his concept of "anatomy trains," Tom Myers discusses the clinical implications of the superficial front line. He notes the effects of a maintained "startle reflex" pattern of shortening of the anterior line along with cervical extension.6
It is tempting to see these considerations as applying only to clinical massage. Yet, apart from sudden injuries, the tensions held from day to day presage the eventual pain-producing dysfunctions. When the tensions are coaxed out in a timely way, via gentle stroke and jostling, the need for remedial work can often be avoided. Working the right areas means making the mental jump from static anatomy on pages of books to the moving anatomy of the actual human body. It is a leap we must take to be effective in the long run.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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