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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.
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.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
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%.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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).
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
September, 2002, Vol. 02, Issue 09
Breathing Fresh Air
By Keith Eric Grant, PhD, NCTMB
Breathing fresh air has literal and metaphorical significance. In the beginnings of the industrial revolution, little thought was given to the environment. As a severe result, the particulate air pollution in London from coal burning resulted in "killer fogs" from the 1800s into the 1950s.9 Since then, greater understanding and attention to the system as a whole has freshened the air. This is partly a change from perceiving everything as simple stand-alone machines, to understanding more of the interactions, feedbacks, and true complexity of systems. It is the change of viewpoint from the industrial revolution to the information revolution. The "fresh air" of a wider perspective can contribute significantly to the literal freshness of the air.
The somatic consideration of breathing fresh air returns us to thoughts from last month's column. I brought up the effects of chronic shortening of our anterior line, including compaction of our ribcage and dysfunctional breathing patterns. Philip Greenman notes that alteration in ribcage function can negatively impact respiratory activity, circulatory activity (arterial, venous, and lymphatic), and neural activity.3 During inspiration, as the diaphragm contracts and descends toward the pelvis, the ribs should elevate and expand using secondary muscles of respiration.1,3,6 The reverse occurs during expiration. Lengthening the anterior line restores space for the ribs to function, but does not automatically restore function. Art Riggs comments on working with clients to correct their breathing patterns:7
Sometimes, especially in relation to chronic postural patterns, the motion of one or more ribs can become restricted - fixed in either exhalation or inhalation. Directly working the soft tissues of the thoracic regions around the costotransverse, costovertebral, costochondral, and sternochondral regions is a first step toward restoring movement.5 Additional steps can involve direct work on the deep intrinsic muscles of the spine, gentle movements of the ribcage, and gentle resistance against breathing in the manner of post-isometric relaxation.5,7 Gentle resistance techniques can also be used to help a client become aware of and relearn breathing patterns.7
Breathing fresh air also has the metaphorical meaning of taking a new path in looking for solutions to well-known problems. One such problem comes in seeking ways to reach out and help at-risk and disadvantaged segments of our population to help themselves. I've recently become involved in such a project via the Touch Health Association, the community outreach agency of the McKinnon Institute at which I've long been teaching massage.8
Many young mothers are unaware of their children's needs because they lack maturity and/or education to pick up on their cues. An infant massage training program, now in its own gestation, will teach disadvantaged mothers to touch their children in a healthy/healing way that improves infant development and increases their familiarity and comfort with appropriate touch. It is planned that, as these women complete their training in massage therapy, they will be hired through the non-profit agency to bring massage and appropriate touch back to their own communities. We will make use of the community knowledge the young mothers already have and the trust they can access from being part of the community served. The focus of the project is to create sustainable job options for young mothers as well as increase availability of massage to underserved populations.
Much of the coursework is based on results of developmental research from the Touch Research Institute (TRI). In many cases the trainees will not be persons fluent in academic learning and assessment methods - chalk and talk and standardized tests won't cut it. The project will have to move both to use of active visual media and to an experiential/kinesthetic mode of teaching topics such as anatomy.1,6 Assessment will need to be done directly within the context of practice.
What I'm describing is without a doubt at odds with many existing state practice acts - laws written and passed without a thought of using massage as a tool for community intervention. The pursuit of "credentialism" embodied in such laws can have needless impacts on those already disadvantaged.2
Such laws were written by people and can be changed by other people. Advocate such change to colleagues and legislators when licensing acts are either being initially considered or are up for a review of need and efficacy. Cherish and preserve the flexibility you do have, working with nonprofit resources and government agencies to create touch-based outreach programs. By caring enough to participate, we can create a breath of fresh air in how we reach out as massage therapists to improve community and culture and stem the tides of despair and violence.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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