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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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?
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.
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).
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%.
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.
December, 2002, Vol. 02, Issue 12
Movement Awareness: Connecting Self with Client, Part I
By Josef Dellagrotte, PhD, LMHC, CFP, RMT
Every massage session is a movement relationship between practitioner and client. Because clients are passive receivers, we tend to ignore their awareness of and responses to what may be happening to their own body image perceptions.We consider our role in this interaction as body use, contact, and application of technique.
Movement organization differentiates between massage as therapy and improvement vs. massage as treatment only, whether as a relaxing or as a myofascial relieving experience. The root of massage practice is in movement itself. The practitioner must move his/her own body in harmony with the inexorable laws of gravity and biomechanics. Massage is not generally considered a movement modality; in reality, it is, and it grows in public significance when it is consciously practiced with self-movement awareness and skill. Sooner or later, the client picks up on whether the message in the massage carries something more. Consider the following:
First, picture a standard massage treatment. The practitioner's actions reveal well-organized movements, or compromised, imbalanced, stressful postures during the application of treatment. There appears to be little client movement, and little equivalent or commensurate response. The client's body absorbs the potentially beneficial forces applied by the practitioner. The neglected, significant question is this: Is the practitioner benefiting? Is he or she getting better or worse?
The general protocol and expectations of a massage session have been shaped by tradition, experience and habit. The passive client comes to a session for the purpose of experiencing relaxation, without movement, or without any self-induced motion except to lie down, remain motionless, and then to get up and leave. The client feels the positive effects, but is minimally conscious of the process. The reality is that the practitioner does most of the moving; the client's body is moved. The effort is distinctly disproportional.
Second, the practitioner's actions reveal active mobilization that resembled work or effort. Any kind of hands-on work must affect one's own body. Physics dictates that any force generated must travel freely, without resistance or torque. To do otherwise is to generate turbulence affecting one or more components: muscle, nerves, myofascia, joints or bones. Whatever the modality used, the body must experience some effect, and this effect must be registered in the nervous system.
Third, the practitioner is moving his/her own body -- but how? The very act of movement involves using vectors of force, direction of force, body tensioning along myofascial planes, and an entire dimension of sensory-motor stimulation through touch. Some of these myofascial pathways of movement have been anatomically described (for example, see Thomas Myers' Anatomy Trains). No matter the technique or style used, the practitioner has to begin with self-organization, in the field of gravity. Technique is secondary to the greater principle: well-organized and efficient direction of movement energy in motion. This can be further broken down into components, such as the core functional movement based on the actions and planes of movement. In essence, every practitioner, either intuitively or by sheer behavioral learning, must use the basic functional components of human biological and biomechanical motion.
When working on a client, a practitioner intuitively recognizes a fundamental need for postural stability; for balance; for transmission of forces from the ground through oneself; for a certain amount of strength; for lengthening of one's own body; for relaxation, and for satisfaction while one works. This means that the practitioner, like the musician, has only natural, core functional motion possibilities: notes, then chords, then melodies or compositions. The notes are single actions of one part. The chords are combinations of notes that form core functional actions of extension, flexion, rotation and lateral bending of the opposite segments. These core functional movements, or colors of the body spectrum, allow joints to perform different actions.
As a functional movement, that action is precise and ideally effortless, not forced. If the articulation, with its corresponding muscle contraction, muscle lengthening, connective tissue or fascial spread, and internal sensory feel, are not resonant and syntonic, trouble ensues. If the movements go well, they combine to form patterns of action, or primary functional actions, the practitioner and the client benefit. As the practitioner moves, so does the client. Where the practitioner is struggling in her/his body, the client absorbs the manual forces, not having a clue (until later, perhaps) as to why a negative reaction was felt. It is rationalized often as: "I felt good, but then the pain came back."
Josef DellaGrotte is a certified Feldenkrais trainer, registered muscular therapist, integrative somatic practitioner and body-centered psychotherapist. He began training with Ida Rolf, then with Moshe Feldenkrais, who named Josef as a training assistant. His interest and practice is in combining therapy with somatic education, taking the client beyond passive experience and dependency into learning and self-care.
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