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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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
December, 2002, Vol. 02, Issue 12
Flushing Out Myths
By Keith Eric Grant, PhD, NCTMB
There's a statement, seemingly pervasive throughout massage education and massage books, that unspecified toxins accumulate in the body, and that these toxins can be flushed out by massage.I believe this is yet another myth that continues to be passed on as misinformation to massage students. This is not to dispute that there are very real toxins that accumulate in the body, notably persistent organic pollutants (POPs) in fatty tissues and heavy metals in skeletal tissues. [7,8] However, these toxins are too chemically bound to their target tissues to be significantly liberated by the mechanical motions of massage.
A more significant issue is whether metabolic wastes and cellular debris can significantly accumulate and be flushed out by massage. To elucidate a negative response to this, I turn to consideration of the circulation of blood and lymph. If the tissue is to accumulate wastes in a static manner, i.e. not as an instantaneous balance between production and removal, the tissue must be isolated. If we assume that the tissue is isolated from blood circulation, then necrosis (cellular death) is the rapid consequence. Such gangrene is, for example, one of the results of the vascular pathology of diabetes. We have to conclude that non-gangrenous tissue must be receiving oxygen and nutrients via circulation and that, for this to continue, venous return flow must also be occurring. If the toxins are accumulating, they cannot be doing so within the reach of the circulatory system. Perhaps we should look instead in the interstitial spaces served by the lymphatic system.
As noted by Bruno Chikly, the lymphatic system is a second pathway back to the heart, parallel to the blood system [2, pg. 27]. Chikly further notes that "about 1.5 to 3.5 liters of lymph per day circulate through the thoracic duct, although the total volume of the flow of lymph has yet to be precisely measured" [2, pg. 51] and expands on the process of lymphatic circulation.
What arises is a picture of tissue far from being in static isolation. If neither necrosis nor severe edema is to result, the tissue environment must be continually bathed in the fluid circulations of blood and lymph, ruling out the accumulation of free toxins. Where there are restrictions, such as adhesions between fascial planes, they must be of a more macroscopic nature, still allowing for the microscopic flow of circulation, just as water can flow through cheesecloth.
Based on the above considerations, I can only conclude that the flushing of toxins is yet another persistent myth. However, this does not imply that massage is powerless to benefit the body. While massage does not appear to directly increase overall blood flow , it can be used to relax muscle hypertonicity. Lowering the level of muscle activity will locally reduce the need for energy and oxygen and the rate of production of metabolic wastes. It will also reduce the muscular pressure on surrounding tissues, effectively improving circulation and recovery from use. This, however, is not massage moving out toxins, but massage facilitating a better homeostasis. It is just this improvement in homeostasis by which, I believe, massage facilitates recovery from exercise and allows a higher level of training to occur.
In cases of excess lymphatic fluid production (overloading a normally functioning lymphatic system), or partial lymphatic system compromise, lymphatic drainage massage may be helpful in promoting the process of lymphatic filtering. The key sign here is the existence of edema. Normally, local muscle contractions promote sufficient lymph drainage. A notable exception exists with breast tissue. Since there is no contractile tissue within the breast to assist lymphatic drainage, overall tissue movement becomes important [3, pg. 101].
There remains a consideration that some clients respond to a massage with reactions of flu-like aches and malaise. Such symptoms have often been attributed to the toxins released. Dispelling with the concept of toxins means that we must seek other explanations for such post-massage malaise. Chaitow notes that fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS) are the distant end of spectrums of dysfunction that can include aches, malaise, and flu-like symptoms [1, pg. 6]. He believes that a great many people are somewhere on those spectrums. Some of the models of dysfunction that Chaitow presents include a sort of systemic allergic reaction characterized by a great deal of pain, either muscular and/or joint-related [1, pg. 33]. Chaitow also notes the hypothesis that the inability to produce an adequate cortisol response to a stress can result in symptoms: "Deficiency in cortisol is characterised by fatigue, weakness, muscle and joint pain, bowel symptoms, nausea, increased allergic reactions, mood disturbance" [1, pg. 68]. I tend to think of a body's neurochemical system on the edge of its ability to adapt being pushed temporarily beyond the edge by accommodating to the work being done. This reaction may be exacerbated by effects of athletic overtraining or by a genetic metabolic predisposition [5,6].
To explain the effects of massage, think not of flushing out toxins, but flushing out tensions - not just in the sense of emotional holding, but in the basic sense of muscles "idling" with the throttle open. As with good mechanics, we're simply readjusting the throttle to a reasonable idle rate. Underlying this way of looking at things, however, is a fundamental shift in orientation from mechanically moving something that accumulates to changing a dynamic balance within the living human body. It is, I believe, an important shift away from mythology and toward better understanding of our work.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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