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TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
January, 2003, Vol. 03, Issue 01
The Perils of Perfect Posture, Part I
By Erik Dalton, PhD
Throughout history, human posture has been scrutinized for symbolic values ranging from socioeconomic status to psychological babble. In schools, teachers often reprimanded students to sit up straight.Young girls innocently walked with books balanced perfectly on the top of their heads during "charm school" classes. Aesthetically, even the dancer has come to represent the epitome of graceful posture and balance, with the ethereal vision of the lithe ballerina artlessly stretching to the sky. Meanwhile, the rest of us may never forget the words of well-intentioned parents, "Now, stand up straight or people will think you have something to hide." Society's undying commitment to its tradition for proper postural codes remains alive today, in circles that not only envelop the military private, but also the young debutante in white.
But as we begin to casually observe the people around us, the question must arise: Is perfect posture really a reasonable goal for the average American living in a flexion-addicted society?
Clinical evidence overwhelmingly supports the fact that prolonged sitting or sleeping in flexed positions neurologically shortens and tightens the body's hip flexors, particularly the iliopsoas muscles. As the antagonist gluteus maximus muscles gradually become reciprocally inhibited and weak, a primary muscle imbalance pattern ensues. Could more harm fall upon someone in this condition? Simply put, yes. As he rises from his chair, the shortened iliopsoas and rectus femoris muscles drag the hips and lumbar spine forward. Thus, the unsettling "before" snapshot: A swayback posture and protruding belly ... paving the way to a disappointing first impression.
However, prolonged slumped sitting can also promote an even greater pain-generating problem. While slouching or leaning forward, such as when we tirelessly perform computer or couch potato work, our swayback curve gradually begins to reverse itself by overstretching the posterior low back ligaments and joint capsules. Gravity loudly demands its pound of flesh, and this newly formed "reversed lordosis" gets an extra boost in its battle with the flexion-addicted swayback.
As we repeatedly stand, sit and slouch throughout a typical 8- to 10- hour workday, our low back curve is forced to repetitively translate anteriorly to posteriorly. The inevitable strain from local lumbar hypermobility soon begins to ravage the vulnerable sensory receptors in the body's joints, ligaments and intervertebral discs. Noxious afferent stimuli bombards the central nervous system causing the brain to react by triggering layers of muscle spasm to protect the unstable spine from further insult. Digging out the deep spasm and fascial contractures is usually a sad waste of time and energy unless the underlying joint dysfunction is first appropriately treated. Approaches to restore optimal posture and relieve chronic pain should include specific techniques designed to co-activate hyperactive sensory receptors such as mechanoreceptors, nociceptors and chemoreceptors in joints and ligaments, while activating muscle spindles to tonify inhibited weak tissues.
Ligaments, Muscles and Strain Patterns
While the overstretched ligaments valiantly strive to maintain spinal stability, the unrelenting force of gravity pounds the posterior facet joints and flattens the lumbar discs. The brain then begins its selective recruitment of specific muscles to provide ancillary support to the unstable spine. The problem worsens since contractile tissues designed to move bones are now required to work as spinal stabilizers. Sustained isometric muscular contraction neurologically weakens the lumbar myofascia due to the sudden influx of lactic acid and other toxic waste products. As the shortened tissue tugs unevenly on the spine, the joints' axis of rotation is altered. Predictable strain patterns and postural compensations reverberate throughout the thorax, neck and head. Forward head postures and slumped shoulders are two favorite dance partners of the pained swaybacks in this rapidly growing social circle of "flexaholics."
Postural muscles, such as the iliopsoas, quadratus lumborum, rectus femoris, and hamstrings, are structurally designed to resist fatigue in the presence of prolonged gravitational exposure. So why are distorted postures and chronic pain problems dominating our practices? The easy answer: overuse, underuse and just plain old abuse.
These three primary culprits create muscle imbalances that reduce the body's capacity to resist stress. As with everything in life, the body exists on a plane of give and take. Therefore, when postural muscles tighten, the antagonist groups are overstretched and weakened, allowing asymmetric patterns to develop. Soon the anti-gravity function of the body's myofascial system sends an alarm to deeper structures, such as spinal ligaments, joint capsules and intervertebral discs, to brace for the overbearing compressional loads. The homeostatic threshold has been violated.
The body must now prepare to battle the devastating, self-perpetuating pain/spasm/pain cycle manual therapists confront each workday.
If considering the medley of countless occupations that require the typical 12-pound head to be held in a bent forward position, with arms positioned in front of the body, why is it any shock that neck, shoulder and arm pain run rampant in today's society? Consider the typical profiles of individuals fitting this definition. This endless list runs the gamut from dentists, car mechanics, stockbrokers, hairdressers, etc. - even bodyworkers.
Long hours of passive sitting at the computer, or leaning over therapy tables, create stretch weakness in the rhomboids and lower trapezius. This repetitive physical practice contributes to forward dragging of the shoulder girdle due to the pectorals propensity for domination. Tight latissimus dorsi and subscapularis muscles unite with the clavicular head of pectoralis major to internally rotate the humerus. With the scapulae protracted and the arms internally rotated, the neck reluctantly moves forward on the shoulders often forming the unattractive "dowager's hump". Unfortunately, as the spinal facet joints slide open, the cervical curve loses its lordosis and transforms to a typical straight cervical curve. To prevent the person from only looking at the ground, the brain recruits the suboccipitals and other capital extensor muscles to cock the head back into hyperextension. As the occiput hyperextends and slides forward on the atlas vertebra, the posterior occipital atlantal membrane is squashed along with local neural and vascular structures.
Sadly, tonic reflexes and dural attachments originating at the O-A joint dictate postural muscle tone throughout the entire trunk. Stubborn head, neck, brachial, and scapular pain refuses to leave when in an agitated state. These painful and chronic conditions frustratingly persevere until the therapist chooses to systematically balance the shoulder girdle on the rib cage, the neck on the shoulders, and the head on the neck.
To better understand the consequences of forward head postures and slumped shoulders, try these two experiments:
Most people experience a 25 percent to 50 percent decrease in range of motion while in the forward head position. This exercise helps illustrate the physical limitations of people suffering forward head postures and demonstrates the negative impact these sensitive neck structures must endure during normal activities, such as driving, shopping, dancing, etc., Spondylosis, degenerative disc disease and osteoporosis are but a few names that describe what physically transpires when this structural alignment problem is not corrected in a timely manner. The farther the head slides forward on the sagittal plane, the more devastating the long-term effects. The posterior longitudinal ligament likes to tear away from the discs and vertebral bodies from C4 to C6 causing internal pressure to fill the cracks with calcium or bone spurs (osteophytes) - the resounding reason why bone spurs originating from forward head postures have become the most common cause of chronic neck pain.
Both exercises lead to a compromising conclusion: Always begin upper-quadrant postural alignment by balancing the shoulder girdle on the rib cage, neck on the shoulders, and the head on the neck, before tackling specific extremity pain problems, such as supraspinatus tendonitis or thoracic outlet syndrome.
Supraspinatus tendonitis pain is generally the result of forward head postures and slumped shoulders ... not the cause. When the humerus internally rotates from a slumped posture, the supraspinatus attachment at the greater tubercle of the humerus also rolls forward. Then when called upon to lift a heavy suitcase, the supraspinatus tendon cries for help as the shoulders are retracted. Pain shoots down the arm as the tendon flips back over the humeral head, and soon the fibers begin to tear.
Click here for more information about Erik Dalton, PhD.
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