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Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
February, 2003, Vol. 03, Issue 02
Yin and Yang Deficiency, Part V
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
If you've been following this series of articles, you're now familiar with the differences between yin and yang deficiency. At this point, you know yin deficiency in depth and have been introduced to yang deficiency.This article explains how to differentiate the different types of yang deficiency, so you can fine-tune your assessment and treatment. (Editor's note: Barbra's entire series of articles can be accessed online by clicking here.)
When evaluating yin and yang, always consider the big picture. Yin aspects are related to nourishment and substance; yang aspects are more energetic and functional. We need yin and yang; women and men contain both, or they cease to exist. In the first article in this series, I discussed the aging process as it relates to yin and yang. People naturally start to decline in yin, yang or both as they age. If yin wanes, people may have less of a desire to nurture or care for others, or they may become more outgoing or outspoken. Substance also declines - for example, bone density decreases. If yang declines, they may become more relaxed and accommodating to others, but they also may have sexual dysfunction and trouble holding urine throughout the night. (This is discussed a little more extensively in part I of the yin/yang series: www.massagetoday.com/archives/2002/09/07.html.)
Yang deficiency always has some cold symptoms in the pattern, but overall, it does not appear as an excess condition. Most people with yang deficiency present with at least a few of these symptoms:
When you determine there is a yang deficiency, the next step is to decide what organ is primarily involved. It could be Spleen, Kidney or Heart, (capitalized to distinguish the Chinese view of these organs as an orb of influence, rather than what we commonly think of in the West). Actually, yang deficiency could be a progression from qi deficiency, such that organ patterns look the same, but with the addition of cold symptoms. (Editor's note: See the General Full Cold Symptoms chart below).
Spleen Yang Deficiency includes any of the broad symptoms listed in the first chart (above), keeping in mind that there must also be cold symptoms because of the relative lack of yang. Various digestive problems also manifest, such as lack of appetite; a puffy, tired feeling after eating; or loose stools. This is an indication that the Spleen's transportation and transformation function is impaired. For the same reason, if the Spleen can't convert the qi in food to a usable form, a person feels tired, listless or has trouble waking up in the morning. Fluids also will build up, because they aren't being transported and distributed properly (another function of the Spleen).
Poor diet is the primary cause of Spleen yang deficiency. Eating excessive cold, frozen, raw or sweet foods will damage the Spleen. Irregular eating habits; under- or overeating; eating too quickly; or eating while working or driving all can damage the Spleen. Is it no wonder that this is such a common syndrome is our society! Taking too many Chinese herbs with a cold nature also can cause Spleen yang deficiency, so if the patient is taking herbs, make he or she is seeing a qualified herbalist.
To evaluate Kidney Yang Deficiency, check for at least a few of the symptoms in the chart above. There may also be problems with the lower back and/or knee pain, both of which can be relieved by warmth. The Kidneys are closely related to Ming Men Fire, which emanates from the area of the lower back. When it fails to warm the body, the lower back feels cold. Whenever there is cold, there is pain, as the cold contracts and obstructs the free flow of qi. In addition, Kidney yang gives strength and support to the bones of the back and knees, so a deficiency will cause weakness in those areas.
The warmth of Kidney yang is needed for sexual function and fertility so a deficiency causes problems such as impotence, infertility, premature ejaculation or decreased sexual desire. Kidney yang also enervates the zhi, which is the spirit housed in the Kidneys. A deficiency will cause lassitude and a lack of motivation or willpower. Patients with Kidney yang deficiency feel they don't have the energy to do anything, or that they have used up all of their reserves -- which indeed they have!
Kidney yang deficiency often develops from Spleen yang deficiency, so you see symptoms such as edema in the legs, caused by lack of fluid transformation. For the same reason, fluids build up in the tongue, causing it to become swollen.
Kidney qi actually holds the urine in place, but since a deficiency of Kidney qi is often a precursor of Kidney Yang deficiency, you will see symptoms of nocturia (getting up at night to go to the bathroom), dribbling after urination or incontinence (in severe cases).
The causes of Kidney yang deficiency include chronic, longstanding illness; excessive sexual activity; a constitutional deficiency; or a decline of the Kidneys with advancing age. Some medications, such as those used for high blood pressure, will also deplete Kidney yang.
When someone seems to have symptoms of a yang deficiency (especially if his or her hands get cold), suspect a Heart Yang Deficiency. The Heart meridian goes down the arms; if there is insufficient Heart yang, qi can't be transported to the extremities. The person may also have a stuffiness or uncomfortable feeling in the region of the Heart. A cardinal sign for any Heart pattern is Heart palpitations, often described as an awareness of the heartbeat, or a fluttering feeling. These symptoms are caused by insufficiency of the Heart yang in moving the qi in the chest.
Heart yang deficiency can develop from a Heart qi deficiency, so you will see symptoms such as shortness of breath, sweating with no exertion and listlessness. The causes are the same as for Kidney yang deficiency. Heart Yang deficiency can also be caused by a sudden or prolonged loss of blood, which causes a deficiency of Blood, qi and (eventually) Heart yang.
I am including a chart on the symptoms of some excess/full cold patterns (below), but I am not going to explain them in detail, because it's not within the scope of this series. Included are four fairly common syndromes you will see in your practice.
By this point, you should be an expert at differentiating a cold from a hot condition, or an excess from a deficiency. You should also be able to pinpoint the exact organ involved. To complete the picture, next month's article will detail treatment protocols for yang deficiency, addressing each of the zang-fu disharmonies. I'll also include dietary, lifestyle and environmental counseling. Until then, keep your yang-deficient clients warm!
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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