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Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
March, 2003, Vol. 03, Issue 03
The Perils of Perfect Posture, Part II
By Erik Dalton, PhD
Editor's note: Part I of this article appeared in the January 2003 issue.
Postural Harm to the Viscera
Prolonged sitting can contribute to a significant loss of cervical and lumbar curve, while increasing thoracic kyphosis.Just like the newborn, the result is one big C-curve, with all the facet joints sliding open - beginning at the sacrum and curving all the way up to the occiput. With the shoulders drawn forward and the chest flattened, the abdomen protrudes below the belly button, resulting in altered breathing patterns. Tension increases on the pericardium and its neurovascular contents, because the diaphragm is now lowered. Individuals who suffer from this condition may seek help from their physician for complaints of heart palpitations or respiratory infections, while ignoring the real cause - a potential alteration of visceral position and function.
Exploring Perfect Posture
To fully understand why aberrant postural patterns create chronic head, neck, back and hip pain, perfect posture must be clearly defined. Simply put, perfect posture is a condition in which body mass is evenly distributed. Muscles are not actively working toward appeasement of pain. Ligamentous tension must be perfectly balanced against compressive and tensegrity forces, so the typical activities of standing and walking require minimal energy expenditure. Because locomotion requires the controlled loss and regaining of balance, movement of any body part with respect to the rest of the body shifts its centerline of gravity, causing an inevitable change in overall balance.
Wasting Precious Energy
Ideally, during standing, postural muscles should be in a state of normal tonus and not actively contracting. However, as the body is subjected to micro or macrotraumas during the normal routines of life, postural balance becomes less than perfect. When this happens, active muscle contraction is required to redistribute body mass and effectively hold it in place. At this point, the muscles are working against gravity requiring them to perform the ligament's job of stabilizing the joints.
Muscle contraction requires energy; therefore, postural imbalances result in an enormous energy drain, proportional to the magnitude of the postural imbalance. Of course, this becomes lost energy unavailable for its original purposes. Energy drains have a dramatic effect on the limbic system - the highest cortical level controlling muscle tone. As whole-body tension builds, clients begin to report strange symptoms resembling fibromyalgia, chronic fatigue syndrome and digestive or hormonal disorders.
Faulty posture becomes magnified in clients who participate in athletic competitions. For example, short leg syndromes from a tilted pelvis can create a dramatic loss in time, strength, coordination and endurance in both amateur and professional athletes. In addition to energy loss, the body's joints are often subjected to abnormal mechanical stresses. When the spinal musculature is involved in lateral curvatures due to compensations from a tilted or side-shifted pelvis, shortening of the ligaments and muscles on one side and lengthening on the other occurs. Alterations in joint function, caused by capsular restriction or loss of joint play, inhibit or facilitate the muscles that cross the misaligned joint.
If proprioceptive impulses from sensory receptors located in joint capsules, ligaments, tendons, muscles, fascia and intervertebral discs become agitated from pelvic misalignment, compensations resound up and down the spine. Even the slightest alteration in the normal balance of the various spinal segments leads to some degree of soft tissue change. Nature inherently attempts to automatically restore equilibrium, by contracting and shortening certain muscles and inhibiting and weakening others.
When a joint's axis of rotation changes, one side of the joint capsule and its supporting muscles and ligaments become overstretched and weak. Meanwhile, sensitive mechanoreceptors imbedded in the articular cartilages and discs on the compressed side send a barrage of mechanical distress signals to the spinal cord.
Facet joints are possibly the most innervated structures in the spine. Their cartilages despise prolonged compression and soon become swollen, inflamed, and eventually degraded. As chemical inflammatory agents accumulate, chemoreceptors are stimulated and join the mechanoreceptors in flooding the neuronal pool with warning bells of possible tissue damage. This stimulates the pain-producing nociceptors that cause the brain to tighten and shorten specific muscles to avoid further pain - the embodiment of our" crooked" clients in acute pain. The brain twists and torques the body in an attempt to alleviate the pain. Regrettably, the cerebellum has the ability to memorize these aberrant patterns and re-learn them as normal. This condition, when the deformed posture long outlasts the painful stimuli, is called neuroplasticity, reflex entrainment or spinal learning.
In the presence of joint blockage caused by capsular tightness and compression, normal articular reflexes may become so disrupted that when the tightened area of the joint capsule is overstretched, reflex inhibition of the overstretched muscle prevents further capsular elongation.
"Feet-shufflers," occasionally seen in malls and supermarkets, represent the perfect exaggerated embodiment of how a dysfunctional hip capsule can disrupt the firing order of muscles that cross a joint. During the walking cycle, the feet-shuffler's push-off leg can't extend backward, due to adhesions in the anterior part of the hip capsule. Therefore, he or she uses the hip flexors to throw the feet forward to walk. Therapists usually attribute this condition to tight hip flexors that won't allow the back leg to follow through in extension. However, during therapy treatment, attempts to increase hip extension by actively or passively stretching the hip flexors can cause an immediate firing of the joint and ligament mechanoreceptors creating a sort of stretch reflex. The adhesive capsule fools the joint receptors into believing the hip has already reached its end range of motion. A condition called arthrogenic muscular weakness inhibits the hip's prime mover, the gluteus maximus, and facilitates the already tight/short iliopsoas. This appears to be a local genetic protective device to prevent excessive hip extension and further jamming of the joints' compressed cartilage.
Regrettably, anterior hip capsule adhesions are a widespread and overlooked source of flexion addiction in our society. Some may conclude that this insidious hip condition is the reason for so many hip replacements being performed in this country each year. Athletes who complain of loss of speed in their competitive trials may also suffer from a lack of full hip extension in one or both hips. Hip flexor work alone just won't solve the problem. One helpful routine is to first dig-out, plunger and stretch the adhesive hip capsule, then tonify the weak gluteus maximus with fast-paced, spindle-stimulating maneuvers. To finalize this procedure, use techniques ranging from assisted stretching, myofascial release, trigger point therapy or muscle energy to lengthen the tight iliopsoas.
The mysterious yet potentially stressful force of gravity affects each of us here on planet Earth. Our body's somatic system is intrinsically involved in its reaction to a shift in the center of gravity. Muscle and ligamentous tension is maintained by negative feedback from sensory receptors located in joint capsules and intervertebral discs. When the normal function of any part of the somatic system becomes overstressed, the vicious cycle of pain and dysfunction begins. Our job as bodyworkers is to maintain normal mobility of all components of the somatic system, to help minimize gravitational strain and any consequences from postural imbalance.
Emerging from an industrial society to one rich in technology, we now live in a world in which our external environment greatly impacts the healthful functioning of our bodies. As therapists working with a flexion-addicted population, we must garner a greater understanding and respect for the goal of perfect posture and its relationship to chronic pain, so we can teach our clients how to lead healthier, happier and more productive lives. May we all be graceful dancers, stretching artlessly to the sky.
Click here for more information about Erik Dalton, PhD.
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