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Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
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 previous articles by Erik Dalton, PhD.
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