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Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
April, 2003, Vol. 03, Issue 04
Tendinitis Masquerading as Knee Joint Pain
By Ben Benjamin, PhD
Question: Which muscle tendon units often masquerade as medial, lateral or posterior knee ligament or joint injuries?
Answer: c - semitendinosis, semimembranosis, biceps femoris and gastrocnemius
The semitendinosis, semimembranosis, biceps femoris, popliteus and gastrocnemius are the muscle tendon units responsible for knee flexion. The semitendinosis and semimembranosis are located on the medial aspect of the knee, while the biceps femoris is located at the lateral aspect. Collectively known as the hamstrings, they work together to flex the knee. The superior portion of the gastrocnemius muscle tendon unit, located at the back of the knee, and the popliteus muscle also assist in the initiation of knee flexion.
All of these tendinous attachments may become injured and give rise to a confusing type of knee injury. Pain felt medially, just posterior to the medial collateral ligament, may mean injury to the semimembranosis has occurred; pain at the medial upper tibia, or slightly behind the medial aspect of the knee in the tendon body, may indicate hamstring tendinitis of the semitendinosis; and pain at the head of the fibula, or slightly superior, may be caused by tendinitis of the biceps femoris.
Since this tendon attaches to the fibula head (the same bony prominence the lateral collateral ligament is attached to), it can be difficult to differentiate these injuries unless the practitioner is skilled at testing both ligaments and tendons. Superficial pain felt directly behind the knee may be caused by strain of the popliteus muscle or the gastrocnemius muscle at its broad upper tendon attachment.
Bear in mind that when a tendon is injured, no swelling or limitation in flexion and extension of the knee occurs. Swelling at the knee usually indicates a ligament injury, or injury to some structure within the joint capsule, such as the medial or lateral meniscus.
Continuing to educate ourselves in the most current information is vital in helping our profession grow in skill and stature. Identifying if a client has a superficial tendon or ligament injury (which can be treated with myofascial or friction massage techniques) is an important part of a therapist's education. On the other hand, trying to treat a client with knee pain caused by torn cartilage or a cruciate ligament tear (for which hands-on therapy will not help) will leave the client confused, frustrated and disappointed. Treating the wrong structure because of limited knowledge is an all-too-common error.
I continue to learn, and encourage you to do the same.
Click here for more information about Ben Benjamin, PhD.
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