resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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 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.
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.
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.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
June, 2003, Vol. 03, Issue 06
The "Secret" of Chinese Pulse Assessment
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
The little-known fact about Chinese pulse assessment is this: It's really easy. When I hear teachers go on and on about the need to take 500 pulses before it means anything, I roll my eyes.Yes, memorizing all 28 pulse qualities takes time; connecting the information to what you feel takes a little longer; and perfecting a more complex system, such as the one described by Dr. Shen in Leon Hammer's comprehensive and eloquent pulse diagnosis tome (800 plus pages), will take quite a bit of discipline, but immediately obtaining usable information you can trust takes only a few hours. These articles will give you an idea of how to complete a qualitative pulse assessment, judging whether qi is weak or strong in each of the 12 main positions. It takes longer to distinguish between the 28 pulse qualities, but when you get confident in assessing the relative strength or weakness in each position, you can start to describe the different qualities of the pulse waves.
Examination Approaches: East vs. West
Although the pulse can give you important information in developing a treatment plan, you must consider it in relation to other signs and symptoms. Actually, looking at the pulse in isolation is contrary to the spirit of Chinese medicine; rather, it must be viewed as an integral piece of a whole complex of symptoms. The Chinese medicine view is broader in scope than the subjective or objective data collected in Western medicine approaches, in which the signs and symptoms are considered directly related to the client's chief concern.
For example, a client presents with lower-back pain. A Western-based practitioner conducts a detailed intake in which he or she asks about the quality of the pain; what relieves and aggravates the pain; the severity of the pain; when the pain started; and how posture, lifestyle and attitude come into play. The practitioner may look at X-rays, MRIs, ROM and other physical exams. Most of this information is thought of as directly relating to the lower-back pain, which yields an assessment and treatment plan.
Suppose the same person with lower-back pain comes to see a practitioner of East-Asian medicine. Many of the results from the same type of examination are considered, but information that appears unrelated can be just as - if not more - important. For example, a weak pulse in the third position can be a tip-off to the presence of lower-back pain even before the client says anything. A slow and deep pulse points to its root cause as a Kidney Yang Deficiency (see corresponding article www.massagetoday.com/archives/2003/03/12.html), but there would have to be other symptoms present to confirm that assessment, such as getting up at night to urinate; cold feet; lack of motivation or will; impotence; and/or a swollen tongue with white coating. At this point, a clear, cohesive picture of the energetic balance of the client develops, including emotions and physical manifestations, so the practitioner can select treatment principles and a plan to obtain optimal results.
Back to pulses. If you are an Asian bodywork therapist (ABT), you gather the above information using the Four Pillars of Assessment, sometimes called the Four Examinations, which are pulses belonging to the "touching" category. Other examinations include looking, hearing, smelling and asking. There are so many strategies under each of these categories that you could spend all day doing an initial intake. I prefer to gather a little bit of information at a time because I find that people don't reveal everything right away anyhow, no matter how thorough the examination. I gather enough information to begin treatment; as clients open up in subsequent visits and I see how they have responded to their last sessions, I can adjust my approach (called "assessment by treatment").
The pulses are examples of how the microcosm reflects the macrocosm. Basically, any part of the body gives you a picture of the entire body. Microsystems developed for the ears, eyes, hands, feet, face and tongue have proved accurate and useful. I'm sure you could come up with a microsystem for elbow assessment and treatment if you were so inclined!
In my next article, I will give you the method for taking the pulse and a map with which to start. For "hands on" pulse instruction, visit www.aobta.org/schools.htm for a list of schools that offer in-depth programs in Asian bodywork therapy.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.