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We Have Come a Long Way – But There's a Long Way to Go; Grounded and Connected.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Leg Length and Pelvic Fixations
A common component of low back pain is sacroiliac joint dysfunction. Signs of SIJ dysfunction can include fixation with reduced range of motion, and localized pain or joint laxity and inflammation.
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
Connections Worth Making
"If most doctors are like me, [they are] isolated physically and professionally. I do not make the time to connect with other doctors and also a lot of doctors do not want to be connected for a lot of reasons. Dynamic Chiropractic keeps me grounded and connected.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Online Efforts That Convert Traffic Into Patients
Most chiropractors are using "dinner with the doc," "refer a friend," customer appreciation days, grand openings, health fairs, chamber of commerce meetings, and other networking events to get new patients.
Joint Supplements for Athletes (Part 1)
Maintaining joint health should be a daily focus for athletes. Joint health is a complex issue for everyone, but for athletes it poses a greater concern.
What's Triggering That Point?
An orthopedic friend recently saw a patient of mine. He felt an injection of a trigger point (TP) at the upper trapezius and surrounding areas was necessary, since that was the patient's area of chief complaint and there was a tender, radiating nodule.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Adjusting the Occiput on the Atlas
You may never see a particular set of patients in your office – the ones who are either afraid of neck adjustments or have had a bad experience. A vast majority of those who had a bad experience did not have a life-threatening vascular event.
A New Era of Injury Awareness Means a New Focus on Prevention
Despite a dramatic Super Bowl last month, the National Football League has taken quite a few hits lately concerning player injuries, particularly concussions.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
The Easy Way to Learn How to Document ICD-10
The 2015 Work Plan for the Office of the Inspector General (OIG) includes a focus on chiropractic services. This means chiropractors can expect to see more audits and reviews in the coming year because private payers pay attention to the OIG's focus as well.
July, 2003, Vol. 03, Issue 07
By Neal Cross, PhD, NCTMB
In 1964, Davis published a wonderful monograph describing the functional anatomy of the Giant Panda,1 including a detailed description of the panda's "thumb." Although not a real thumb, this connective tissue pad and underlying bony anatomy functions as a thumb in helping to grasp bamboo: the mainstay of the panda's diet.
Stephen J.Gould's 1980 volume, discusses various functional anatomical adaptations that have occurred in many different taxa over evolutionary time; chapter one discusses the panda's thumb specifically. As functional as this tissue is, it is a far cry from our opposable thumbs. One could, in fact, make the argument that our thumbs are one hallmark of being human - certainly our hands are the mainstay of the massage profession.
The thumb, or first digit, is made up of two phalanges and associated soft tissue. It is attached to the wrist at the first carpometacarpal (CMC) joint. This is a classic saddle joint where the base of the proximal first phalanx and the distal surface of the trapezium are reciprocally saddle-shaped. This allows for considerably more degree of motion than found with any of the other four digits.
The motions allowed at this joint are flexion/extension; abduction/adduction; opposition/apposition/reposition; and circumduction:
The ligaments surrounding the first CMC are very important to the integrity and function of this joint. There have been five ligaments described.4 These ligaments generally allow considerable motion, thus they are not as commonly injured as the metacarpophalangeal (MP) joint; however, the CMC is commonly affected by osteoarthritis. 5 The ulnar ligament of the thumb's MP is frequently stretched or torn. This has been referred to as "gamekeeper's" thumb (early gamekeepers used to dispose of farmyard fowl by placing the bird's neck between the thumb and forefinger and snapping the neck) or "bowler's" thumb.
Currently, the most common injury here is related to ski pole usage. At any rate, the injury is the result of a traumatic event that tears the ulnar collateral ligament when the thumb is forced into hyperabduction/extension. By gapping the MP joint using a valgus force, one sees a dramatic gap on the ulnar side of the joint. Splinting is indicated for a stretched ligament, and surgery for a torn ligament.5
Another common problem of the thumb is de Quervain's tenosynovitis.5 This involves inflammation of the abductor pollicis longus and extensor pollicis brevis tendons within their tendon sheaths at the lateral (anterior) border of the anatomical snuffbox. Remember, the anatomical "snuffbox" is that region bounded by the tendons of the abductor pollicis longus and extensor pollicis brevis, laterally (anteriorly); and the extensor pollicis longus, medially (posteriorly). The radial artery runs along its floor; here, the artery's pulse can be palpated. Treatments of de Quervain's tenosynovitis include immobilization, steroid injections and surgery.
Back to the panda's thumb: Where did it come from? It seems to be a modification of the connective tissue overlying a modified sesamoid bone. We have two sesamoid bones associated with our first metacarpophalangeal joint. These bones serve as attachments of thenar muscles. The abductor pollicis brevis and flexor pollicis brevis attach to the lateral sesamoid and the proximal phalanx, while the two heads of the adductor pollicis attach to the medial sesamoid and the proximal phalanx. Both of these attachments continue on to the extensor hood, as well. It seems that over evolutionary time, some carnivore taxa had a more developed lateral sesamoid bone. This developed into a large sesamoid bone, as seen today in the Giant Pandas. Other mammals, like the raccoon, have sophisticated grasping function, but not nearly as sophisticated as ours.
Take good care of your thumbs. They serve you well.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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