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Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
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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