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Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
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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