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Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
September, 2003, Vol. 03, Issue 09
What Memories Can Bring
By Keith Eric Grant, PhD, NCTMB
Teaching massage has many rewards.One of these comes from simply enjoying the interplay of individual personalities working together closely, as we do in massage classes. An even deeper satisfaction comes in watching how students' skills develop and their confidence increases over periods as small as several weeks. These developments imply that our teaching is making it into our students' sensory input through the filters of awareness and practice, and into their multiple types of long-term memory. Without memory, we would begin anew each week and never get far. Understanding more about the structure of memory gives us a hint of how learning occurs.
Neurologists have broken the structure of memory into sensory working and long-term memory.6 The first stage, sensory memory, receives the river of input from our senses. It has a large capacity, but only holds information for about one second. The next stage, working memory, has a more limited capacity (seven items, plus or minus two) and holds information for 20 to 30 seconds. Neurologists believe working memory can be divided into a central executive controlling attention, an auditory (phonological) input loop, and a visual input sketchpad.1 The final memory stage is long-term memory, which handles anything we remember longer than working memory can hold. Long-term memory has a near-infinite capacity and seems to be broken up neurologically to process different types of input and content. Long-term memory is thought to divide into declarative memory (conscious memory for events and facts) and implicit memory (unconscious memory for skills; habits; repeated recognition; emotional responses; skeletal musculature; and reflex pathways).9
What neurologists and psychologists have learned about the structure of long-term memory functioning has often come from examining the effects of brain injuries. More recently, functional magnetic resonance imaging (fMRI), which measures oxygen flow to different areas of the brain, has been used to display activity in different structures of the brain while doing specific mental tasks. Foster and Jelicic discuss research with amnesia from brain injury in introducing a recent compendium of articles on the structure of memory:5
The term 'memory' can refer to numerous different kinds of remembering and types of knowledge. We will be dealing with information, which is retained in long-term or secondary memory, also referred to by some authors as the permanent memory store. This memory store spans a period from a few minutes to a lifetime. Within this system, evidence from amnesic subjects has proven particularly informative in determining the organization and operating principles of memory. Thus, amnesic individuals have profound memory loss for events which occurred after their brain damage (i.e. they manifest a severe anterograde amnesia), but relatively better preserved memory for events which took place before the occurrence of the brain damage (i.e. their retrograde amnesia is typically less severe). Amnesiacs also typically have preserved functions in other psychological domains; for example intelligence, perception, language and motor functions. Importantly for the theoretical view of long-term memory organization, amnesiacs continue to be able to learn specific types of new information, such as perceptual and motor skills.
It's striking that motor skills can be learned by amnesiacs when they no longer have the ability to memorize facts or remember events for more than a few seconds. This "dissociation" between brain functions indicates to neurologists that conscious (declarative) memory and (procedural) memory for motor skills are physically separated in our brains. Even more intriguing, amnesiacs presented with a word, such as "reason," tend to complete the word fragment "rea" as "reason," rather than other alternatives, such as "reader " or "reality."3 Although conscious memory was lost, some previous experiences remained at an unconscious level.
There is a profound implication in this research that the touch we provide in massage will interact with both conscious and unconscious memories. This provides a pathway for working with life experiences our clients may have consciously forgotten but still recall in their body usage. Such research also adds direct neurological support for pediatrician Mel Levine's observation that neurologically based memory deficits can be very specific, compromising performance; for example, in the massive detail recall used on tests while allowing near normal processing in the less memory-intensive activities of everyday life.7
The physical separation of different facets of memory helps explain the observation that the activity in which facts are presented is an integral part of what is learned. Situations co-produce knowledge through activity. Learning, and the ability to use what is learned, is fundamentally linked to the situation in which it occurred. There is a strong indication that competence can only be measured in situations approximating actual usage. Even the medical profession is becoming aware that objective knowledge and competence are not equivalent, leading to a proposal that "professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served."4
Working with the memory we each have been given, there remain ways in which we can prompt our memories. Elizabeth Phelps describes ways that emotional content may improve recall, perhaps explaining Elizabeth Bowen's observation in my opening quote:8
For instance, although we know that there are several different types of memory in humans, the predominant one is the ability to recollect information at will. These memories for emotional events seem to have a persistence and vividness that other memories lack. There are several possible ways emotion may alter this explicit, hippocampal-dependent form of memory. Emotion may alter the rate of forgetting for emotional stimuli. Emotion may also provide an organizing theme to aid in later recall. Emotion may influence attention or perceptual encoding, which may effect later recollection. Emotion could also add a component of distinctiveness. All these variables may act independently to influence our ability to recollect emotional information.
Before the printing press was invented, techniques for memorization held greater importance for maintaining and passing on knowledge in an oral tradition.10 People used mnemonic strategies that grouped information using acronyms for easier recollection. We still do this today, using the acronym SITS, to help remember the muscles of the rotator cuff, the Supraspinatus, Infraspinatus, Teres minor and Subscapularis. We still use acrostics, in which the first letter of each word in a sentence is the first letter of a bone or muscle. Thus, the phrase, "Some Lovers Try Positions That They Can't Handle" helps us to remember the eight carpal bones: Scaphoid, Lunate, Triquetrium, Pisiform, Trapezium, Trapezoid, Capitate, and Hamate.
A more involved visual format of mnemonic, the Method of Loci or "Memory Palace", dates back to the Greek orator Simonides in the 5th century BC. Supposedly, Simonides was at a banquet, but had left the room just before the roof collapsed. He helped identify the bodies by visualizing a walk through the room, as it was when he left it, noting where different people were in the room. Later, remembering would be visually associated with specific settings in visualized buildings, or so-called "memory palaces." To remember the material, one simply walked mentally through the buildings, often to recalling sequences of items that numbered in the thousands.
Memory brings us much in our senses of self and embodiment. Living within our bodies, sensory input - touch; texture; odors; and light - acts as a direct pathway into accessing memories held below our conscious recollection. In touching our clients' skin, we touch their entire lives - history, present, and future. It's something to remember.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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