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HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
October, 2003, Vol. 03, Issue 10
CranioSacral Therapy and Scientific Research, Part I
By John Upledger, DO, OMM
I cannot count the number of times I have been told by well-meaning friends and harsh critics that CranioSacral Therapy (CST) should be investigated using scientific methods. Many people say CST would be a real boon to health care - if only there were more scientific proof.In a recent article (www.massagetoday.com/archives/2003/03/07.html), I explained why I believe CST can never be adequately evaluated within the confines of the laboratory. In addition, many people don't realize that research has indeed been done. For you skeptics, I offer the following overview:
In the mid-1970s, I was approached by Michigan State University (MSU) to uncover the scientific basis for a premise put forth by William Sutherland, DO, in the 1930s: that the joints and sutures of the cranium do not fully ossify, as was once believed. From 1975 through 1983, I was a professor in the department of biomechanics at MSU's College of Osteopathic Medicine, where I led a team of anatomists, physiologists, biophysicists and bioengineers to test and document the influence of the craniosacral system on the body. Together we conducted research - much of it published - that formed the basis for the modality I went on to develop and name CranioSacral Therapy.
I first worked with neurophysiologist and histologist Ernest Retzlaff, PhD, to prove that under normal conditions, cranial sutures do not calcify before death. We studied numerous bone and suture samples taken from neurosurgery patients between the ages of seven and 57 years. Not only did these samples show living sutures completely free of calcification, but they were chock full of collagen and elastic fibers; arteries; arterioles; capillaries; venules; veins; nerves; and neuroreceptors.
After in-depth examinations, we demonstrated definitive potential for movement between the cranial sutures. Yet these results appeared to contradict anatomy-lab samples taken from cadavers whose skull sutures were calcified. These seemingly conflicting findings suggested that the calcification of skull sutures seen in preserved cadavers was due to postmortem changes and reactions to chemical embalming agents. Our findings supported those published in Anatomica Humanica by Italian professor Guiseppi Sperino, who noted that cranial sutures fuse before death only under pathological circumstances.
Once we saw the potential for motion in living sutures, our next step was to demonstrate that the motion we had hypothesized actually existed in the living skull. With the assistance of biophysicist Richard Ropell, PhD, we began using head (band) strain gauges on living subjects. These gauges demonstrated rhythmical expansion-contraction movements of the cranial circumferences at eight to 12 cycles per minute; however, there were other variables that could discredit these measurements as solid evidence of sutural movement, so we had measure the movements of one skull bone in relation to another. While we could not use humans for studies like this, we were able to use live monkeys from the university's pharmacology department.
In pain-free experiments, we anesthetized the monkeys and did minor surgery to cement an antenna directly to each parietal bone, about two centimeters lateral to the sagittal suture, and two centimeters posterior to the coronal sutures. We then wired these two 10-inch antennae so that we could broadcast a radio signal between them. In the recorded wavelengths, we discovered as the parietal bones moved independently of each other, the distances between antenna times changed. These changes demonstrated interparietal movement of about 12 cycles per minute. At one point, I placed a fingertip on the monkey's coccyx. With minimal pressure, I was able to stop the parietal bone motion.
Now we had evidence of a system that could move parietal bones rhythmically - and be stopped by pressure on the coccyx. This and a multitude of other factors caused me to deduce that the coccygeal pressure influenced the parietal motion via the hydraulic force of cerebrospinal fluid (CSF) moving through the dural membrane and myofascial system related to the spinal column and the cranium.
My first inkling that such a hydraulic system existed came some years earlier during a neck surgery I assisted. The lead surgeon had removed the spinous processes and part of the laminae of the middle cervical vertebrae (C4 and C5) in order to expose the meningeal dura mater and keep it intact. At that time, I witnessed a rhythmical rise and fall of CSF pressure at about eight cycles per minute. It became clear that a fluid pressure deep to the dura mater was causing its continual movement. This fluid had to be cerebrospinal, and its volume had to be increasing and decreasing cyclically. Why hadn't this phenomenon been noticed in surgeries before? The answer is surprisingly simple: In most cases, the dura mater was incised. (Fortunately, that's not always the case.) I recently received a letter from Professor Charles Probst, a prominent Swiss neurosurgeon. He reported seeing,
In the case of lumbar-puncture procedures, when the needle enters the CSF compartment, the fluid enters the manometer via the needle and an elbow apparatus. When the fluid rises to its peak pressure, a valve is opened to take a specimen. It was generally assumed that the CSF specimen that was removed accounted for the reduction of pressure in the manometer. Any cyclic drop in fluid pressure was thus overlooked.
Editor's note: Look for the conclusion of this article and its relevant references in the November issue.
Click here for previous articles by John Upledger, DO, OMM.
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