Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
March, 2004, Vol. 04, Issue 03
Discovering the Mastery in the Art of Connective Tissue Massage, Part One
By John Latz
Shifting paradigms is hard work for most people, especially when our egos are involved and our paradigms are reinforced by cultural norms. I encountered my own misinformed paradigm when I experienced Dr.Ida P. Rolf's structural integration work for the first time. Before that, I had only one perspective about my body, but structural integration changed that. It shifted my paradigm.
I started competitive swimming at a young age; by the time I entered college I was training three hours a day. The years of conditioning had left my extrinsic musculature overdeveloped. I believed this condition was ideal until I studied massage therapy in 1980, when I realized how much muscular effort I used in everything I did. I enjoyed giving massage, but it wore me out. I did not know how to relax and access my own power while giving massages. When I received a massage, it was difficult for me to feel "inside" myself. My body was incapable of proprioceptive feeling. Years of tension had created thick, dense patterns of physical and emotional armoring; this is what led me to receive the 10 session series of structural integration.
tructural integration reorganizes the body into a balanced vertical alignment within the gravity field. During these sessions, I was taught how to relax and let go of tension. It was freeing when constricted layers of connective tissue let go of adhesions and "knots." I experienced a new, inner awareness of my body, and I became more in touch with my emotions and how they affected my body and structure. I felt stronger when I swam, and I had more energy when I gave a massage. I was so happy with this "new" me that, in 1985, I decided to learn structural integration at the Rolf Institute.
The Body has a "Sleeve" and a "Core"
Ida Rolf's theories about human structure radically changed my concepts about my body. She described the body as having a "core" and a "sleeve." Think of a tree with a core. In each year of growth, a new layer of tissue wraps itself around the core. Human bodies are a lot like trees. We are made of layers of fascia, wrapping around our center. Our outermost layer of connective tissue is like tree bark; most of us live and work in this tough outer layer, protecting our soft inner selves. This deeper core space - symbolically and experientially our center - is our place of inner peace, contentment and deep feeling. Dr. Rolf described the core and sleeve as having a functional aspect, using the words "intrinsic" and "extrinsic." In general, the musculature closer to the bone is intrinsic; tissue nearer the surface is extrinsic.
In movement, intrinsics initiate a movement, and extrinsics take it further. According to Dr. Rolf, there needs to be balance between intrinsic and extrinsic function to achieve what she called "balanced movement." She often said, "If you can see the muscle that's doing the movement, it's not a balanced movement."1 Dr. Rolf extolled Fred Astaire as a model of balanced - intrinsically and extrinsically - powerful movement. She said that his knees had a life of their own, and asked us to watch his effortless movements as an example of natural intrinsic capability. According to Dr. Rolf, this intrinsic movement initiated from the core of the body with minimum expended energy. She often said: "Strength that has effort in it is not what you need. You need the strength that is the result of ease. To me, strength is balance."2 Strength comes when we integrate our core and sleeve; then we have the potential for graceful and balanced movement.
The opposite of balanced movement is movement from the "sleeve." Kramer, the character from the TV sitcom, Seinfeld, models fast, jerky, uncoordinated movement, tension, and a high-stress lifestyle. His unbalanced emotional behavior is part of his sleeve-dominated body image. Kramer, like all of us, has a core, but he cannot access it. Ida Rolf would have said that Kramer is "stuck in his sleeve."
As a beginning massage therapist, I also felt "stuck in my sleeve." I wasn't quite like Kramer, but I felt restricted in my somatic growth, nevertheless. In the paradigm we absorb from our culture, we overemphasize extrinsic movement, giving us a power produced by gross motor actions. This is the paradigm I had as a competitive swimmer. I was absorbed by esthetics: a body image that included six-pack abs, buns of steel and bulging biceps. Balanced movements, however, are rarely promoted in the media.
Our desire to match images of fashion models and actors has created a belief that the external body is what counts. This notion sends people to the gym, where they - like me in my youth - unconsciously create tension, contraction, compression and restriction in their structures. Our cultural paradigm is eroding our ability to connect with our place of inner peace, contentment and deep feeling - it is eroding our ability to move freely.
Over the years, I learned to access my intrinsic movement. I went through a process of evolution to find the best way to use my body. I wanted to transfer the intrinsic healing energy to my client without extrinsic blocks, and I found that the positioning of every aspect of my body affected the power factor. I use the term "body mechanics" to describe my relationship in space to a client's body. I show massage therapists this system of body mechanics as the foundation of connective tissue massage (CTM).
Once I accessed my core, I found more power in my work and could utilize that power to reach deeper layers in the bodies of the client with little effort. I was able to stay present in a session and was no longer distracted or disconnected. I recognized these changes as personal somatic growth and maturation. I finally understood, in my own body, the words that Ida Rolf had spoken years before: "This business of living in extrinsics is characteristic of the very young; it is characteristic of the immature...it may be that as long as you pre-eminently use the extrinsic muscles, you are immature. Perhaps maturity occurs as you begin to get intrinsics into the picture and bring both to balance. That is what it looks like as you work on kids."3
Learning to connect with our core is easier when the CTM body mechanics become part of our working posture.
Connective Tissue Is an "Organ of Posture"
It is helpful to have a three-dimensional understanding of connective tissue. No textbook, picture, or cadaver can adequately represent life-filled fascia. The supporting nature of fascia and its relationship to the structure of the body requires a new way of seeing and feeling the body in action. Our body's connective-tissue system is structured like a honeycomb and designed to keep our internal "honey" in the right compartments. Our connective-tissue structure is intimately integrated with our skeletal system and keeps our structural integrity intact.
Without three-dimensional connective tissue, our bones would fall into a heap; therefore, connective tissue is an organ of posture. Many people are surprised when they first experience fascial manipulation. The experience helps shift our point of reference from fixed landmarks (like frozen shoulder or tennis elbow) to relational webs. We experience our fascia like strands of spherical spider webs. We sense how our fascia connects to some part of our body that we previously thought was unrelated to our "sore spot."
This relational web of fascia in our bodies can also create problems. Connective tissue is capable of shrinking, twisting and sticking to itself and to other structures, especially our bones and organs. Connective tissue can dehydrate and shrivel like a wool sweater that is put into a hot dryer; in essence, the entire body is pulled out of alignment. Since fascial sheaths surround all muscles, bones and organs, dehydrated fascia compresses these structures, compacting the body, restricting movement, and often creating pain.
Typically, clients believe their pain is caused by muscle imbalance, skeletal displacement and nerve compression. They strengthen their muscles using extrinsic methods, such as weightlifting and power stretching. In reality, this cultural paradigm of extrinsics - while it may enable us to function in basic ways - reduces our freedom in movement, and disconnects us from our core. By practicing CTM, we can re hydrate, re-energize and lengthen the connective tissue quickly and easily. Tight, congested muscles release, increasing flexibility, and reducing strain and discomfort.
Editor's note: Part two of this article will appear in the April issue of Massage Today.
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