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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.
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.
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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).
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.
August, 2004, Vol. 04, Issue 08
Stuck With Positioning in Seated Massage?
By Lee Chaffee
I feel a need to address the subject of client positioning during seated massage. I hurt for those clients I've seen in airports, malls, and wherever chair massage is administered, who are positioned with necks over-contracted, shoulders up to their ears, and severely arched low backs.No wonder there aren't lines of people waiting to jump aboard! Just as a client cannot be expected to climb onto a massage table, lie down, and have everything "comfy," a seated massage takes some adjusting. It takes being familiar with your chair and "sizing up" the client.
Get familiar with your massage chair. Open and close it several times, and position your friends and family in it, adjusting for different body builds, before you attempt to sit a paying client in it. As clients enter your room, notice their height, weight and proportion. Sizing up clients will become easier with practice. For the comfort of the client, the neck muscles need to be elongated, not contracted. This position also gives you the ability to get your hands in between the upper traps and base of the occipital ridge.
Observe the positional needs of the client throughout the massage, since it can change based on the amount of pressure applied. Usually, asking the client to put his or her chin a little closer to the chest will correct any loss of position. If the neck is contracted after a few moments of applying pressure to the back, the client will usually end up with a headache. Would you want to pay a minimum of one dollar a minute to obtain that result?
This is how I help direct clients sit comfortably in my massage chair: First, I tell them to sit, then kneel on the kneepads and place their hands on the armrests. Then, with me standing in front of the chair with all levers unlatched (no matter what brand of chair I'm using), I ask them to put their chin to the chest and aim their forehead for the top of the hole in the face cradle, applying a little weight until they feel comfortable. Then I lock the face cradle in place.
Next, I check the client's shoulders to make sure they are not too high or low. I also make sure that the traps are not too contracted or over-stretched, and will raise, lower, or angle the chair's arm rest accordingly. If the chest plate is adjustable at an angle (as well as for height), make sure it is not pushing in on the diaphragm. Doing so can cut off a client's breath and may cause them to faint. I prefer a 45-degree angle, if possible.
The position of the knee rest is up to the clients, as to whether they feel comfortable with their feet touching the floor or not. Usually, if they are not comfortable with their toes touching the floor, they can slide their knees forward. On some chairs, the knee rest comes off.
On some chairs, the seat adjusts but not always to my height. If possible, and if it does not disturb the client's comfort, I prefer the seat of the chair to be a bit higher than my knee. I have found that this height works for any modality. Experiment with this aspect of chair adjustment so that you and your clients are as comfortable as possible.
With a little adjusting, clients can also sit face-forward in a massage chair. I have used the chair this way when clients want work done on their face, head and shoulders. The client carefully sits backward on the seat and leans back against the chest rest, while the headrest is brought up as far forward as it will go. Most chairs have an added adjustment to bring them forward for larger clients. I hope these suggestions have helped. Happy seated massaging!
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