resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
November, 2004, Vol. 04, Issue 11
Myoskeletal ... Machinery of Life?
By Erik Dalton, PhD
The human body is not a machine; indeed, it is very plastic. This plasticity is what gives a dancer grace and an athlete power of movement. Like a machine, however, the body is comprised of many parts - each working for the benefit of the others.Smooth functioning of each part is required for the optimal efficiency and well-being of the entire organism. Proper functioning requires structural balance of all myoskeletal tissues forming from the mesoderm: ligaments, fasciae, muscles, joint capsules, intervertebral discs, bones, etc. This article discusses the mysterious beauty of the body's self-regulatory mechanisms and the reciprocal nature of structure and function.
For the body to sail smoothly through life, it must have a way of repairing, regulating and protecting itself. Unlike a machine, the human body has self-regulatory mechanisms that allow it to adjust to environmental stresses while maintaining homeostasis in all systems: myofascial, skeletal, nervous, circulatory, endocrine, etc. These mechanisms attempt to keep the body in balance regardless of what works upon it or what happens around it; thus, the human body has built-in devices to protect it from disease and other outside forces that may jeopardize its health. It has the ability to produce specific antibodies after exposure to an antigen through a process called active immunity. Through complex interactions, the body is able to detoxify ingested, absorbed, inhaled or injected drugs, and foreign substances. Likewise, when physical injury occurs, local myofascial structures tighten (protective muscle spasm) allowing the body to compensate and continue on its journey safely, healthfully and productively. Regrettably, the compensations often spread and are soon reflected in every step we take.
So, the body is not a machine. It is a dynamic mechanism capable of continually repairing and replacing worn-out and injured cells. It works to heal dysfunctional joints and soft tissues, including visceral structures. D.D. Palmer, the father of chiropractic, once noted, "the body is always working toward order" in a process guided by an underlying "innate intelligence." Through years of acute observation, many manual therapists have become aware of this innate intelligence and learned to view the body itself as the primary healer, offering their hands and skills only as tools to assist the process.
From this perspective, the therapist's job - and ultimate intent - should be simply to guide the healing process. There is no need to control the process or force one's will upon it. Albert Einstein offers a beautiful summation, "All means prove a blunt instrument if they have not behind them a living spirit."
Structure and Function
An important guideline for all manual therapists specializing in pain management is to develop a basic understanding of the reciprocal interrelationship between structure and function. Simply stated, structure affects function; function affects structure. It is not necessary to look very deeply to see that functional demands require specific structures. A jet is cumbersome on the ground, and the wheelbarrow was not designed to fly. For the jet to function in the air, it needs wings, navigational instruments, rudders, and the like. Yet having that structure makes it perfectly suited for the function of flying, so structure also determines function.
The body's myoskeletal system was not designed to simply lug around 30 feet of intestines, 60 miles of blood vessels, the heart, lungs, sex organs, etc. It exists so people can accomplish tasks and effectively communicate physically and emotionally. The myoskeletal system should therefore be considered a major part of the "machinery of life." With this understanding, it can be said that there are neurological as well as myoskeletal components present in every dysfunction or disease, although all aspects may not be immediately obvious (e.g., with such conditions as fibromyalgia, chronic fatigue syndrome or visceral disorders). In fact, prolonged myoskeletal dysfunction will eventually "burn" a memory pattern within the central nervous system so that even after the initial irritating myoskeletal obstruction is removed, the original symptoms continue and may actually grow in severity.
When working from a structural model, the trained manual therapist is often able to identify and treat dysfunction in patients who have no symptoms and by some standards would be considered healthy; this is done by identifying strain patterns before they become pain patterns.
Structure and Function: The Relation to Gravity
When studying human structure, it becomes apparent that structure and function of the musculoligamentous system are particularly influenced by, and responsible for, static and dynamic postural alignment. Postural (tonic) muscles are structurally designed to resist fatigue and function in the presence of prolonged gravitational exposure, such as standing upright. When their capacity to resist stress is overwhelmed, tonic muscles become irritable, tight, and often shortened; through reciprocal innervation, their antagonists become weak and inhibited. As typically weak muscles, such as rectus abdominis, gluteals, deep neck flexors, and lower shoulder stabilizers, begin to loose the battle with gravity, weight is transferred to deep ligamentous and bony myoskeletal structures. The antigravity function of the body's myofascial system is lost.
This persistent gravitational loading ultimately results in the formation of predictable asymmetrical postural patterns in the neuromyoskeletal system. Dr. Ida Rolf made this relationship of structural alignment to gravity one of the keynotes of Rolfing, and it remains a definitive feature of all forms of structural integration.
A person's posture (structure) has much to do with the ability to perform efficiently. When the viscoelastic deformation properties of muscle are unable to resist postural stresses, predictable pathophysiologic changes occur. These changes are both functional and structural. The elastic component represents the transient functional change in connective-tissue length, occurring in response to stressors such as forward-head postures (i.e. Dowager's humps). The viscous component, on the other hand, is responsible for the more permanent deformation of connective tissue that occurs with static, long-term postural change as witnessed in the scoliotic population.
Musculoligamentous structures are easily recognized in clients exposed to prolonged gravitational stress. Symptoms arising from these common myofascial strain patterns have certain associated palpable characteristics that include the following:
Eventually, prolonged postural stress leads to predictable functional changes, such as a loss of flexibility, shallow breathing patterns, chronic fatigue, and digestive or hormonal disorders.
Therapists must learn to identify the subtle palpable changes and postural-pattern clues when assessing for neck, back and extremity pain. As myofascial structures undergo sustained changes in length and strength, new collagen realigns the connective tissues in response to vectors of stress. Often this process perpetuates postural problems by amplifying the biomechanical stress of gravity. Although these postural patterns are compensated, without proper manual therapy and home retraining exercises, they can easily de-compensate and quickly manifest as primary pain-generators.
Manual therapists often filter the results of the client's history, palpatory findings, and all other pertinent tests through a philosophic lens formed via the scientific scope of basic science and clinical experience. Impaired or altered function of the neuromyoskeletal system leads to stress and pain which may alter performance of internal organs, the hormonal system, and psychoimmunological functions. Fortunately, the body is not a machine and possesses the innate ability to heal - with a little help from friendly hands.
Click here for previous articles by Erik Dalton, PhD.
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