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The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
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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