resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
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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