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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.
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.
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.
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).
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.
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.
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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%.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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).
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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