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Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
December, 2004, Vol. 04, Issue 12
Medical Massage for Jaw and Joint Disorders
By Boris Prilutsky, MA
"Stay in Touch With..." is a periodic column designed to provide an overview of a particular technique or modality. If you would like to contribute to this column, please e-mail .
As a result of a tremendous exposure to stress, the development of temporomandibular joint (TMJ) disorders has reached pandemic proportions.TMJ sufferers experience high-intensity headaches, difficulty with chewing, painful joint clicking and popping, and other symptoms. With the progression of the pathology, individuals may even develop sleep disorders.
TMJ Anatomy: The TMJ is formed by the temporal and mandibular bones. Attached to the mandibular condyle is a fibrocartilage meniscus or articular disk, which allows the mandible to move smoothly. The masticatory muscles (temporalis, masseter, lateral pterygoid, and medial pterygoid) are responsible for movement and stabilization of the TMJ.
Bruxism: Due to stress, people often develop bruxism. Bruxism is a pathological clenching and grinding of teeth that usually occurs during sleep. Bruxism is caused by the hyperactive contraction of the masticatory muscles. Imagine any other muscles in our support and movement system kept under tight contraction for seven hours. Pathological hypertonus in these muscles will be formed, followed by restriction of range of motion, trigger point development, and other symptoms. With time, hypertonic condition in the masticatory muscles leads to the development of osteoarthritis in the TMJ, including negative effects on the articular meniscus. In such a case, the above-mentioned TMJ pathology starts producing severe headaches and painful "clicks."
Massage therapy and Post-Isometric Relaxation Techniques for TMJ Disorders: Massage therapy should be focused toward the reduction of tension in the masticatory muscles, releasing tension in fascia, and elimination of trigger points. Post-isometric relaxation is an extremely important tool for the restoration of the range of motion. Massage therapy steps for TMJ:
Mechanisms of Trigger-Point Therapy: A trigger point is a localization of pain. It can be found in muscles, periosteum, tendon attachment points to bone, as well as near muscle-tendon junctions. Even given the fact that most typical trigger points are developed in the middle of the muscle belly, at the place of nerve-muscle junction, I recommend two ways for discovery of trigger points: First, ask the patient to point to the exact localization of pain (trigger point); second, at the time of performing kneading and myofascial tissue release, ask your client to let you know if they feel a sharper level of pain under your fingers, which will be the trigger point.
The main mechanism of trigger point therapy is ischemic compression. Automatically, we can assume that in the area of the trigger point, arterial blood supply is significantly decreased. By gradually compressing the trigger point and reaching the threshold of pain, we additionally decrease this blood supply to the point. After 10 seconds of this ischemic compression, we ask our client to report their ability to tolerate additional compression (please do not overdo this pressure; stop at a pressure that your client indicates is sufficient, and do not increase it.
Do not increase the pressure if muscles demonstrate protective contraction to the pain sensation.) After 20 additional seconds of compression, quickly withdraw your fingers. While performing ischemic compression of trigger points, arterial blood will accumulate around the compressed point. With the fast withdrawal, arterial blood will rush to the area of the trigger point, and a vasodilation reflex will be awakened.
Mechanism of Post-Isometric Relaxation: One of the factors responsible for the restriction of range of motion is an energetic unbalance inside of the muscles, which is expressed in the form of different tension levels in the fibers of the same muscle. Imagine that in the same muscle, a portion of the fibers is in pathological hypertonus and the rest is in normal tonus. Every movement will increasingly overload the contracted part of the fibers.
This, of course, will cause a higher level of pathological accumulation of tension. At the time of isometric contraction, the fibers of the muscle are actively stretched, which leads to a balancing of the tonus between different fibers in the muscle. After 30 seconds of isometric tension following post-isometric relaxation (stretching), Golgi organs are activated, which in turn will contribute to normal tonus in muscles. In such a case, the muscle will be able to produce adequate energy during contraction and relaxation. The above-mentioned positive changes in muscular tissue will help to restore normal range of motion.
Full-Body Stress-Management Massage: As mentioned before, stress is the main cause of the development of bruxism and TMJ disorders; therefore, it is very important to those who suffer from TMJ disorders (in addition to the protocol which I offer you in this article) to receive full-body stress-management massage. From my experience, the phenomenon of bruxism can be reduced within five full-body stress-management massage treatments given on a weekly basis. Elimination of bruxism is an extremely important factor that will allow the masticatory muscles to be restored to normal metabolism and prevent re-accumulation of tension in the muscles.
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