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Acupuncture and the Pulse
In 1991, I attended a martial arts workshop hosted coincidentally by Sung Baek, a martial artist and the head of his lineage as a Korean trained acupuncturist. I was enamored by the details Sung could attain from the pulse, as told to me by some of his apprentices.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
Use Technology to Gain New Patients and Improve Efficiency
From the smartphone in your pocket to your microwave oven, advancements in technology have made almost every aspect of our lives easier.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
How One Little Symbol (#) Gets You More Patients
Are you struggling to get more fans or followers for your acupuncture practice? Or are looking for ways to simply connect with your patients? Or do you just want to know how to keep them engaged (comments, retweeting, liking and sharing)?
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Calculating Billable Units
I recently learned of an office that was audited based on the number of acupuncture sessions performed in one day. Is there a maximum number of sessions that can be performed in one day?
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
The Source-Luo Point Combination
The luo collaterals are part of the acupuncture channel system presented in the Su Wen and the Ling Shu (The Nei Jing). The function and clinical application of the luo mai are primarily presented in chapter 10 of the Ling Shu, however, they are also found in others chapters in the Su Wen and the Ling Shu.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
Acupuncture in the U.K. Today: A Personal View
When asked to write a short piece on the current state of the U.K. acupuncture profession, my first response was to say it has all been relatively quiet.
The Modern Acupuncturist
You studied ancient Chinese medicine, but I'll bet you don't practice it! Contrary to popular belief, our medicine has evolved A LOT over the years. Let's take a brief walk through history and discover the differences between ancient and modern acupuncturists.
TMF 2015 Scholarships
The Trudy McAlister Foundation (TMF), a nonprofit organization established to support students who are on track to make contributions either to clinical practice and/or to the understanding of the role of Traditional Oriental Medicine, has announced the 2015 scholarship recipients.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients, in May 2014, researchers showed that drinking the equivalent of 2 to 4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
What Does Success Mean to You?
Recently, I was asked to speak to young, budding businesswomen about running a successful business — and at first I thought, "Me? You want me to speak to others about success?!"
Breath: The Movement of Oxygen and Energy
I remember with surprising clarity the first time a patient started crying during an acupuncture treatment I was giving. This is now quite a long time ago, back in 1999, when I was a student.
The Nectar of Plants: Essential Oils and Chinese Medicine
Essential oils are a very hot topic these days, especially with the likes of the Ebola virus and the resurgence of measles lurking in our awareness, but when I first became interested in Chinese medicine, essential oils weren't on the radar screen for acupuncturists.
The Year to Make Things Happen
It is hard to believe that the Year of the Ram – 2015 is half over. Time seems to be moving especially fast. This is the year for things to happen for the acupuncture profession.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
February, 2005, Vol. 05, Issue 02
Syndesmosis Ankle Sprains
By Whitney Lowe, LMT
Ankle sprains are the most commonly occurring lower extremity soft-tissue injury. An estimated 85 percent of all ankle injuries involve ligament sprains. Of the various ligaments around the ankle, the majority of injuries occur to the ligaments on the lateral side of the ankle, primarily the anterior talofibular (Figure 1).If injuries are more severe, they may also include damage to the calcaneofibular ligament.
While the lateral ankle sprain is the most common ankle ligament injury, it is not the only one. Failure to recognize other types of ligamentous injury, such as a syndesmosis sprain, may lead to inappropriate treatment and prolonged disability.
Due to the number of joints in the ankle region numerous ligaments are needed to maintain joint stability. Most of the joints in the foot and ankle have significant movement capability; however, that same degree of mobility is not present in a syndesmosis joint. A syndesmosis is a fibrous joint with very little mobility where two bones are directly connected by ligaments or some other connective tissue membrane. The syndesmosis in the ankle where ligament sprains may occur is the distal tibiofibular syndesmosis. It is the tough fibrous connection that holds the distal ends of the tibia and fibula together.
The distal tibiofibular syndesmosis is composed of several ligaments and connective tissues. They include the lower margin of the interosseous membrane, interosseous ligament, anterior tibiofibular ligament (Figure 1), and the posterior tibiofibular and transverse tibiofibular ligaments (Figure 2). Because the syndesmosis ligaments are more proximal than the other ligaments commonly injured in an ankle sprain, the syndesmosis injury is often called a "high ankle sprain."
Injuries to the ankle syndesmosis are most likely to result from excessive rotation of the ankle (adduction or abduction of the foot), extremes of dorsiflexion, or combinations of dorsiflexion with adduction or abduction. The type of injury that produces syndesmosis sprain commonly occurs in sports played on turf with cleated shoes. For example, suppose an athlete has a cleated shoe that digs into the turf and keeps the ankle relatively immobile. If that person falls forward (causing dorsiflexion of the foot) at the same time that s/he is attempting to turn to the side (causing rotational stress in the ankle), injury to the syndesmosis is likely.
The common lateral ankle ligament injuries are usually not difficult to identify because the injured ligaments are superficial, making their palpation much easier; however, in the syndesmosis joint, palpation of the injured ligaments is not easy because other soft tissues obscure the ligaments. Therefore, several special orthopedic tests are used to help identify the syndesmosis sprain.
In addition to other important factors from the history, visual examination, and range-of-motion evaluations, the squeeze test and external rotation stress test may be used to evaluate syndesmotic injury. In the squeeze test, the distal tibia and fibula are gently squeezed together proximal to the syndesmosis joint.
If the client's pain is reproduced with this maneuver, damage to the syndesmosis ligaments is likely. In the external rotation stress test, the practitioner uses one hand to stabilize the tibia and fibula while the other hand gently externally rotates (abducts) the foot. The foot is in a neutral position or slightly dorsiflexed when the rotational movement is started. If this movement reproduces the client's primary pain, there is a good chance that the distal tibiofibular syndesmosis is involved in the injury.
It is important to recognize an injury to the ankle syndesmosis because an incorrectly identified problem may lead to errors in treatment or prolonged disability. If your client has sustained an ankle injury, identify the primary tissues injured so appropriate treatment can be provided. Refer the client if the injury appears more serious. Syndesmosis sprains may become chronic instability problems in the ankle if they are not properly evaluated and treated.
Click here for more information about Whitney Lowe, LMT.
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