resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
May, 2005, Vol. 05, Issue 05
The Amazing Fascial Web, Part I
By Leon Chaitow, ND, DO
Author's note: Research information summarized in this article has been drawn from content in the 2nd edition of my book, Clinical Applications of Neuromuscular Techniques: Volume 1[Churchill Livingstone, 2001], due for publication early in 2006.
I don't know about you, but "wow" moments seem to be on the increase for me.I guess we all have our own sense of what's exciting, important, "new." For me, it is when different strands of our knowledge-base collide as a result of new research or insightful observations; when connections are made between apparently different aspects of what we know and do, as we attempt to assist our patients/clients towards better health. My intention in this short communication is to share a few of the most recent of these synchronous pieces of information, in the hope that you might experience some of the excitement that research into the way the body functions appears capable of regularly delivering.
Helene Langevin, PhD, is a research scientist working at the University of Vermont. What she and her colleagues are doing is nothing short of revolutionary, and we owe gratitude to them for the new vistas that are opening as a result. Another researcher of importance in this story is Donald Ingber, PhD, whose work on bone-density problems in astronauts, on behalf of NASA, is part of a marriage between ancient Chinese concepts, modern molecular research, and the space program!
Let me start somewhere else, and to then try to bring the focus back to the work of Drs. Langevin and Ingber. Many years ago (early to mid 1960s) as a young-(ish) osteopath working in London, I completed my acupuncture training, and found myself experiencing a sense of deep frustration at my inability to integrate traditional Chinese medicine (TCM) concepts with my understanding of anatomy and physiology, based on Western scientific tradition. The solution for me was to write a book on the subject (Acupuncture Treatment of Pain, Healing Arts Press, 1976).
I have often found that when a subject confuses me, or when I have partial knowledge of an area of my work, the best way of really getting to grips with the problem is to write a book about it - a process that virtually guarantees sufficient research and study to really understand it by the time the book is finished!
To be sure, the writing of the acupuncture book and of a number of "soft tissue manipulation" books did offer some enlightenment; however, there remained until recently a gray area of confusion surrounding just where fascia and myofascial trigger points fit into the acupuncture/TCM story.
Most people nowadays are aware that acupuncture points in TCM are thought of as being linked along invisible lines (meridians) that apparently connect anatomical areas and organs, and along which energy (chi) is thought to travel. Obstructions to this flow, leading to areas of congestion or deficiency, are seen as contributing to health problems, and that these can be relieved by appropriate needle application (or manual treatment of the points - as in shiatsu). Please forgive this simplistic outline of what is in fact a far more complex theoretical construction, but it may help in my attempt to eventually get to the "wow" moments from Vermont and outer space.
Apart from the hundreds of "official" acupuncture points, lying on these meridian maps/lines, another class of acupuncture point has always fascinated me. This is the so-called Ah shi point. These are areas that become spontaneously tender/painful in response to local problems (strain, draughts, etc). They (ah shi points) become "eligible" for treatment in acupuncture (needles or acupressure) when they are sensitive. Now anyone who knows very much about Simons, Travell & Simons' (1999) work on trigger points might be forgiven for thinking that these points sound like those points...if you see what I mean?
Since we already know that approximately 80 percent of the main trigger point sites lie on points located on the meridian maps (Wall & Melzack 1990), the conjunction of these two areas of study (TCM/acupuncture points and myofascial trigger points) should not come as a surprise. Indeed, many experts believe that trigger points and acupuncture points are the same phenomenon (Kawakita et. al. 2002). Whether this is so or not, it suggests that in trying to understand trigger points better, we need to pay attention to research that tries to explain the processes of acupuncture, and the structural aspects of these invisible points.
Dr. Langevin and her research colleagues have helped to clarify the situation, having shown that acupuncture points, and many of the effects of acupuncture, seem to relate to the fact that most of these localized "points" lie directly over areas where there is a fascial cleavage, where sheets of fascia diverge to separate, surround and support different muscle bundles (Langevin et. al. 2001).
It seems that the meridians may, in fact, be fascial pathways. This is not too surprising, since we know the fascial network represents one continuum from the internal cranial reciprocal tension membranes to the plantar fascia of the feet. Now we know that acupuncture points (and it seems the majority of trigger points) are structurally situated in connective tissue, but how does application of a needle or pressure in one part of the fascia translate to distant sites? How does the fascia communicate with other parts of the body?
Well, the Vermont researchers have also shown that connective tissue is a sophisticated communication system, of as yet unknown potential:
Are you are experiencing minor "wow" tingles? I know I am just writing about it again!
Editor's note: Read part II of Dr. Chaitow's article in the June issue.
Click here for more information about Leon Chaitow, ND, DO.
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