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Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
June, 2005, Vol. 05, Issue 06
The Soft Touch
By Keith Eric Grant, PhD, NCTMB
In our technically oriented culture, we have become accustomed to relying on our instrument readouts and conscious reasoning. We can, in our wanderings, for example, routinely and accurately determine time and position from our communicating electronics. Vital signs of medical patients, once done periodically by a human, can now be continually taken by electronic sensors and monitored for changes by computers.
What we tend to forget is that our human bodies are covered with a network of tactile sensors numbering 6 million to 10 million in all,5 making us superb sensors in our own right. Equally forgotten is that our ability to integrate the ongoing stream of information from these sensors is beyond the capabilities of today's computers or of our conscious minds. Profound statements of our sensing and processing abilities come from a decade ago by dance/anatomy teachers Andrea Olsen and Caryn McHose8 and very recently by sensory scientist Martin Grunwald:5
"The somatosensory cortex of the cerebrum has a precise map representing sensory information from all parts of the body, and works in conjunction with the cerebellum of the brainstem to maintain a continuous, cumulative picture of the body's position in space. The cerebellum, in particular, is responsible for constant coordination and correction of posture, movement and muscle tone. Even more fascinating, it holds the image of where you just were, where you are now, and it projects where you will go next."8
"Our sense of touch also enables us to take the measure of our body's size and position. The parietal-cortex apparently combines millions of individual data points from the touch sensors in muscles, joints, tendons, and skin to create an internal picture of ourselves. Normally, people are very good at estimating how tall, heavy and broad they are, allowing them to duck sufficiently for a low doorway or turn sideways to slip through a narrow passageway."5
The subconscious "computational" processing that creates our body image from our sensors extends our responses to stimuli beyond direct reaction. The basis for meridian theory, for example, might lie as much in our processing of input as in our physical bodies. Grunwald and his group hypothesize that body image afflictions, such as anorexia nervosa, may lie partly within faulty integration of sensory information. Their research indicates that other touch-based (i.e., haptic) processing, such as drawing simple shapes from touch, may also be adversely affected by the underling dysfunction. Other paths of current research tie our sensory and neurological systems to our immune systems.9 The brain and immune system continuously signal each other, often along the same pathways, which may explain how sensory input and state of mind influences health.
Sensory research has also recently uncovered why being cuddled feels so good - human skin has a special network of nerves that stimulate a pleasurable response to stroking.10 Normal touch is transmitted to the brain through a network of fast-conducting nerves called myelinated fibers, which carry signals at 60 meters per second. But there is a second slow-conducting nerve network of unmyelinated fibers, called C-tactile (CT), the role of which was unknown. The CT network carries signals at just one meter per second. By examining the response of a woman who had lost the normal sense of touch, scientists were recently able to look at her responses to the C-tactile system. MRI scans of her brain revealed that brushing strokes activated insular region of the cerebral cortex associated with emotional response. The researchers concluded that the CT system may be important for emotional, hormonal and behavioral responses to tactile stimulation.
As sensory images, understanding anatomy via names and insertions is only one path, and perhaps not the optimal one. Olsen and McHose8 take the experiential path to learning about anatomy via touch and position, literally making use of sensory input rather than rote memorization. In her book, The Anatomy of Movement, Blandine Calais-Germain provides a dancer's dynamic view toward understanding muscles.2
The focus throughout the book is on anatomy not for its own sake as items to be memorized and recited, but in its functional relationship to the actual movements of the body in dance, exercise and other physical disciplines. I delight in teaching that a muscle, ever so gently activated against a resistance, suddenly takes on sharp form to our touch. The activated muscle, whether subscapularis or psoas, suddenly becomes "visible" to our searching fingers.
As sensory beings, we learn to understand the body by palpation - the soft touch of awareness and wonder.3 Our fingers and hands, via practice, learn to seek and find asymmetries and differences in range of motion and tissue texture.4 The benefits of practice don't come from mechanical practice of technique, but from performance with awareness of both the effort and of the actual results. The adjustment comes in first doing and then making a correction to our inner picture or body-sense and running through the process again. Practice should be done enough to solidify it yet stop before physical and mental fatigue undermines the efforts by decreasing attention, increasing response times, and recruiting less optimum patterns of muscle activation.
Ultimately, practice with attention takes one from inability, to perform a pattern of skilled actions, to slow conscious control of performance, to mixed conscious control of learning with use of already learned patterns, to unconscious performance in response to environmental stimuli and conscious wish. Learning of new movement and body usage patterns can temporarily disrupt similar existing patterns. It's as if the body experiences a short-term period of confusion about which pattern to use in a given situation. Teaching sports or deep tissue massage to existing practitioners of Swedish massage, for example, can result in feeling that well-known patterns feel a new uncertainness. The situation sorts itself out, resulting in both patterns being available for use. Research indicates that consolidation and integration of practice continues hours later during sleep.1
The greatest determinants of good work that I have seen are an attitude of humility, respect for the client to react individualistically rather than as the textbook predicted, and cumulative attention to sensory input and client responses. An initial sensory feeling of "groping in the dark" rather rapidly becomes knowledgeable palpation as we observe sensation, client response, and effects. Those who have learned from their clients and can organize what they have learned, have the potential to become teachers who can shorten the path for the attentive student.
Often the greatest learning comes not from what is written or recorded, but simply from watching a master worker move and interact with a client. Hours and facts memorized out of their context of use are the poorest training outcomes I've yet to find for the process of teaching others. That's something to sleep on, the approach with a soft touch.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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