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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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.
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.
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.
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.
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.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
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.
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.
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 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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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).
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.
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.
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.
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%.
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.
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.
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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