resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
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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