resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
June, 2005, Vol. 05, Issue 06
Cubital Tunnel Syndrome
By Whitney Lowe, LMT
Nerve compression problems are a frequent cause for pain and dysfunction in the upper extremity, particularly in the occupational environment. Although not as present in the popular literature as carpal tunnel syndrome, cubital tunnel syndrome is a common nerve compression pathology.In fact, it is the second most common peripheral compression neuropathy.1 It occurs when the ulnar nerve is compressed between the two heads of the flexor carpi ulnaris on the posterior elbow within a region called the cubital tunnel.
The cubital tunnel is located on the posterior elbow and is bordered by the two heads of the flexor carpi ulnaris (FCU) muscle. One head of the FCU muscle comes from the common flexor tendon attachments at the medial epicondyle of the humerus. The other comes off the medial aspect of the olecranon process. The two heads eventually join to form the belly of the FCU.
The nerve eventually passes between these two heads (Figure 1). Space within the cubital tunnel may decrease as much as 55 percent during elbow flexion, making nerve compression more likely.1 In addition, during flexion the ulnar nerve is increasingly pulled taut which may also aggravate symptoms. Subluxation (shifting position) of the ulnar nerve as the elbow moves into flexion could produce symptoms in this region as well.2
Cubital tunnel syndrome may occur as a result of direct compression of the elbow (either acute or chronic), excessive cubital valgus, bone spurs, synovial ganglions, fibrous bands within the muscle, or mechanical compression of the nerve during elbow flexion. The most frequent cause of cubital tunnel syndrome is hypertonicity of the FCU. The ulnar nerve may also be sensitive to compression if there are more proximal ulnar nerve compression pathologies such as thoracic outlet syndrome.3
Cubital tunnel syndrome usually produces a variety of sensory symptoms, including pain, burning, tingling or paresthesia. Motor symptoms such as weakness or atrophy may be seen as well. Weakness usually affects the intrinsic muscles of the hand more than other muscles in the forearm innervated by the ulnar nerve.
The client may report an acute compression injury to the posterior elbow that started the symptoms, such as striking the elbow on a hard object. This condition should not be confused with hitting one's funny bone. In this instance, the blow causes nerve compression between the medial epicondyle of the humerus and the olecranon process of the ulna just before it enters the cubital tunnel.
Cubital tunnel syndrome is more likely to occur as a chronic condition and is seen more often in men than women. The practitioner should identify actions that involved repetitive or static flexion of the elbow prior to the onset of symptoms. Prolonged compression of the elbow region, such as leaning on the elbows for long periods, should be identified. Symptoms are often aggravated at night if the client spends long periods with the elbow in a flexed position.
The client usually reports pain, aching, burning sensations or paresthesia in the ulnar nerve distribution of the hand (Figure 2). Weakness or atrophy are likely to affect the adductor pollicis muscle, which is an important muscle in grasping objects. Consequently, the client may report difficulty holding objects or having a degree of clumsiness when attempting to perform precise tasks. Atrophy of this muscle may be apparent with a decrease in the size of the muscle mass between the thumb and fingers compared to the unaffected side. Other instrinsic hand muscles innervated by the ulnar nerve are those of the hypothenar eminence (the fleshy bundle of muscles near the base of the hand on the ulnar side). Atrophy in these muscles may be evident with a decrease in size compared to the unaffected side.
Pressing directly over the cubital tunnel is likely to elicit the client's symptoms. Palpate the region when the elbow is in neutral, as well as full flexion. If the symptoms are exaggerated during flexion, this may be an indicator of cubital tunnel compression. There may also be anatomic obstructions in the cubital tunnel, such as bone spurs or synovial masses that are palpable. Tenderness or hypertonicity may be evident in the FCU muscle throughout the forearm.
Massage is helpful for cubital tunnel syndrome because a primary cause is muscular hypertonicity in the wrist flexor muscles. Techniques such as deep stripping to the flexor carpi ulnaris may help decrease compression on the ulnar nerve. Particular caution should be observed in applying pressure to the flexor carpi ulnaris near the region of ulnar nerve entrapment so as not to aggravate the pathology.
Click here for more information about Whitney Lowe, LMT.
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