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Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
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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