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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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).
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.
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.
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.
September, 2005, Vol. 05, Issue 09
By Elaine Stillerman, LMT
A good friend and colleague of mine attended a professional seminar this past June in New York City called "Challenges in Women's Healthcare: Urogynecology for Primary Care Providers." All of the speakers and most of the attendees were doctors, but there also was a smattering of physical therapists, like my friend, and occupational therapists.The general topic of the seminar was the female pelvic floor, in all its glory and with all its problems.
As my friend relayed to me (and I have the course material to back all this up), one of the doctors gave a speech on "The Effects of Pregnancy and Childbirth on the Pelvic Floor." Supported by many impressive studies, the doctor proffered that a vaginal birth is responsible for urinary and anal incontinence, pelvic prolapse, sexual dysfunction, pudendal nerve damage and pubococcygeal muscle damage. The cure? Cesarean section!
The other doctors fastidiously took notes. A few doctors and several allied professionals questioned the doctor's findings. For instance, were these births augmented and were there obstetric interventions (e.g., forceps, episiotomy)? Were the laboring women in these studies given Pitocin or any pain medications that blocked sensation? How were they pushing during active labor? What position were these women in while giving birth? Were they taught exhalation pushing and how to use their transverse abdominis during labor, or were they directed to "hold their breath, bear down and push?" Were any of these women in the studies taught correct Kegel exercises during pregnancy or given physical therapy during postpartum recovery? Were any of these case studies performed on women who had water births?
None of these valid points was addressed in the lecture, but C-sections nonetheless were hailed as the best way to avoid pelvic floor complications after childbirth.
I'm floored. OK, let's look at the pelvic floor during childbirth. The compression of the fetus on the muscles of the pelvic floor, along with the effects of progesterone and relaxin, softens joints and ligaments and allow these muscles to stretch and bulge. The bladder and ureters also lose their tone during pregnancy (even if the birth is surgical). But Kegel exercises have been proven to maintain and restore functional integrity to the pelvic floor (antepartum and postpartum), and the position in which the gravida labors can have a tremendous impact on the strength of the pelvic floor.
In addition, the directed pushing needed as a result of anesthesia or labor position is responsible for many of the long-term weaknesses of the pelvic floor. Known as the Valsalva technique (holding the breath and forceful bearing down), this method of pushing encourages fetal hypoxia (lack of oxygen), perineal tears, increased intrathoracic pressure, increased cardiac output and blood pressure, slowed maternal pulse rate and damage to the pelvic floor. It might be a vaginal birth, but one that was poorly guided.
During the pushing process, the laboring woman should be in a squatting or semi-sitting position to widen the pelvic outlet and work with gravity, not against it. The woman should exhale, or allow the air to escape from her lungs as she pushes, to reduce pressure on the pelvic floor. Some care providers actually prefer for the woman not to push at all in the early second stage of labor, because the natural forces of uterine contractions move the fetus quite handily down the birth canal. The focused pushing only is used to expel the fetus from the birth canal. In this way, little pressure is exerted on the pelvic floor and little, if any, damage is done.
Prenatal care and postpartum recovery should include exercises and physical therapy, if necessary, to maintain and restore the pelvic floor muscles. Birthing in female- and fetus-friendly ways can do more to keep the pelvic floor intact than a traumatic surgical procedure.
Instead of a surgeon recommending surgery as a preventative measure, why not teach women (and their doctors) the most effective way to maintain and respect their bodies during pregnancy and childbirth?
Click here for previous articles by Elaine Stillerman, LMT.
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