resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
October, 2005, Vol. 05, Issue 10
Understanding Disuse Atrophy
By Whitney Lowe, LMT
Observations from clinical practice have indicated that one of the most significant detrimental effects of disuse on the body is muscular atrophy. Disuse atrophy might occur from an injury that forces the individual to keep an area in a cast for a prolonged period.It also might occur in situations in which bed rest or non-weight-bearing is mandated for rehabilitation from an injury. Regardless of the cause of the disuse, we now have learned a great deal about what occurs in muscle tissue as a result of disuse, and it's clear that it leads to significant muscular dysfunction.
Muscles throughout the body are comprised of different types of fibers. Human muscle has two primary fiber types. The first is called type 1, or slow-twitch muscle fiber. These fibers are most prevalent in muscles used for endurance, such as the postural muscles of the body. The second fiber variation is type 2, or fast-twitch fibers. These fibers are more prevalent in muscles that do short, powerful bursts of activity. Note that not everyone has the same percentage of fiber type in each of his or her muscles. That is one reason some individuals excel at distance running, while others excel at sprinting. In animal studies, there is some indication that disuse atrophy affects these two different types of fibers at a different rate.1 However, in humans there is no conclusive evidence to suggest either type of muscle fiber atrophies faster than the other.
It's surprising how fast disuse atrophy might occur. This has been studied by investigating what happens during limb immobilization after injury. One study found that muscle wasting was detected in as little as three days following immobilization.2 The degree of atrophy experienced in a muscle depends on how that muscle is used. For example, it's evident that disuse atrophy occurs much more rapidly in antigravity muscles than in their antagonists.1 Antigravity muscles are the primary ones used to hold us upright and resist the downward pull of gravity. This is one reason you see atrophy in the quadriceps muscles much more quickly than in the hamstrings.
Another factor related to disuse atrophy that is very evident with the quadriceps, is the position of immobilization. It has been shown that disuse atrophy is exacerbated for a muscle held in a shortened position. Most knee pathologies keep the knee immobilized in extension, rather than in flexion. When the knee is in extension, the quadriceps are passively shortened and the hamstrings are held in a lengthened position. The passive shortening of the quadriceps encourages the loss of integrity of sarcomeres in the muscle.1 This is one of the primary reasons range of motion is limited following immobilization. Immediately after the immobilization, it's important to encourage adequate stretching of the quadriceps fibers to speed the return to optimal function.
Interesting studies about muscle atrophy have been done with astronauts and cosmonauts aboard the space shuttle and the space station.3 These individuals develop significant amounts of muscle atrophy after spending time in a zero-gravity environment. At first, it was thought the lack of movement was what led to the muscular atrophy, but recent studies have indicated otherwise.4 During space shuttle missions, the astronauts often are engaged in vigorous muscular activity while carrying out their work on equipment. What appears to be more significant for all muscles of the body is the absence of load-bearing and muscular effort required to resist gravity.
It appears disuse also might have detrimental effects on neuromuscular function, in addition to the structural changes in muscle tissue. Several researchers examined muscle strength after immobilization and found there was a greater degree of strength loss compared to the amount of muscle atrophy measured by muscle size reduction.5 Because the strength loss was greater than the degree of muscle atrophy, there appears to be something else occurring other than muscular atrophy alone. It has been suggested the strength loss is due to an inability to recruit the motor unit properly. In essence, there is a "forgetting" of how to properly coordinate motor function that occurs from disuse.
It has been established that there are significant structural, neuromuscular and biochemical changes in muscles as a result of disuse. We also know from clinical experience that massage appears to have significant beneficial effects in restoring range of motion following immobilization or inactivity. It would be valuable to take these concepts and look at them together, to see if there is some better understanding we might gain of how best to use massage to combat muscular atrophy resulting from disuse.
Click here for more information about Whitney Lowe, LMT.
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