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When Patients Lie (Bribe or Flatter)
Recently, a new patient told me about what I thought was a novel twist on the doctor-patient relationship. She felt she had to lie to her DC to discontinue her treatment.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
We Get Letters & Email
It was with great interest that I read "Trouble in the Wellness Waters?" in the May 1, 2015 issue of Dynamic Chiropractic. I heartily applaud Dr. Hayes for his insightful and informative article.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Why More Patients Don't Come to Your Office
Every so often, something turns out to be much easier than anticipated. It's like ordering a piece of furniture or a child's toy that comes in 167 pieces.
Dietary Fat and Prostate Cancer: An Important Update and Review of Mechanisms
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Active Care for Ankle Sprains
An ankle sprain is a common injury, since this joint is required to perform complex movements under high forces during normal walking. In fact, 10 percent of all emergency-room visits are ankle-sprain related and an estimated 25,000 ankle sprains occur in the United States daily.
A Tribute to a True Chiropractic Leader
President of Texas Chiropractic College (alumnus, class of 1950) and the American Chiropractic Association (ACA) Board of Governors. President of the Texas Chiropractic Association and twice-appointed member of the Texas Board of Chiropractic Examiners.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Troubleshooting: Billing Multiple Fees for the Same Service
I am afraid I may doing something illegal. I have heard I cannot bill different fees for the same service.
Do You Have a Post-ICD-10 Strategy?
Post-ICD-10 planning is critically important to the health of a practice, in part because ICD-10 is brand new to providers, payers and related affiliates alike.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Thinking About Cohen's Kappa
Let's think about some notions of reliability and validity, and about what it means for diagnostic examiners to agree in meaningful ways. Diagnostic tests must obviously be both reliable and valid.
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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