resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
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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