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Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Preventing ACL Injuries in Female Athletes
For female athletes, the key to optimal athletic health lies in preventing ACL injuries. In medical terms, the anterior cruciate ligament (ACL) is the primary restraint to the anterior displacement of the tibia on the femur at all angles of the knee flexor.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Do You Teach Patients How to Breathe Properly?
Spinal manipulation often produces quick results in terms of pain alleviation and improved range of motion. Unfortunately, once the patient is no longer in pain, they may discontinue therapy, only to be plagued by the same complaint at a future date.
Spine Surgery: A Tale of Greed and Corruption
All too often, where there's substantial money to be made, greed and corruption inevitably follow.
We Get Letters & Email
In the Dec. 1, 2015 issue, we have Donald Petersen reporting on "the adapting chiropractic practice," which includes multidisciplinary practice as an option; a ChiroPoll indicating 59 percent of DCs are seeing at least 21 patients per day and 27 percent are seeing more than 40.
News in Brief
A Winner in and Out of the Office; Ready for the "Have-A-Heart" Campaign? New Integrative Medicine Journal.
The Future of Functional Neurology
Functional is the hot buzzword in health care these days; witness the rising popularity of functional medicine, functional testing and yes, functional neurology.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
The Amazing Clinical Versatility of Milk Thistle (Part 1)
Most of us know that the standardized extract from the seeds of milk thistle (Silybum marianum) is probably the best-proven herb for protecting the liver from chemical and inflammatory damage.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Elevated Shoulder? Check the QL
As you know, posture reveals a great deal about the body. Posture is a unique mental and physical landscape revealing compensations and adaptations to life. It's a classic mind-and-body story.
Sell Out: Using Research for the Wrong Reasons
The above chorus is from the ska band Reel Big Fish's 1997 hit song, "Sell Out," from their album, "Turn the Radio Off." In the song, the singer sarcastically relates the plight of a musician who is tired of "flipping burgers" and is willing to get "lots of money" by playing "what they want you to hear" in order to get a recording contract.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
The MRI: When and Why to Order One
As I lecture around the country to both chiropractors and medical specialists, it's clear one of the main disconnects between the two professions is that of an accurate diagnosis.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Osteoporosis Isn't Always the Case
What is your diagnosis? The patient is a 58-year-old female with back pain. I am sure all of you see the compression fracture at L2; however, there are some findings that suggest this is not a compression fracture due to osteoporosis.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
December, 2005, Vol. 05, Issue 12
By Keith Eric Grant, PhD, NCTMB
In a previous column, I touched on medical applications of massage that appeared in the indexed medical literature from 1997 to the present. Of 213 instances of medical goals addressed by massage, 155 (73%) were systemic rather than tissue-specific (clinical/orthopedic) interventions. Systemic treatment goals included increased well-being, stress and pain management, and improvements in self-image. These "systemic" effects of massage also are well-represented in the research reported by Tiffany Fields and the Touch Research Institutes (TRI).5 The TRI home page highlights observations that massage therapy: facilitates weight gain in preterm infants, reduces stress hormones, alleviates depressive symptoms, reduces pain, improves immune function and alters EEG in the direction of heightened awareness.5 With the above observations in hand, it seems time to consider mechanisms for the effectiveness of massage.
Tissue specific interventions (TSIs), while requiring understanding in anatomy and movement to implement effectively, are simpler conceptually. TSIs largely can be understood by reduction to specifics. The practitioner needs to be able to listen to client history, assess active and passive range of motion limitations, look-up and implement special orthopedic tests as needed, and thus gain a working hypothesis of the location, extent and nature of injured tissue i.e. the "lesion" resulting in pain or limitation. I differentiate active and passive range of motion limitations because they differentiate between pain felt in a musculotendinous unit when it's actively contracting and pain produced in ligaments, joint capsules and antagonist muscles when they are passively stretched. I note "looking up" special tests because I am a believer in having and knowing how to use information resources rather than in memorizing everything in sight (or reach). Procedures frequently used will be memorized. I define the result of assessment as a "working hypothesis" to clarify that it's not a medical diagnosis.
With TSIs, the techniques follow from assessment and isolation of the lesion(s). Tendinosis on tendinous attachments benefits from the stimulation of inflammation by local friction.1,2 Adhesions between fascial layers release under slow separating pressure. Trigger points succumb to ischemic pressure combined with various methods to lengthen the affected tissue. Muscle hypertension can be lowered by methods of positional release and post-isometric relaxation. The assessments and treatment might be intricate, but they are not inherently complex in the sense that we can conceptually connect the treatment goals and the intervention.
Understanding how non-tissue-specific touch affects the state of our human systems has not been so easy. We are able to record the effects, as has the Touch Research Institutes, but we haven't had a sound mechanism to explain them. My opening quote from Ashley Montagu motivates why touch would be expected to have profound effects on us, but it, too, stops short of mechanism. The answer, however, is starting to take shape in diverse venues of science and mathematics.
Over the last two decades or so, a new area of research has evolved. There are systems in which important properties lie, not in the individual parts alone, but in the interaction and communication between the parts. These properties have become known as "emergent properties," be cause they literally emerge from the complexity of interactions.6 In 1984, the Santa Fe Institute was founded specifically to study such complex systems.4 The April 2, 1999 issue of the journal Science was devoted to interdisciplinary viewpoints on research in complexity. These included papers on "Complexity and the Nervous System," and "Complexity in Biological Signaling Systems." Numerous papers and books have come out of studies of things describable as "information networks," including studies on organization spontaneously emerging in the structure of the Internet. We slowly are gaining the tools and the understanding that seemingly simple appearances can arise out of the complexity of interactions. We also are finding understanding that such systems can have multiple stable states and flip between them depending on input from outside.
Thus, we come to the human body as a system of systems a system with neurological, chemical, immune, emotional and sensory interactions all communicating. Sensory input includes touch in a big way. We come back to the observations of TRI and Ashley Montagu, with the understanding of massage and touch as a major input to a complex system. We don't understand the details, but we understand the basis for touch to create profound changes in the homeostasis of the human system. There are important structures of the human body that are not physical; they exist only in the fluid interchange of information within the living system.
In the end, it's not the complexity of the touch being done, but the complexity of the human system being touched that is most profound. Someday, we might be able to model the complexity of neurological-chemical-emotional-sensory interactions to determine patterns of sensory input that are most effective at inducing positive change. We still are far away in the infancy of such concepts. The best tool we have to bring to bear today is the equal complexity of the observational instrument known as the human practitioner. The human ability to learn from practice and observation and then to react in real-time to sensory input remains unmatched. We are slow at consciously processing input, but rapid at "unconsciously" matching patterns. There is great value in being able to initiate a simple touch, judge the response and adjust our input toward assisting the client's system toward a better place. We've known this intuitively for a good while. We are just beginning to develop the scientific finesse to explain it.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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