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Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
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.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
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.
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?
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.
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.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
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.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
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.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
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.
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.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
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.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
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.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
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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