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Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
December, 2005, Vol. 05, Issue 12
Shin Splints or Compartment Syndrome?
By Whitney Lowe, LMT
One of the most common overuse injuries affecting the lower extremity is the condition known as shin splints. While the term shin splints routinely is used, especially among the athletic population, it does not represent a specific clinical pathology.Instead, it describes chronic shin pain resulting from overuse. It occurs in two regions of the leg. When it occurs in the proximal anterior lateral region of the leg, it's called anterior shin splints. It's also seen regularly in the distal medial region of the leg, where it's called posterior shin splints or medial tibial stress syndrome (MTSS). This discussion focuses on anterior shin splints, which routinely is confused with another overuse condition of the lower leg called anterior compartment syndrome.
Anterior shin splints are attributed to overuse of the dorsiflexor muscles, such as the tibialis anterior, extensor digitorum longus and extensor hallucis longus. Overuse results from excessive eccentric loading on the dorsiflexors. An example is walking or running downhill. With anterior shin splints, the client reports a history of repetitive activity performed on a regular basis or a sudden increase in activity levels. Pain is felt in the anterior lateral region of the leg near the proximal tibialis anterior attachment. The client with shin splints routinely reports pain at the beginning of an activity that gradually subsides with use, only to return after activity has ceased. The pain is like delayed onset muscle soreness by coming on hours later, even at rest.1
Anterior compartment syndrome sometimes occurs as an acute injury from a direct blow to the lower leg. However, it's more commonly a chronic condition resulting from overuse, such as running on a hard surface or suddenly changing the intensity of training. The condition often is referred to as exertional compartment syndrome (ECS) if it results from changes in training intensity.
Muscles of the extremities performing similar functions are enclosed within fascial compartments separating them from other muscles. Repetitive overuse of these muscles causes these tissues to swell, increasing compartmental pressure. Subsequently, the deep peroneal nerve and tibial artery or vein are squeezed within the compartment. Ceasing the offending activity allows symptoms to subside immediately. Anterior compartment syndrome and shin splints frequently are confused because symptoms are felt in the same region of the lower leg.2
Clients with exertional compartment syndrome will describe a repetitive activity performed on a regular basis. The client also might report a sudden increase in activity levels preceding the onset of symptoms. For example, chronic compartment syndromes often develop in military recruits when they begin basic training and their activity levels are drastically increased.3 Symptoms might include aching lower leg pain, paresthesia, coldness in the feet, color changes in the distal lower extremity, or motor impairment to the dorsiflexor muscles, in more extreme cases. The more pressure within the compartment, the worse the symptoms will be.
With a compartment syndrome, symptoms increase as the client engages in the aggravating activity. Once the activity is ceased, symptoms generally subside within about 30 minutes as compartmental pressure returns to normal. The reduction of symptoms when activity is ceased is one way to distinguish compartment syndrome from shin splints. Although there might be some initial soreness, shin splint pain characteristically increases after the activity with delayed onset soreness.
Compartment syndromes usually produce pain with palpation only if the compartmental pressure is elevated, such as right after the activity, while shin splints likely are to be tender to palpation long after activity has ceased. Shin splints produce pain with stretching and manual resistance (resisted dorsiflexion). Compartment syndrome is not as likely to be painful with either manual resistance or stretching because neither of these maneuvers increases the intracompartmental pressure. If paresthesia is present, compartment syndrome should be suspected because this is a symptom of nerve involvement and there is no nerve pathology in shin splints.
Both conditions affect the same region of the body and result from similar patterns of overuse. However, it's crucial to make a distinction between the conditions because treatment strategies for each differ. The only way to accurately identify the crucial differences between these similar conditions is with a comprehensive and thorough examination process.
Click here for more information about Whitney Lowe, LMT.
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