resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
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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