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Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
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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