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Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
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.
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.
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.
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.
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.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
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.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
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.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
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.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
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.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
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."
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
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.
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.
April, 2006, Vol. 06, Issue 04
A Reflexogenic Relationship: The Muscle/Joint Battle, Part 1
By Erik Dalton, PhD
Reflexogenic - Producing or increasing reflex actions between muscles and joints.
Myoskeletal - All soft tissues forming from the mesoderm including muscles, ligaments, joint capsules, discs, fascia and bones.
Surprisingly, the "key" that unlocked the door to this muscle/joint mystery initially was revealed in a presentation to the American Back Association by the legendary osteopath Dr. Philip Greenman when he stated, "In the presence of vertebral dysfunction, palpable fourth-layer muscle hypertonicity will always be found." The fourth-layer transversospinalis muscles include the rotatores, multifidus, levator costalis and intertransversarii (Fig. 1). These phylogenetically old laminar-groove muscles are the first structures neurologically stressed by joint blockage, and often are the very same tissues that prolong the dysfunction.
Working with the understanding contained in Greenman's statement, the massage therapist can maximize therapeutic outcomes by:
Under normal conditions, the superior vertebra of each joint smoothly flexes, extends, sidebends and rotates on its inferior neighbor. Too often, however, hypertonically short spinal muscles bind one side of a joint altering its axis of rotation and center of gravity (Fig. 2). When therapists continually palpate lumpy, stringy or wiry fourth-layer intrinsic muscles session after session, underlying joint dysfunction is present and must be addressed.
According to John Mennell, MD, all of the body's synovial joints must have at least 1/8 inch of movement not controlled by voluntary muscle contraction. The term "joint play" was coined to describe this essential principle of normal, pain-free, non-restricted vertebral movement. Deep-tissue myoskeletal techniques focus on restoring joint play and stopping the reflexogenic battle between muscles and joints.
This article offers an overview of current theories and myoskeletal strategies for preventing and correcting "catch 22" pain/spasm/pain cycles perpetuated by abnormal muscle/joint reflex actions.
Fourth-Layer Spinal Muscles
Working through the bulky paravertebral muscles and fascia, bodyworkers' sensitive fingers frequently encounter small, hard and sometimes tender knots in the deep transversospinalis muscles of the erector spinae group. These highly innervated tissues located in the medial groove adjacent to the spinous processes contribute to rotation, sidebending and extension in each spinal segment. According to Greenman, "Fourth-layer muscles are dense in spindles and function more as proprioceptors than prime movers. When dysfunctional, they alter joint mechanics locally and alter the behavior of the larger muscles of the erector spinae group." Therefore, muscles such as the multifidus and rotatores (and suboccipitals) are perceived as dynamic ligaments designed to stabilize the spine. Acting as supporting, information-gathering ligaments, they allow the brain to coordinate more gross movements of the vertebral column via longer-lever muscles that have greater leverage and mechanical advantage.
The power generated by short fourth-layer spinal muscles is easily underestimated. These highly innervated little critters readily pack enough punch to lock spinal joints open or closed with their strong torsional forces (Fig. 3). Holding a telephone with the shoulder to one ear is a perfect example in which prolonged cervicothoracic sidebending unilaterally compresses joint surfaces, creating reflex transversospinalis and erector spinae spasm. This predictable neurological firing pattern represents the beginning of many functional scoliotic cases seen in the clinic. However, specially designed deep-tissue massage techniques can be very effective in releasing hypertonic myofascia and recovering joint play to fixated facets. Regrettably, some of the tightest transversospinalis muscles are buried deep to more superficial groove muscles such as the multifidus and spinalis, making it difficult and sometimes impossible to mobilize them with fingers and thumbs (Fig. 4). So, how can massage therapists access and release short, concealed spinal muscles that bind joints and perpetuate aberrant pain and posture problems? In part two of the "Reflexogenic Relationship" series, I will demonstrate innovative soft tissue techniques for creating joint-play in fixated facets.
Editor's Note: Part two of Erik Dalton's article, along with a complete list of references, will appear in the May 2006 issue of Massage Today.
Click here for previous articles by Erik Dalton, PhD.
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