resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Wisconsin Exam in the Spotlight
You've passed your national boards with flying colors, including Part IV, the practical examination, at a combined cost of more than $3,000.
News in Brief
Cancer Treatment Centers of America Continues Support of Chiropractic; ACBOH Announces 2013 Practical, Written Exam Dates; PCORI Approves Funding for Research on Spinal Stenosis; Macquarie University to Cease Offering Chiropractic Program.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
Exercises for Back Pain: Low-Compression Training Program
This program is intended for two groups of people: 1) those who want to engage in resistance exercises for the major regions of their body without developing back pain in the process; and 2) those who already have back pain and want to do resistance exercises, but consistently re-irritate their back when trying to do so.
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
Happenings in Our Evolving Profession
Good things seem to be happening for our profession and recent developments show we are all on board. Talking about being on board, this September The Veterans Express-Purple Heart Tour is expected to make its way out of the station.
Calcium Supplements and Mortality
When the National Institutes of Health's AARP Diet and Health Study reported that men who took calcium supplements had a higher risk of dying from cardiovascular disease compared those who didn't, it was the third large cohort in six months with alarming findings regarding calcium supplements.
Let's face it – patient evaluation takes time. Unless you are really into the diagnostic evaluation game, you probably have found the formal exam protocol tedious if not downright annoying.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
The Pallof Press for Core Stability Evaluation
Many people become injured because of instability, weakness and poor neural-sequencing patterns in the core. Lack of bracing and support from the inner core cylinder during coronal and transverse movements makes the body vulnerable to compensation injuries.
Business Building: What's Your Strategy?
I know some in our profession love to debate about whether or not spinal curvatures change as a result of our chiropractic adjustment, but I have a question that hits a little more close to the belt than that: Are chiropractors capable of change?
Covering Chiropractic as a Profession, Not a Single Service
Recently Dynamic Chiropractic published a front-page article about various state essential health benefits and referred to Oregon and four other states not currently providing chiropractic as a covered benefit.
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
Telecommuting and Technology: Ergonomic and Worker's Comp Considerations
As our world becomes more and more reliant on technology, equipment becomes more dependable and we become increasingly more comfortable with e-mail, the fax machine, the Internet and the smartphone, it is becoming easier and easier to work away from the office.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
History Repeating Itself in Wisconsin?
Thirteen years ago, the Wisconsin Chiropractic Association (WCA) "agreed to settle Federal Trade Commission allegations that [the association] orchestrated a conspiracy among WCA members to increase prices for chiropractic services and to boycott third-party payers to obtain higher reimbursement rates."
Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Repeating Bone-Density Tests
The U.S. Preventive Services Task Force recommends that women older than age 65 undergo bone-density testing. However, organizations in general have not stated when repeat bone-density testing should be done.
In a previous column, I discussed the history and definition of evidence-based practice (EBP), and expressed concerns with how the concept has been narrowly construed by some academics and payers.
Chiropractic Research: A Moral Issue
This year I've had the opportunity to go to three great chiropractic research conferences; the ACC-RAC, the Fédération Internationale de Chiropratique du Sport (FICS) Congress and the World Federation of Chiropractic Congress.
Medical Payola (Part 2)
Not only has Medtronic made billions selling expensive screws and hardware for highly controversial spine fusions, but a Senate investigation also found Medtronic felt compelled to write and edit medical journal articles attributed to outside physicians that downplayed the risks of the company's best-selling bone graft, Infuse.
Spinal-Cord Injuries: Saying No to Steroids
With steroids, epidural and otherwise, in the news lately for their overuse when treating back pain (and their danger when tainted by fungal meningitis), it was high time for a policy change, and we've got one, from the Congress of Neurological Surgeons and the American Association of Neurological Surgeons.
April, 2006, Vol. 06, Issue 04
By Whitney Lowe, LMT
The glenohumeral joint is a highly complex articulation. It has the greatest range of motion of any joint in the body. However, its increased motion occurs at the expense of stability, requiring the soft tissues to play a more critical role in maintaining joint integrity.As a result of increased mechanical demands, numerous soft-tissue injuries occur in the shoulder. In fact, shoulder pain is the third most common musculoskeletal disorder, following low back and cervical pain.1
Chronic injuries are common in the shoulder, and develop from the movement requirements in repetitive upper-extremity activities such as sports (e.g., tennis, swimming) and assorted occupations. Also problematic are activities requiring that the shoulder be held in an elevated position for prolonged periods. One of the adverse effects of repetitive motion or holding the shoulder in a static position for long periods is shoulder impingement. Shoulder impingement involves compression of soft tissues between the head of the humerus and the underside of the acromion process or coracoacromial ligament. Impingement might lead to tendinosis, rotator cuff tears, calcific tendinitis, bone spurs or subacromial bursitis.
There is a region in the shoulder composed of the acromion process, coracoacromial ligament, and coracoid process known as the coracoacromial arch (Figure 1). Several tissues are susceptible to compression under the arch: the upper margin of the glenohumeral joint capsule, coracohumeral ligament, supraspinatus muscle-tendon unit, tendon from the long head of the biceps brachii, and the subacromial bursa. Any of these tissues might be compressed against the acromion process or coracoacromial ligament.
Impingement might result purely from the structure of the coracoacromial arch, but commonly results from a combination of architecture and repetitive motions, especially those involving flexion and internal rotation of the humerus. In some cases, bone spurs or osteophytes develop on the underside of the acromion process and serve to further decrease the subacromial space and impinge tissues.
There are three progressive stages of impingement syndrome.2 Stage 1 is more common in patients 25 years old or younger. It is characterized by acute inflammation, edema and hemorrhage in the affected tissues. Repeated overhead use of the upper extremity usually is involved. Stage 2 occurs more often in patients between the ages of 25 and 40. There is a progressive degeneration in the rotator cuff structures that involves fibrosis and tendinitis. Stage 3 usually affects patients older than age 40. Tears of the supraspinatus and long head of the biceps tendon might occur. In addition, bone spurs and osteophytes might develop along the underside of the acromion and further contribute to subacromial impingement.
A further classification of impingement pathologies divides them into primary or secondary. Primary impingement is predominantly caused by the architecture of the subacromial region.3 Primary impingement is directly related to the variations in shape of the acromion process. There are three variations in the shape of the acromion process (Figure 2),4 which are described as Types 1, 2, and 3. A Type 1 acromion has a flat undersurface; Type 2 has a curved undersurface; and Type 3 is referred to as a hooked acromion. The hooked acromion is associated with a greater incidence of impingement syndrome.5
It is mostly a result of dysfunctional shoulder biomechanics, and is exacerbated by excessive motion or long periods of compression. Several biomechanical factors can contribute to secondary impingement, including rotator cuff muscle weakness, joint capsule restrictions and dysfunctional coordination of scapulothoracic muscles.6
Shoulder impingement is a challenging problem to treat because many of the affected tissues lie underneath the acromion process. However, in many cases, such as secondary impingement problems, repetitive motion and altered shoulder biomechanics aggravate the condition. In these cases, massage is a highly effective treatment to address the muscular dysfunction that leads to the biomechanical stress. Identifying which tissues underneath the acromion are affected is essential for constructing an effective treatment plan. A future installment of this column will investigate how to determine which of the different tissues are affected.
Click here for more information about Whitney Lowe, LMT.
comments powered by Disqus