resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.