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Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
May, 2006, Vol. 06, Issue 05
A Reflexogenic Relationship: The Muscle/Joint Battle, Part 2
By Erik Dalton, PhD
Editor's Note: Part 1 of "A Reflexogenic Relationship: The Muscle/Joint Battle" appeared in the April 2006 issue of Massage Today. To access the online version, visit www.massagetoday.com/archives/2006/04/07.html.
Myoskeletal Muscle Manipulation Through Joint Mobilization
A confounding situation arises as the therapist's fingers attempt to pry between joint surfaces to contact the short rotators, intertransversarii, and intertransverse muscles.Although these tiny, one-joint rotators/side-benders typically are the tightest in the presence of joint dysfunction, application of direct localized pressure sometimes is impossible, given the limited space between articular surfaces. Here's when the myoskeletal technique comes in handy. The therapist utilizes sustained manual pressure on the superior fixated vertebra as the joint is taken through a specific range of motion. Basically, bones are used as levers to create a Golgi tendon organ (GTO) release in all fourth-layer muscles, causing the joint blockage. The question then arises as to the nature of the fixated joint: Is it locked, open or closed? And which side of the spine is stuck?
Using the myoskeletal approach, the therapist's fingers and thumbs wade through the paraspinal laminar groove tissues, scanning for lumpy, wiry and knotty transversospinalis muscles. Once the hypertonic little muscles are found, what information is revealed about the nature of the dysfunctional joint? Not much! By Greenman's definition, it's obvious that joint dysfunction exists, but what type? Is one side of the joint jammed closed and unable to open during forward bending, or is a superior facet not closing on the vertebra below during backward bending?
In Figure 5, the therapist's thumbs apply sustained pressure to the bony knot where the fibrosis was found, as the side-lying client flexes and extends the spine through the affected area using a chin-tucking enhancer. If the bony knot pushes back into the thumbs as flexion is introduced, the joint on the ipsilateral side is not opening. The joint's axis of rotation is forced to revolve around the fixated facets, causing the superior transverse process to push back against the therapist's thumbs. The thumbs hold a gentle, sustained headward pressure on the superior transverse process as the client flexes the chin toward his chest. This produces a GTO release in the deep groove muscles and stretches the fibrosed spinal ligaments and joint capsule, allowing the fixated facets to open. In the myoskeletal method, bones are only applied as levers to release adhesive spinal soft tissues that cannot be liberated directly with traditional deep-tissue techniques.
During the fourth-layer assessment, if the bony knot does not push back into the palpating thumbs or fingers as the client flexes through the area, the joint is not closing on the contralateral side. To free the hypertonic tissues preventing closure of the superior facets on their inferior neighbor, the client assumes a prone position. The therapist's fingers, thumbs or elbow slowly glide down each side of the lamina groove as the client rhythmically raises and lowers his head. In Figure 6, the therapist uses the elbow to traverse down the groove while the client extends and lowers his neck and upper thoracic spine. If a bony knot is palpated, the joint is not closing on the contralateral side. Gentle, sustained pressure (with client-enhancing movement) releases fibrotic groove muscles, joint capsules, and spinal ligaments, allowing the superior facets joints to glide inferiorly and close on the vertebra below.
Scope of Practice
As with all treatment protocols, exceptions occur that can render the myoskeletal method ineffective. Damaged joints often create stubborn fixations that cannot be released by working muscles alone. Vertebrae that have undergone adherent cartilage degradation, apophyseal joint swelling and facet "nipping" due to prolonged microtrauma, typically will not regain lost motion simply by releasing the fibrotic muscles, joint capsules and spinal ligaments. True adhesive joint-fixation problems point to a more serious condition. However, massage therapists who regularly work in conjunction with chiropractors and manipulative osteopaths can enhance therapeutic outcomes by "prepping" the affected area, so that high-velocity thrusting maneuvers are more effective. Manual therapists must develop a good complementary health care referral base so prompt referrals can occur if soft-tissue approaches do not alleviate all the client's pain and/or posture problems.
Combining muscle and joint modalities increases therapeutic efficiency and encourages referrals as therapists resolve stubborn, long-standing pain/spasm/pain cycles. By incorporating holistic-minded reflexogenic routines, today's touch therapist can help solve America's epidemic musculoskeletal pain crisis. Therapeutic outcomes are enhanced as assessment and treatment routines are expanded to include all soft tissues forming from the mesoderm, including muscles, fascia, joint capsules, spinal ligaments, nerve dura, and intervertebral discs.
Although myoskeletal therapy delves deep into body structures, the intent is still slow and sustained soft-tissue work combined with specific client-initiated enhancers, such as chin-tucking, eye movements, deep breathing, pelvic tilting, etc. The client's experience following a myoskeletal session should be one of invigoration, pain relief, increased range of motion and postural improvement. Bones are assessed and treated as soft tissues in the myoskeletal system, with pressure often applied directly to myofascia overlying transverse processes. It's of the utmost importance to stress that bones only are used as levers to release hard-to-access, fourth-layer muscles, ligaments and fibrotic joint capsules (much like frozen shoulder work). Therapists always must remember that joints should never be taken into a nonphysiologic range of motion, which remains outside the scope of practice for most massage and bodywork practitioners.
Click here for more information about Erik Dalton, PhD.
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