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Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
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 previous articles by Erik Dalton, PhD.
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