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News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
May, 2006, Vol. 06, Issue 05
By Garry Adkins, NCTMB
The idea of exploring palpation came from a doctor/client of mine I was working on years ago. As I worked on her, she told me I was using advanced palpatory techniques; at that time, I had no formal training in that regard, other than traditional massage or neuromuscular therapy.
When I attended bodywork classes in the past, the instructor would lecture on anatomy, and then tell the class to just feel the structures, without telling us how.Over years of doing bodywork, I have developed a certain confidence in my sense of touch; a form of teaching myself which way to stroke a muscle or tendon to receive the most benefit. After I read the book Palpation Skills: Assessment and Diagnosis Through Touch, by the experienced clinician Leon Chaitow, ND, DO, it all made more sense to me.
Chaitow writes that, according to Viola Frymann, "Palpation cannot be learned by reading or listening; it can only be learned by palpation." He goes on to say that an open mind also is vital to the task of learning palpatory literacy: Practitioners with the greatest degree of "rigidity," in terms of their training, often have the hardest time allowing themselves to feel new feelings and sense new sensations. Those with the most open, eclectic approaches (massage therapists are a prime example) usually find it easiest to "trust" their senses and feelings.
According to Karel Lewit, noted Czechoslovakian physician, "To begin to learn palpatory skill, one must possess a firm grasp of anatomy and the supporting soft-tissue structures. Palpation of tissue structures seeks to determine the texture, resilience, warmth, humidity and the possibility of moving, stretching or compressing these structures. Concentrating on the tissue palpated, and pushing aside one layer after another, we distinguish skin, subcutaneous tissue, muscle and bone; we recognize the transition to the tendon, and finally the insertion."
Regarding the learning process, Gerald Cooper states: "To begin to learn palpatory skill, one must learn to practice to palpate bone or muscle or viscera. Gradually, one learns to distinguish between a healthy muscle, a spastic muscle and a flaccid one, and gradually one learns there is a difference in feel between a hard malignant tumor and a firm benign tumor."
Chaitow also says, "Later on, critical judgment may be used in interpreting what was felt, but the process of 'feeling' needs to be carried out with that faculty silenced." No one has better expressed this need than John Upledger, DO, OMM, the developer of CranioSacral Therapy. He states: "Learning to trust your hands is not an easy task. You must learn to shut off your conscious, critical mind while you palpate for subtle changes in the body you are examining. You must adopt an attitude so that you may temporarily accept without question those perceptions which come into your brain from your hands. After you have developed your palpatory skill, you can criticize what you have felt with your hands. If you criticize before you learn to palpate, you will never learn to palpate."
This seems to work in a diagnostic sense, but to become proficient with your palpation skill while doing bodywork, we should look at what guides us. Intuition is an internal mechanism that aids in decision-making. It's what is called an instinct, a sense of something that tells a person to go in one direction or another. Combined with knowledge and training, it gives a person the tools to make solid decisions and get results they never thought possible.
Intuition has been defined by Shakti Gawain as an inner knowingness that we all have. It's knowingness that comes not from facts or life experiences; it's deep within us and gives us a connection to the intelligence of the universe. And if we learn to trust that and look within us for the source, we can find the awareness and actually find the answers to our questions. We also can find very specific and direct moment-by-moment guidance that will let us know what we are supposed to do and what we need to understand. If you think about it, anything we really need can come to us from that intuitive sense.
The Rational Mind
In our Western culture, we have been programmed to distrust our intuitive self. We have been taught to look toward and trust our rational, logical faculty. Our rational mind is like a computer. Any fact or information we have read or learned goes into our computer. The function of the rational mind is to pull out the appropriate pieces of information and combine them in ways to come up with the best answers based on that information.
The limitation is that the rational mind can only function on information it has received through learning and experience. The intuitive principle within us seems to have access to a much vaster storage of information. We seem, through our intuition, to be able to connect with infinite intelligence and awareness. So, we are not limited to just what we have learned in this life. We are able to tap into things we have no logical way of understanding, much in the same way a baby deer has the instinct to stand up just after birth.
To examine how our culture's attitude toward the rational mind has changed, imagine how the Native Americans lived long ago. They were taught from a very early age to smell the air, feel the wind and listen to the ground, just as animals can sense danger or tell just before it is going to rain. In our modern society, we have machines that can tell us if the atmospheric pressure indicates rain or snow is imminent.
Does everything you have seen, heard and felt about the person make sense? Let your rational mind come to a conclusion on how to proceed. Check your confidence level. Know you can help or satisfy this person. Let your rational mind go to the back and your intuitive self come up front. If you have to, say to yourself, "Intuitive self, I stick with you; whatever you say goes."
The Most Effective Direction
With your client prone, uncover the back to expose the trapezius. Apply little or no oil. While using only your fingertips, glide medial to lateral on the upper trapezius, and then lateral to medial. Did you notice any difference?
Now glide inferior to superior, and then reverse direction. Did you notice any difference? Try anterior to posterior, and then reverse. Maybe try diagonal? Of the four strokes, which one is easiest; which one has more resistance?
Next, try this with your client supine. Uncover one leg to expose the quadriceps. While using only your fingertips and no oil, glide medial to lateral, and then lateral to medial. Did you notice any difference?
Now glide inferior to superior, and then reverse direction. Did you notice any difference? Maybe try diagonal? Again, of the four strokes, which one is easiest; which one has more resistance?
With these two examples, the stroke with the most resistance is twice as effective as the other three or four. By going against the grain of a muscle, you will release the muscle faster, as well as help to relieve fasical restrictions.
Develop Your Intuitive Self
Finally, I feel that the last step to develop your intuitive self is to raise your self-esteem a notch. People come up to me all the time and say they wish they had my ability. What ability? Some of those people have had more training and experience than me. Life is a series of changes, yet many people cling to familiar things, disregarding their inner desire to grow as an individual. Openness to change can be risky. These people would say something to the effect of, "To be the kind of therapist I want to be, I have to have many years of training and experience. Maybe someday I will get there."
I say that you are there right now! Take the information you have. Be open to change and allow your instinct to guide you.
Garry Adkins is a senior faculty member and clinical event director at Irene's Myomassology Institute in Southfield, Mich. He is the former president of the Association of Michigan Myomassologists and has more than 15 years of experience as a massage and bodywork professional.
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