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Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
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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