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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.
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.
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.
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.
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.
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.
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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?
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.
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.
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.
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.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
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.
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.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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.
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.
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.
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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