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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.
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.
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?
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.
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.
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?"
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
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:
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.
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.
July, 2006, Vol. 06, Issue 07
Pain Under the Medial Arch of the Foot
By Ben Benjamin, PhD
Question: If a person experiences pain under the medial arch of the foot while walking or while rising onto the balls of the feet to reach for something, which structure is likely to be injured?
Answer: The flexor hallucis.The flexor hallucis is a very strong muscle-tendon unit that takes the lion's share of our weight while we walk, stand and rise onto the balls of our feet. The muscle is located in the calf, and its tendon begins just medial to the Achilles' tendon. The tendon passes under the medial heel and travels along the medial arch of the foot to attach distally at the great toe.
Poor alignment makes the flexor hallucis tendon more susceptible to injury. In a normally aligned foot, roughly one-third of the body's weight falls onto the great toe, with one-sixth falling onto each of the other toes. If the feet are turned out while standing and walking, even more weight falls onto the great toe - and therefore onto its flexor tendon. In such cases, strain or tendinitis of the flexor hallucis tendon is fairly common. In cases where poor alignment is placing pressure on the medial arch, there often is a callus at the medial edge of the great toe and/or the medial aspect of great toe joint.
Flexor hallucis injuries occur most commonly in the medial arch of the foot. Injuries to the flexor hallucis tendon at the back of the ankle, where the tendon is running parallel to the Achilles', are sometimes mistaken for Achilles' tendinitis. Injuries to this tendon near the anterior portion of the heel often are mistaken for plantar fasciitis. If a person feels pain not just at the medial arch, but in a wider area under the arch of the foot, this might indicate that the flexor tendons of several other toes also are strained or that a plantar fasciitis is present.
Question: What assessment test would you perform to verify this injury?
Answer: Resisted plantar flexion of the great toe.
First, hold the great toe in slight dorsiflexion (Figure 1) with your thumb and ask the person to push the toe down against you (into plantar flexion). If the injury is relatively severe, this test will be positive (causing a little pain). If the tendon is only mildly strained, you'll need to perform one or two additional tests to place more stress on the tendon.
The second test is performed in a standing position. While holding the client's hands for balance, ask the person to rise onto the balls of the feet (Figure 2). If this reproduces the person's pain, and the pain is in the medial arch, you have confirmed the presence of flexor hallucis tendon strain. If the reproduced pain is in the Achilles' area, you'll need to do further testing to determine whether it's coming from the Achilles' or the flexor hallucis. If this second test does not cause discomfort, move on to the third test.
For this final test, have the client face a wall and lean against it at approximately a 35-degree angle, while rising up onto the balls of the feet (Figure 3). If this causes no pain or discomfort in the offending area, ask the person to transfer most of his or her weight onto the big toes. This places maximum stress on the flexor hallucis tendon.
Click here for more information about Ben Benjamin, PhD.
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