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Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
August, 2006, Vol. 06, Issue 08
Skills of Touch
By Keith Eric Grant, PhD, NCTMB
Touch inherently is a two-way sense - we cannot touch without being touched back. We have the sensors to receive far more tactile input from the world than we can consciously process. Thus, habitually, we filter out the vast majority of the sensory input we receive. Without such filtering, we would have a hard time living within our skins, constantly being aware of every contact and friction with clothes and other objects. Yet, in massaging another, we can learn more by training both our conscious awareness and our unconscious filtering processes to better discriminate both client tissue and client responses. Open your sensory filters and explore your awareness of touch. Compare the sensation of touching and holding with slight back and forth movements (sliding touch) or touch with slight vibration. Touch surfaces at different temperatures, with different textures and with different levels of plasticity or give. In touching surfaces with some give, slow down and observe the differences in what you perceive with different pressures of touch. Particularly with touching human skin, muscles and fascia, practice feeling the different layers and the differences in texture, temperature and direction that distinguish them.
One of the classical sensory analogies for deep tissue work is the cornstarch and water solution. In the worlds of children's play and physics, this solution has become known as Oobleck.5 Add water to cornstarch in a small bowl until the solution as the consistency of pancake batter when stirred very slowly. If you tap the surface quickly, the surface is hard. Your fingers come away without intermingling with the solution. If your place your fingers on the surface and pause, your fingers sink in. Suddenly the solution is liquid. For deep tissue work, the lesson is one of working slowly and giving the tissue a chance to deform plastically rather than trying to force a rate of movement. In teaching such work, I use the term "glacial creep," literally meaning to apply pressure obliquely to the body's surface and let the stroke move naturally with the plastic movement of the tissue beneath, much as a glacier deforms and moves under the pressure of its own weight. On a sensory level, feel for the give in the tissue and work to enhance that, working the directions of give into the directions of restriction. The sensation is one of eroding the edge of a restriction rather than jumping directly into the middle. Applying pressure and waiting also provides the advantage of making the work easier; you simply relax and lean into the technique, letting your bodyweight do the work while you "hangout" in the tissue waiting for pressure and accommodation to interact.
In looking at good resources on palpation, Philip Greenman gives a thorough overview of palpation skills in his book on manual medicine.3 He divides the process of palpation into reception, transmission and interpretation. Sensation involves the activation of skin sensors by the variations in touch. Transmission is the internal processing of the stimuli. Finally, and likely the most learned and learnable stage, you have to interpret the signal at multiple levels of awareness, your conscious mind analyzing linearly and your unconscious mind matching the signal to previous patterns of experience. Greenman's practice of palpation involves varying the pressure, depth and movement of touch, and noticing differences. How thick, how deep, how warm and how mobile are the tissues?
Leon Chaitow, in Palpation Skills provides an extremely thorough guide to using touch for assessment.1 He sets five objectives for palpation:
Chaitow notes that successful palpation requires trusting the sensory input; paying attention to what is being felt and suspending critical judgment while the process is being carried out. "Critical judgment may be used in interpreting what was felt, but the process of 'feeling' needs to be carried out with that faculty silenced."
Clyde Ford, in Compassionate Touch, describes an exercise in pacing another with touch that provides some additional insights. The exercise itself is simple, having the other person lie supine and actively pacing their breathing with a hand on their chest or abdomen (i.e. the hand is not laying there as dead weight but is actively moved with the breath). Part of the value of the exercise comes in realizing the power of simple attention to another and in attuning your actions to their responses. Another part comes from the opportunity to be still and observe. As you quietly pace their breathing with your touch, you can notice changes in the depth and rate of their breathing, in the tension and overall small movements of their body, in rates of eye blinking, and in coloration of their skin with superficial changes in circulation. Touch and attention are profound and powerful gifts. Value them and use them well and wisely.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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