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Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
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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