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Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
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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