Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
August, 2006, Vol. 06, Issue 08
Types of Tendon Injury
By Whitney Lowe, LMT
The primary function of a tendon is to transmit the contraction force of its associated muscle to the bone. Consequently, the tendon needs to have sufficient tensile strength. Tendons have various shapes, such as the sheet-like aponeurosis of the latissimus dorsi or the long, pencil-like structure of the biceps brachii.They are constructed with parallel collagen fibers running the length of the tendon. The longitudinal arrangement of the collagen fibers gives the tendon its tensile strength.
Tendons are a fundamental part of the contractile unit. The tensile strength in a tendon can be more than twice that of its associated muscle.1 As a result, they are rarely torn. Even in muscles where complete ruptures occur, such as the biceps brachii or triceps surae group, the rupture usually is at the musculotendinous junction or in the muscle fibers. The musculotendinous junction is the weak point in the entire contractile unit because it's where the two different tissue types (muscle and tendon) meet.
In some cases, the muscle fibers remain intact and the tendon tears or pulls away from its attachment site on the bone (another instance where different tissue types meet). This is known as an avulsion. More often, tendons are damaged with internal structural pathologies such as tendinosis and tenosynovitis. These conditions generally result from repetitive overuse as opposed to an acute injury.
The most common pathological problem involving tendons used to be referred to as tendinitis but is now more correctly known as tendinosis, which means abnormal condition of the tendon. Tendinitis implies an inflammatory condition and it previously was believed that chronic overuse lead to tendon fiber tearing and inflammation. We now know this does not occur in most overuse tendon pathologies. True tendinitis, or tendon fiber tearing with inflammation, occurs but it's a rare condition.2
Recent investigation of tendon overuse dysfunction shows most overuse tendon pathologies are devoid of inflammatory cells and instead involve a breakdown in the collagen matrix.3,4 Because of the lack of inflammatory activity in these conditions, the term tendinosis is encouraged. The term tendinosis does not specify the pathological process, only that the tendon is dysfunctional. High levels or prolonged periods of tensile stress on the tendon can lead to collagen breakdown. While any tendon can develop tendinosis, tendons in the extremities are more susceptible. Another result of chronic load on the tendon is alteration in the tendon's vascularity (blood flow). An increase in vascularity is indicated in some studies, while other research shows decreased vascularity. Either problem contributes to chronic tendon pathology.
Even though there is significant research and evidence showing it's the pathology of tendinosis occurring, physician diagnosis and rehabilitation practitioners often call this injury tendinitis. Rehabilitation, in many cases, continues to focus on anti-inflammatory treatment strategies, rather than collagen rebuilding. In some cases, the use of anti-inflammatory medication, such as corticosteroid injections or oral anti-inflammatory medications, can be detrimental for healing collagen degeneration.5 Overuse tendon disorders can take a long time to heal due to the slow rebuilding of collagen. If tendon fiber tearing (tendinitis) were the primary problem, the tissue would heal rather quickly as it moves through the various stages of the inflammation and tissue repair process. Collagen rebuilding is a slow process and tendinosis can become chronic or recurrent.
Another chronic overuse tendon problem is tenosynovitis, which is an inflammation and/or irritation between a tendon and its surrounding synovial sheath. This condition affects only those tendons enclosed within a synovial sheath. The synovial sheath is also called the epitenon. The synovial sheath surrounds tendons in the distal extremities and a few other locations, such as the biceps brachii long head tendon as it travels through the bicipital groove. The sheath reduces friction between the tendon and the retinaculum (or, infrequently, a ligament) that binds the tendon close to the joint. The tendon must be able to glide freely within the sheath.
Chronic overloading or excess friction leads to adhesion between the tendon and its sheath. The adhesions cause a roughening of the surface between the tendon and its sheath, and a subsequent inflammatory reaction results. The rough tendon surface routinely produces crepitus (grating sensations) when the muscle-tendon unit and affected joint are moved through their range of motion. The symptoms of tendinosis and tenosynovitis are similar, but one can help distinguish between the two by determining if the tendon has a synovial sheath. If it does, tenosynovitis is possible. If there is no sheath, tendinosis is probably the cause.
An avulsion is an acute tendon injury resulting from high tensile loads, in which a tendon is forcibly torn away from its attachment site on the bone. In a majority of tensile stress injuries of the musculotendinous unit, fiber tearing occurs at the musculotendinous junction producing a strain. In some other cases these fibers remains intact and the tendon pulls away from its bony attachment site.
Avulsion injuries occur in regions where a large muscle attaches at a relatively small site on the bone, such as the hamstring attachment.
Click here for more information about Whitney Lowe, LMT.
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