resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
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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