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The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
September, 2006, Vol. 06, Issue 09
By Erik Dalton, PhD
Many of today's medical texts tell us the coccyx fuses into one rigid segment by adulthood in most people. However, several well-designed studies have shown that a normal coccyx should have two or three movable parts that gently curve forward and slightly flex as we sit.Two medical papers (Postacchini and Massobrio1 and Kim and Suk2) found that test subjects with fused coccyxes that didn't flex upon sitting were more likely to experience tailbone pain than those with a normal coccyx. Postacchini and Massobrio performed radiographic studies of 171 coccyxes, and found less than 10 percent were fused into one piece...most had two or three, and a few had four segments. The primary conditions they found to be associated with coccyx pain were: coccyx angled sharply forward; coccyx side-bending more to one side than the other; and coccyx completely rigid (all segments fused together and fused to the sacrum).
Although none of the abnormalities listed above always cause pain, clients seem more likely to experience coccyx problems when one or more of these conditions exist. Over the years, I have noticed clients with particularly long coccyxes also seem more likely to report local tenderness and pain. Although not reported in the literature, it seems obvious that a long coccyx would be more likely to suffer damage than a shorter one.
Why some hurt and others don't is unclear. In the case of a misaligned coccyx, it might be that the pain is caused by the coccyx pulling on muscles, ligaments or overstretching the filamen terminale (end of the dural tube). Connective tissues called the filum durae spinalis enclose the end of the spinal cord and attach it to the deep dorsal sacrococcygeal ligament. A major source of hip and back pain occurs as fibrotic sacrococcygeal ligaments anteriorly flex (hook) the coccyx and compress/overstretch the sensitive filum terminale (Fig.1). In the case of a rigid coccyx, it might be that the tissues under the inferior segments might create a pad of irritated tissue (like a bunion) that can rub the dura raw. But the most common pain-generator helped by manual therapists is neuroreceptor pain from a misaligned sacrococcygeal joint.
Coccydynia (Coccyx Pain)
When sitting, the coccyx shifts forward and acts as a shock absorber. However, falling on the tailbone or events such as childbirth can lead to coccygeal pain, known as coccydynia. In most cases, the pain is caused by an unstable coccyx, resulting in chronic inflammation of the sacrococcygeal joint. Coccydynia also can be attributed to a malformed or dislocated coccyx and the growth of bony spurs on the coccyx. Resulting pain often is resolved by performing specific soft tissue techniques to release the levator ani muscle, anococcygeal, sacrotuberal and sacrospinal ligaments, as well as the gluteus maximus muscles.
Another common etiology is childbirth. The coccyx is considered by some to be in the way during childbirth. At the end of the third trimester, certain hormonal changes enable the synchondrosis between the sacrum and the coccyx to soften and become more mobile. This increased mobility of three to five coccygeal segments allows for more flexion and extension, which might permanently change the resting tension of the surrounding ligaments and muscles. Unlike fractures, which can remodel, injuries to the sacrococcygeal junction often become inflamed as the joint is repeatedly forced out of its normal position. Physical examination should include direct palpation of the coccyx for tenderness. In true coccydynia, the coccygeal region usually is markedly tender. If the client reports coccygeal pain but is not tender upon palpation, the therapist should refer out for an orthopedic workup to rule out lumbar disk disease.
Ida Rolf, PhD, referring to the coccyx as the "seat of the soul," insisted on correcting hooked and side-bent coccyxes during her famous session six of the Rolfing® series. When this tiny group of bones "hooks" anteriorly or bends to one side (typically the left), the dural tube tightens. In reported cases, a hooked coccyx actually has shut down the entire CNS by hindering cerebrospinal fluid flow. A hooked coccyx also can lead to loss of psychological integrity. Reported cases cite severe emotional disturbances in people whose coccyx has been removed or broken off, leaving no anchor for the dura mater. The coccyx has been implicated in clients presenting with functional scoliotic patterns. Through its connection with the sphenoid, excessive dural tension stresses the eleventh cranial accessory nerve, which, in turn, shortens the SCMs and upper trapezius muscles. A modified version of Dr. Rolf's coccyx technique is demonstrated in Fig. 2.
Coccyx pain often is caused by falling backwards or by childbirth, although in many cases, the exact etiology is unknown. There are various treatment modalities available, and the great majority of sufferers can be helped. Due to the vertebra's direct attachment to the dural membrane through the filum terminale, coccyx work can cause a client to become very emotional. Prior to treating coccyx dysfunction, always ask the client's permission to perform this technique due to possible physical and emotional hypersensitivity in the area. Before performing any type of coccyx work, take time to clearly explain your therapeutic intent and the desired outcome. All coccyx alignment techniques should be performed through underwear or draping.
Click here for previous articles by Erik Dalton, PhD.
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