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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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%.
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).
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
January, 2007, Vol. 07, Issue 01
By Whitney Lowe, LMT
The foot provides dynamic stability for a person's entire body weight, while simultaneously maintaining flexibility for shock absorption and propulsion along uneven surfaces. As a result, there are unique biomechanical demands on the foot.One of the body's adaptations to these demands is through specialized movements in the foot, such as pronation. In order to fully understand pronation, let's look at some fundamentals of movement and mechanics.
Most joint movements of the body are described in one of the three cardinal planes: sagittal, frontal or transverse. While there are foot motions such as dorsiflexion and plantar flexion that occur in these standard planes, most foot and ankle motion is not adequately described by these planes. More commonly, motion of the foot at the ankle is in a diagonal or oblique plane. This oblique plane motion involves movement through all three planes. For example, pronation is a diagonal plane movement of the foot around an oblique axis that combines the primary cardinal plane movements of dorsiflexion, eversion and abduction of the foot.
The diagonal plane movement of pronation occurs normally during walking or running. Although the term pronation routinely is used to describe dysfunctional foot mechanics, a better description of the pathological problem is overpronation. Also called hyperpronation or excessive pronation, this biomechanical disorder involves too much pronation during gait. Overpronation results when an individual moves either too far, or too fast, through the phases of pronation, placing more weight on the medial side of the foot during gait.
Unless there is a severe, acute injury, overpronation develops as a gradual biomechanical distortion. Several factors contribute to developing overpronation, including tibialis posterior weakness, ligament weakness, excess weight, pes planus (flat foot), genu valgum (knock knees), subtalar eversion, or other biomechanical distortions in the foot or ankle. Tibialis posterior weakness is one of the primary factors leading to overpronation. Pronation primarily is controlled by the architecture of the foot and eccentric activation of the tibialis posterior.1 If the tibialis posterior is weak, the muscle cannot adequately slow the natural pronation cycle.
Another primary cause of overpronation is subtalar eversion, also called calcaneal valgus (Figure 1). When the calcaneus is everted, weight is forced onto the medial edge of the foot. The subtalar eversion of pronation is visible in a standing position and it's evident that increased weight is placed on the medial side of the foot (Figure 2). Obesity can cause overpronation because the additional weight produces subtalar eversion and forces the longitudinal arch to collapse.
Overpronation can be a contributing factor in other lower extremity disorders, such as foot pain, plantar fasciitis, ankle injuries, medial tibial stress syndrome (shin splints), periostitis, stress fractures and myofascial trigger points. Overpronation increases the degree of internal tibial rotation, thereby contributing to various knee disorders such as meniscal injury or ligament sprains. The effects of the postural deviation are exaggerated in athletes due to the increase in foot strikes while running and the greater impact load experienced. When running, three to four times the body weight is experienced with each foot strike.2 If overpronation exists, the shock force is not adequately absorbed by the foot and is transmitted further up the kinetic chain.
Overpronation is best viewed from the posterior while the individual is walking, such as on a treadmill. When viewed with the client in a standing position, the overpronated foot looks similar to calcaneal valgus, because subtalar eversion is a fundamental component of overpronation. Examine the shoes for evidence of excessive pronation. If the shoes have had sufficient use, there will be an exaggerated wear pattern toward the medial side of the shoe bottom.
Overpronation usually is corrected with orthotics and/or strengthening exercises for the tibialis posterior. Massage treatment can relieve myofascial trigger points in the tibialis posterior, and other muscles, and address any resulting neuromuscular dysfunction in the leg or foot. Biomechanical correction of overpronation might require orthotics, neuromuscular reeducation, or gait retraining methods, as well. Stretching the gastrocnemius and soleus muscles will reduce hypertonicity in these muscles and also is essential for effective treatment.1 Because of impacts throughout the remainder of the body, the detrimental effects of overpronation should not be overlooked.
Click here for more information about Whitney Lowe, LMT.
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