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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.
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.
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.
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.
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.
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.
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.
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.
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?"
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.
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.
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.
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.
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?
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:
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.
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.
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.
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.
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.
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.
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."
February, 2007, Vol. 07, Issue 02
The Body Is in Charge
By David Kent, LMT, NCTMB
Welcome to the first installment of "Keeping it Simple," named for my preferred method of instruction.
I like to keep things simple and I strongly believe learning should be fun.Not too many people would have thought I could have made dissection simple and fun, but let me show you just how my curiosity works.
There are five senses we learn from: visual, auditory, kinesthetic, olfactory and gustatory. Everyone learns differently. I am primarily a visual and kinesthetic learner. The first time I learned about fascia, muscles, tendons, ligaments, cartilage and adipose in massage school, I processed the information by asking myself several questions: What do these structures look like? What do they feel like? And is it possible for me to see them? Lastly, where could I − a naive massage therapy student − find the answers to these questions? This was, after all, 15 years ago, when massage therapy instruction was slightly less sophisticated. I didn't know, so I improvised.
The local grocery store has its own lovely lab called the meat department. To be honest, I initially found the answers to these questions by purchasing a whole chicken and dissecting it! The next day, I brought my chicken to show the class. My classmates thought my findings were cool, and soon thereafter, the teacher made this exercise a regular part of the course. Thankfully, today there are more impressive ways to learn about anatomy firsthand.
I had taken my first sip from the "cup of dissection knowledge" and I was hooked. It was this newfound addiction that led me to wonder how I could see, touch and study these structures in the human body. Ultimately, the answer to that question led me to create a full-body dissection course specifically geared toward massage therapists, acupuncturists and other allied health care professionals.
You might wonder how and/or why dissection is applicable or helpful to massage therapists. Let's think about it. Would you want a surgeon who has only read medical textbooks operating on you? Would you want a mechanic who has only watched engine repair videos working on your car? Of course not. You want somebody with real-world, hands-on experience − you want an expert who has a thorough and in-depth understanding of their field.
Massage therapist Anna Gallagher attended a dissection course and had this to say: "This was the opportunity for the senses in my fingers and hands to relate to my eyes. This put everything together for me."
The human body is a complex unit. As healthy, fully functioning human beings, it's easy to take our capabilities for granted, which is another reason why massage therapists can benefit from a course in human dissection. Often, such a course educates us in unique scientific wonders of the body that we wouldn't have otherwise known about or considered possible. I always am amazed at how often I find structural anomalies while dissecting the human body (G. anomalia = irregularity: a deviation from the average or norm; anything structurally unusual). Generally, anomalies are not taught in anatomy and physiology courses. However, it's important for all health care providers to consider the rare possibility of a structural anomaly when assessing the cause of a client's pain or dysfunction.
Sometimes, patients present with confusing, subjective complaints that are "out of the box." In these situations, I consider the potential causes of pain and/or dysfunction from an anatomical point of view. However, it's also important to remember that there are a number of other dynamics which influence pain and dysfunction, including nutritional, physiological, psychological, financial, professional and spiritual factors. While we, as massage therapists, cannot diagnose, we can assess patients by taking a thorough medical history and conducting postural analysis, range of motion (ROM), orthopedic, neurological and functional testing, and palpation exams. Each of these clinical assessment protocols is a means of narrowing down the origin of pain and dysfunction and designing a treatment plan.
Aside from typical discoveries, such as hip replacements, pacemakers, etc., I have encountered a few interesting anomalies over the years. For example, on one cadaver, the upper trapezius was missing; on another, the levator scapula had rib attachments bilaterally. What a mystery! I wish I could have known how these anomalies affected the regular activities in the daily lives of these people.
During another dissection, after reflecting the gastrocnemius muscle, I found two yellowish lumps, one proximal and one distal, on the lateral aspect of the soleus muscle. The larger proximal lump was approximately 12 mm wide and 35 mm long. Further investigation revealed that the lumps were lipomas (Lip = fat + G. - oma = tumor) that had taken the place of muscle tissue. Typically, the muscle fibers of the soleus slope infero-medially, which was the case for most of the fibers on the soleus of this specimen. The exceptions were the fibers between the lipomas, which were running medially and laterally. Interestingly, the posterior aspect of the fibula also had developed a unique ridge that protruded approximately 6 mm posteriorly from the head and neck of the fibula to the proximal lipoma. In case you were wondering, the anomaly was unilateral.
And here is one of my favorite cases. See if you can identify this muscle: We discovered a muscular anomaly while dissecting an 87-year-old female cadaver. It was present bilaterally, deep to the pectoralis major and immediately lateral to the pectoralis minor. Inferiorly, this muscle attached to the sixth rib, blending with the fascia of the external oblique. Superiorly, the tendon of this muscle blended with the tendons of the coracobrachialis and the short head of the biceps brachii as they attached onto the coracoid process of the scapula. Here are a few more hints: This muscle is an accessory derivative of the pectoral mass and is innervated by the pectoral nerves. It has a specific name that is 16 letters long, contains seven syllables, and has the following breaks: ---/--/---/-/---/--/--. Can you name it?
To see an image of this muscle before making an attempt at the answer, visit www.kenthealth.com. Other structures are labeled as well, including the pectoralis minor, serratus anterior, and other surrounding structures. If you do not have Web site access, see my next article for the answer!
I often wonder how these anomalies impacted these people in their day-to-day lives. The truth is, we will never know if an anomaly affected a particular person or not, since the only information we receive from most state anatomical boards is limited to gender, age,
Click here for more information about David Kent, LMT, NCTMB.
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