resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Are They Finally Fixing Medicare Reimbursement?
Even with federal sequestration cuts taking effect in March, including a 2 percent reduction in Medicare reimbursement to health care providers, hope may be on the horizon in the form of a much-anticipated, perpetually suggested overhaul of Medicare's Sustainable Growth Rate formula, which serves as the basis for determining physician reimbursement.
Going Shoeless: The Pros & Cons of Barefoot Running
With the subculture of barefoot runners and the products catering to them growing daily, just about every chiropractor has been asked at one point or another about their opinion regarding barefoot running.
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
A Building Block of Healthy Aging
Coenzyme Q10 has gained enormous attention in recent years, and with good reason —it's the Energizer Bunny of the cellular world.
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
Happenings in Our Evolving Profession
Good things seem to be happening for our profession and recent developments show we are all on board. Talking about being on board, this September The Veterans Express-Purple Heart Tour is expected to make its way out of the station.
Correcting Kid Logic in Health Care and Research Design
A recent broadcast on public radio described a fascinating phenomenon known as kid logic.
Let's face it – patient evaluation takes time. Unless you are really into the diagnostic evaluation game, you probably have found the formal exam protocol tedious if not downright annoying.
What the Science Says About Magnesium Stearate
It's often been said that scientific studies can be used to support just about anything. But discoveries are never made one study at a time.
Some Thoughts on the TMJ
The temporomandibular joint is an interesting and dynamic articulation that can cause a lot of problems.
Research Abstracts From the Journal of Manipulative & Physiological Therapeutics
Effect of Pain Relief on Lumbar Muscle Function and Activation; Effects of Thrust Amplitude and Duration of HVLA Spinal Manipulation; Immediate Effects of Upper Thoracic Manipulation on Cardiovascular Response.
Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Side Effects From Big Pharma: Wellbutrin – Dangerous for You and Your Baby
Are some of your pregnant patients taking Wellbutrin? If so, it could be a danger to them and their baby. This drug is extremely popular, but it has a serious history.
Why You Should Get to Know the National Vaccine Information Center
Barbara Loe Fisher has been a diligent advocate for providing parents with the information necessary to make informed decisions regarding the usage of vaccinations for their children.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
Remembering Joe Weider (1920-2013)
With the death of Joe Weider, the world's most famous body-building visionary, crusader, fitness magazine publisher and icon, on March 23, 2013, chiropractic has lost one of its greatest friends and supporters.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
The Potter's Wheel: Reflections on Practicing in a Technology-Driven World
In my very early years of practice, an older patient named Cora would call me at home, usually late Sunday night after she had consumed an unknown quantity of beer.
Medicine Presents: A Great Opportunity
The changing nature of health care presents both opportunities and challenges. While we tend to focus on our profession, we can sometimes forget the impact other health care professions can have on us.
Have a Heart: Say No to Soda
It's not enough that soft drinks and other sugar-sweetened beverages have been linked to cavities and weight gain, among other negative health consequences.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
What They Don't Say Could Hurt You
I have written previously regarding the difficulties of drawing information from patients who are poor historians, forgetful or just plain uncooperative. The thought to revisit the topic occurred recently during preparation for an upcoming seminar.
We Get Letters & E-Mail
Patient Perception and the Farce of "Fast Relief"; A Fly in the Ointment; Persecuted for Choosing to Practice Chiropractic.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
Chiropractic: The Right Choice for Relieving LBP
"Low back pain (LBP) is a common threat to medicine and a reasonable threat to all national health care systems. ... Reducing ineffective treatments is necessary to decrease the LBP associated costs."
SOAP Notes: It's Time for a Cleaning
I have been planning for some time to write an article about how traditional SOAP notes do not fit chiropractic practice, and the unfairness of holding DCs to a model clearly created for and primarily applicable to medical physicians.
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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