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Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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).
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%.
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.
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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