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Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
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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