resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
May, 2007, Vol. 07, Issue 05
Pronator Teres Syndrome
By Whitney Lowe, LMT
Upper extremity nerve entrapments are a common cause of pain and disability. The increase in repetitive motions associated with occupational and recreational environments usually is singled out as the primary cause of these problems.Many individuals with nerve entrapment symptoms will seek the care of a massage practitioner.
If a client comes to you with an upper extremity pain condition, you want to accurately identify that problem so you can determine if it warrants massage treatment or referral to another health professional. In some cases, a condition might have symptoms that very closely mimic a different pathology. If you don't identify the condition correctly, your treatment is not going to be as effective.
The symptoms of pronator teres syndrome (PTS) can be identical to those of carpal tunnel syndrome because they both involve compression of the median nerve. PTS may be underdiagnosed by medical professionals because its symptoms are so closely related to carpal tunnel syndrome, which is a much more well-known condition.1
PTS develops from compression of the median nerve by the pronator teres muscle, and is sometimes referred to as pronator syndrome. The term pronator syndrome also can include median nerve compression by other structures in the elbow, such as the ligament of Struthers or the bicipital aponeurosis (lacertus fibrosus).2
As the median nerve passes the elbow, it runs between the two heads of the pronator teres muscle, where the nerve may be compressed (Figure 1). Compression can be due to muscle hypertonicity or fibrous bands within the muscle pressing on the nerve.3 In some cases, pressure is placed on the nerve by anatomical anomalies, such as the nerve traveling deep to both heads of the pronator teres.4 In this situation, the nerve might be compressed against the ulna by the pronator teres muscle itself.
PTS results from repetitive motions that cause hypertonicity in the pronator teres. Occupational activities such as hammering, cleaning fish, or performing any activity that requires continual manipulation of tools can cause overuse of the pronator teres. The hypertonicity then causes nerve compression, and the symptoms are felt in the anterior forearm and the median nerve distribution in the hand (Figure 2). Women are affected more than men, although the reason for this is not clear.
Most symptoms of nerve compression radiate distal to the site of compression. Aching forearm pain and paresthesia, along with pain in the median nerve distribution in the hand, are likely to be PTS and should not be assumed to indicate carpal tunnel syndrome.
While PTS and carpal tunnel syndrome both affect the median nerve and have similar symptoms, there are distinct differences. PTS pain is exacerbated by repetitive elbow flexion, and symptoms arise in the forearm as well as the hand. Carpal tunnel syndrome is aggravated by wrist movements, and pain is not experienced as much in the forearm. In both cases, atrophy is possible in the thenar muscles of the hand, which are innervated by branches from the median nerve.
There are several other ways to identify PTS and distinguish it from carpal tunnel syndrome. Clients with carpal tunnel syndrome frequently report night pain, while individuals with PTS generally do not.1 Prolonged wrist flexion during sleep aggravates carpal tunnel syndrome because it decreases the space in the carpal tunnel and presses on the median nerve. Because wrist flexion does not affect the pronator teres muscle, this wrist position does not increase nerve compression symptoms in PTS.
An evaluation procedure called the pronator teres test also is helpful in identifying the condition. The client stands with the elbow in 90 degrees of flexion. The practitioner then places one hand on the client's elbow for stabilization and the other hand grasps the client's hand in a handshake position. The client holds this position as the practitioner attempts to supinate the client's forearm (forcing the client to contract the pronator muscles). While holding the resistance against pronation, the practitioner extends the client's elbow (Figure 3). If the client's pain or discomfort is reproduced, there is a good chance of median nerve compression by the pronator teres. The client should keep the elbow relaxed during the test, because holding the elbow firmly in flexion will not allow elbow extension.
Pronator teres syndrome is most commonly caused by muscular compression of the median nerve. Therefore, it is a condition that is effectively treated with massage. However, it is important that the practitioner accurately identify the problem so treatment can be directed to the proper region of the upper extremity.
Author's note: The content of this article is excerpted from: Lowe W. Orthopedic Assessment in Massage Therapy. Sisters, OR: Daviau-Scott; 2006.
Click here for more information about Whitney Lowe, LMT.
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