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Building Kidney Yang and Jing
Kidney yang, if we include mingmen fire, is the energy and heat source for the whole body. Jing is the essence of yang, and is stored in the kidney, extraordinary channels, and in the bone marrow, which in TCM also includes the brain.
A Very New Year: It's Time to Track
As we enter 2017, we find "affordable care" is not so affordable for many individuals. They are discovering what employers learned long ago: Health care is expensive – and keeps getting more expensive.
Change on the Horizon? New White House Spells Shift in Health Care Policy
On the morning after Election Day, many in our country were surprised to learn that not only did the Republican nominee win the White House, but also that the House of Representatives and the Senate remain under GOP control.
The Key to Recovery
Starting in the 1970s and developing over a decade of assessment and improvement, the South Bronx's Lincoln Recovery Center staff refined the method of using five basic ear-points, which became the NADA protocol for the treatment of addiction.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion.
What Are Prebiotics – and Why Should You Care? (Part 1)
In previous articles, I spoke about the different kinds of fiber and their effects, and the potential risks of taking probiotics without also consuming prebiotic soluble fiber (PSF) in foods and/or supplements [see August & October 2016 issues].
Case Study of Benign Hand Tremors
Patients without degenerative diseases causing tremors are often given the diagnosis of essential tremors, for which treatment options are limited to lifestyle changes and medications.
Increase Your Practice Income With Retail Products
With only so many hours in a day, there is a cap on the revenue an acupuncturist can generate by way of appointments. Once your appointment book is filled, you can't really add more without burning yourself out.
The Mysterious Divergent Channels
The divergent channels are among the most mysterious entities in all of Chinese medicine. They are rarely mentioned, lacking reference in modern TCM study, and rarely used within popular Chinese medical treatment.
Losing Your Mind? Try Coconut Oil
Alzheimer's disease (AD) is currently the 6th leading cause of death in America according to the CDC. It affects over 5 million Americans and 50 percent of nursing home residents (2014), and is projected to spike to 16 million by 2050.
Top 2017 Health & Fitness Trends
We really did sign up for a career of learning and development. Now that you have built a strong foundation of your manipulation skills, nutrition base, movement assessments and business knowledge, it's time to keep up with the American College of Sports Medicine's 2017 worldwide health and fitness trends.
MD-DC Affiliations Under Fire
I am George P. McAndrews, lawyer for the chiropractors in the Wilk, et al., v AMA, et al., antitrust suit that resulted in an injunction against the AMA and others, banning them from interfering in lawful professional relationships between medical physicians and doctors of chiropractic.
Your Patients With Cancer Need You
It was a chilly Minnesota morning in March 1999 when she asked to speak to me alone. My then-busy chiropractic practice wasn't built for much privacy, but I quickly scooted the 60-some-year-old, white-haired patient to my exam room, as the open adjusting area was buzzing with excitement.
An Education in Stroke Risk and Chiropractic
Dr. Steven Shoshany's ninth appearance on "The Dr. Oz Show" may prove to be his most significant, as he addressed questions related to the death of Katie May, who suffered two strokes in February 2016, hours after her third visit to a chiropractor for what she described in a Twitter post as a pinched nerve in her neck experienced during a photo shoot days earlier.
Scope of Chiropractic Practice: Time for Change?
The University of Bridgeport, College of Chiropractic Student Government Association sponsored a panel discussion on Oct. 25, 2016.
Acute Locked-Back Syndrome: Cause and Correction
As we all know, occasionally a patient will present with acute-onset low back pain with or without a precipitating incident. A distinguishing feature of the presentation is visible lateral antalgia, both standing and walking.
Scar Reduction With Acupuncture & Microneedling (Part 1)
Applied correctly, modern skin needling techniques can form part of a holistic treatment and incorporate the principles of Chinese medicine.
Clinical Outcomes & Safety for TCHM
The practice of Traditional Chinese Herbal Medicine (TCHM) may appear archaic to those who misunderstand the theories and principals that guide it. In fact, TCHM continues to evolve and new systems are consistently being discovered and applied within the tradition.
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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