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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).
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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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.
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.
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.
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.
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.
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.
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%.
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.
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.
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.
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
May, 2007, Vol. 07, Issue 05
Cranial/Structural Soft-Tissue Releases
By Don McCann, MA, LMT, LMHC, CSETT
For the past 15 years, I have been working with a paradigm that has greatly expanded the effectiveness of my soft-tissue therapy. When I began applying the cranial/structural releases to initiate structural balance, there was a quantum leap in the effectiveness of my treatments and long-term rehabilitation for my clients.The cranial/structural releases initiated an unwinding of the body out of its collapsed spiral that had been the cause of so much soft-tissue compensation and pain; and corrected the weight-bearing separation between the rotated iliums and tipped sacrum.
With weight-bearing support quickly established in the first 20 minutes of treatment, the old compensations and myofascial holding patterns in the soft tissue began to release, resulting in more efficient soft-tissue treatment and allowing the structure to move more easily into balance. Before the cranial/structural releases, it would usually take at least five to 10 sessions for any noticeable improvement in the client's structural collapse. Even then, the weight-bearing separation of the sacrum and ilium was not completely resolved. Let's look at the difference between craniosacral and cranial/structural soft-tissue releases.
Cranial/structural techniques are very different from craniosacral techniques in intent and application. Craniosacral techniques are applied within the soft-tissue restrictions of the normal cranial motion to achieve homeostasis. Cranial/structural techniques release the soft-tissue restrictions of the distorted cranial motion, resulting in structural balance throughout the body. Let's take an in-depth look at the need for cranial/structural techniques.
Within the structure of every client's body there exists a core distortion pattern. Many liken it to a spiral that runs throughout the structure, resulting in an anterior/posterior rotation of the iliums, a tipped sacrum and a degree of classic scoliosis. This spiral is evident from the top of the head down to the feet and, not surprisingly, also is found in the relationship of the bones and soft tissue of the cranium. When clients are experiencing musculoskeletal pain, there is an observable increase in the degree of this distortion. This can be viewed as a degree of structural collapse or a lack of structural support. The resulting pain can be evidenced in the compensation for this increased distortion, the strain in the musculature or the actual distortion of the skeletal structure. Thus, the key to relieving the painful symptoms and balancing the structural support system lies in releasing this exaggerated core distortion.
For years, in developing my soft-tissue protocols, I struggled with the major components of this core distortion, in an effort to relieve my clients' painful symptoms. Whether it was whiplash flexion/extension injuries, headaches, neck pain, shoulder pain, degenerative disc disease, bulging disc, carpal tunnel, nerve entrapment, sciatica, low back pain, hip pain, knee pain or foot pain - it was related to structural collapse. Therefore, addressing and releasing the core distortion pattern appeared to be the most direct way to achieve pain relief, homeostasis and a return to normal function.
Within every collapsed structure, I found an anterior/posterior rotation of the iliums, stretched ligaments between the sacrum and the ilium at the SI joint, and a tipped sacrum. The degree of distortion was directly influenced by the degree of the rotation of the iliums, the degree of stretched ligaments and the degree of tippage of the sacrum. Further, the degree of distortion in the body was directly proportional to the intensity of the pain and symptoms the client was experiencing. The longer the client remained in this distortion, the more the entire musculoskeletal system distorted into the lack of support, which usually resulted in an extended recovery process.
One of the greatest challenges was stabilizing the SI joint. While the client was on the table, the position of the iliums could be shifted through soft-tissue releases, and the feet and legs could be aligned to support the shift. However, when the client became weight-bearing, the weakened ligaments would not be able to stabilize the SI joint and the sacrum would again slip and tip, re-creating the structural collapse.
A missing link in the treatment to stabilize the pelvis was found in the relationship between the cranial bones, reciprocal tension membrane, dura and the myofascial planes of the body. Dr. G. Dallas Hancock, a chiropractic physician, discovered the relationship between two of the cranial bones (the sphenoid and the occiput), the sphenobasilar synchondrosis (SBS) where they meet, and the torsion of the pelvis. He noted that the rotation of the iliums and tippage of the sacrum were in direct relationship to the rotation of the wings of the sphenoid and the tippage of the occiput. I had the privilege of working with him to develop the techniques of releasing the cranial torsion of the SBS that successfully released the torsion of the pelvis.
One of the ways to understand the effect of this incredible discovery of Dr. Hancock's is to view these two cranial bones (sphenoid and occiput) as handles for the reciprocal tension membrane, dura and the entire myofascial plane of the body. The distortion found in the SBS joint is supported by the restrictions in the reciprocal tension membrane, dura and fascia, which affect the entire structure of the body. The techniques that were developed to unwind the torsion of the SBS released the restrictions in the reciprocal tension membrane and dura, which, in turn, released the restrictions in the myofascial planes of the body that related directly to the dura. In addition to the release of the restrictions in the dura, its relationship to the sacrum allowed the sacrum and the iliums to balance.
The greatest significance of this was that the weight-bearing separation of the SI joint was corrected, even though the ligaments had been stretched. Another exciting discovery was that clients would not return to this weight-bearing structural collapse unless a very severe trauma was experienced. With the balancing of the SI joint and iliums, the myofascial planes of the body down to the feet also were beginning to unwind and balance, bringing support into the entire structure.
The torsion found in the cranium also was the principal cause of problems such as TMJ. When the torsion was taken out of the cranium (SBS), a balancing of the bite took place. Most clients who suffered TMJ symptoms would have an immediate improvement. Even without focusing on the usual TMJ soft-tissue treatments, clients would continue to improve and often become pain-free.
Cranial work that focuses on this structural shift is called cranial/structural due to its direct relationship to structural balance. Prior to having these techniques to balance the SBS and correct the weight-bearing collapse found in the core distortion pattern, I was not able to achieve a long-term correction of the distortion in the pelvis. However, with the cranial/structural techniques, my clients showed dramatic changes in the initial session and I was able to achieve long-term correction of this distortion throughout the body in only a few treatments by integrating my soft-tissue protocols.
Jerry, 33, an avid weekend basketball player, had been developing low back pain for five years. He was then rear-ended in an auto accident, resulting in a cervical flexion/extension injury and excessive soft-tissue damage. His chiropractor referred him for soft-tissue therapy, as he was having difficulty stabilizing his neck. At Jerry's first session, evaluation revealed a structural collapse of the core distortion with an anterior/posterior ilium rotation, tipped sacrum, scoliosis, reverse curvature of the neck and a jammed C1. Applied kinesiology evaluated the weakened strain patterns of the structural collapse and revealed weakness in the legs down to the feet.
The cranial/structural soft-tissue releases were applied and Jerry noticed an immediate improvement in the range of motion of his neck, less neck pain, a flattening of his back on the table and reduced back pain. Upon becoming weight-bearing, Jerry also noticed that both feet felt like they were directly under him with the weight evenly distributed. He was standing straighter, his arms were more equal along his sides, and the top of his left shoulder was no longer hurting. It was obvious there had been substantial improvement in Jerry's structure. It was now time for soft-tissue treatments to release the myofascial holding pattern and address shortened fascial fibers, adhesions and scar tissue from the auto accident, and the structural collapse from basketball. Jerry's neck stabilized in just two sessions.
Cranial/structural is most effective when applied at the beginning of the first session to release the core distortion pattern and balance the SI joint. However, the soft tissue (dura, reciprocal tension membrane and fascia) will only release so far using the cranial/structural techniques alone. The structure of the body is then trying to move into balance, but the soft tissue that was tightened and forming adhesions and restrictions in the holding pattern of the core distortion will impede the process. To complete the balancing process, it is necessary to include specific myofascial releases, myofascial unwinding, and scar and adhesion fiber work to allow the whole body to move into structural balance.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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