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Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
July, 2007, Vol. 07, Issue 07
Successfully Treating Cervical Trauma Using Deep-Tissue Techniques
By Don McCann, MA, LMT, LMHC, CSETT
Jim, a 35-year-old accountant, suffered a cervical flexion/extension injury in an auto accident. After chiropractic treatment had exhausted his personal injury protection (PIP) coverage, his chiropractor released him saying he had reached maximum medical improvement.However, he still was having severe neck and shoulder pain with headaches. He sought treatment from several massage therapists whose ads stated that they did deep tissue, therapeutic massage. He was totally unimpressed both by the amount of pain he endured during his sessions and the lack of improvement. A friend referred him to our clinic with the reassurance that not all deep-tissue therapy had to be a painful experience and he would see results.
During Jim's initial session, structural evaluation revealed a forward head posture with a reversed curvature of his neck. On his intake form he marked the back of the neck and top of the shoulders as primary pain areas. The therapist explained to him that his treatment would address the pectoralis region and anterior neck first, and then the painful areas in the back of his neck and the top of his shoulders. Jim was amazed because previous therapists had only concentrated on the areas of pain. As the treatment proceeded, he was pleasantly surprised that this therapy was very tolerable even though some of the strokes were deeper than previous work, and he was feeling better.
The important thing to learn from this is that it is crucial to have a structurally-based strategy for applying therapeutic massage techniques. Deep tissue therapy, whether it is myofascial release, myofascial unwinding, myofascial stretching, or deep trigger-point release, will result in significant long-term structural changes. If these releases and changes do not contribute to structural balance and normalization of structural function, then they are likely to contribute to structural distortion patterns and structural dysfunction, which tend to create worsening conditions and increased client pain.
In Jim's case, the tension was released from the musculature of the anterior shoulder and neck first, allowing the shoulders and neck to move back facilitating the initial structural improvement. As the shoulders and neck released, the spasms in the back of the neck and top of the shoulders began releasing even before treatment was ever applied to those areas. If therapy had been applied to the primary areas of pain in the back of the neck and top of the shoulders first, the tightened musculature in the anterior neck and pectoralis muscles would have pulled the head and shoulders forward even further as the posterior musculature was released. The structure would have worsened by the increased misalignment resulting in increased pain. Thus, it is very important for therapists doing therapeutic massage to always be aware of the structural consequences and ramifications of releasing fascia, adhesions and shortened muscles. To address Jim's complaint regarding the pain he experienced with other deep-tissue work, a three-step approach to working deep tissue was used.
The first step is the application of milking strokes to release the fluids, toxins and ischemia, which reduces the inflammation and clears some trigger points. Tissues swollen with toxins, fluid and inflammation are extremely sensitive and painful to touch, so light, slow, gentle strokes are used. This results in a decreased sensitivity of the tissues, which allows palpation of the tissues without major discomfort and prepares the tissues for deeper work.
The second step is the application of directed myofascial unwinding strokes to release the holding pattern of fascia in the structural dysfunction and to further clear trigger points. These strokes are very slow. You sink in until you feel the resistance in the tissue and then hold constant, steady pressure until the resistance starts to melt. Follow the tissue as it melts, keeping the pressure slow, steady and constant. You will feel many layers softening and releasing at a deeper level than where the actual pressure is. The deeper you go, the slower you go. These strokes released most of the myofascial holding pattern that held the structural distortion within Jim's neck and shoulders preparing this area for more specific deep work to release scars, adhesions and tightened individual fibers.
The third step is the application of individual fiber strokes to release deep fascia, adhesions, scar tissue and atrophied tissues locked in the soft tissue. Many of these deep adhesions, along with scar tissue, entrap nerves and lock the structure into distortion. These are deep, specific strokes, moving very slowly, staying within pain tolerance levels.
This three step approach can be used in any area of the body and will allow you to apply effective, deep therapeutic massage while staying within your clients' pain tolerance. Jim stated that, even though these strokes appeared to release tissues more deeply than previous deep-tissue treatments, he did not have the discomfort that he experienced in those treatments and his pain disappeared after just a few sessions.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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