resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
The Bottom Line ... From a Surgeon Who Knows
Regardless of individual relationships between providers, there continues to be a type of Hatfield-McCoy feud between the philosophies of medicine and chiropractic, particularly when it comes to musculoskeletal ailments.
Drug War Rages in Wisconsin
Based on its actions over the past 15 years (review the sidebar in the app version of this article), controversy and the Wisconsin Chiropractic Association seem to go hand in hand.
Alcohol Consumption Strongly Linked to Risk of Colorectal Cancer
Alcohol intake is one of the primary risk factors for many human cancers, and is strongly associated with cancers of the oral cavity, pharynx, larynx, esophagus, liver, breast, and notably, the colon and rectum.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
The McGill Approach to the Lower Back (Part 1)
Stuart McGill, PhD, brings a unique combination of tools to the table. He is a scientist who also functions as a clinician. He describes himself as a medical consultant who is referred challenging patients. He is both evidence based and practical.
News in Brief
Foundation for Chiropractic Progress Enrolls Second Group Member; Focus on Chiropractic Education at WFC-ACC Conference in Miami; Are You Ready for Another "Have-a-Heart" Campaign?
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
"Turn, Turn, Turn"
Many people are credited with saying, "If you remember the '60s, you really weren't there." Given the fact I didn't become a teenager until 1970, I actually do remember the '60s (or at least part of it). And as a child of the '60s, I was, of course, influenced by the music.
Correcting Dysfunctional Movement Patterns – Is Local Treatment Enough?
It is widely believed that mechanical, non-traumatic back pain is largely related to dysfunctional or compensatory movement patterns the body has adopted over time.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Giving Chiropractic Some Much-Needed PR
Public relations has not always been the chiropractic profession's strong suit, a shortcoming that has subjected the profession to countless attacks on its legitimacy and seemingly perpetual confusion among the public and the health care world as to the skills and services doctors of chiropractic provide.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
September, 2007, Vol. 07, Issue 09
Achilles Tendon Disorder
By Whitney Lowe, LMT
Massage therapists see many clients with active lifestyles. Running, jumping, dancing, climbing, or any number of other activities can put serious stress on the Achilles tendon (AT). AT disorders also can contribute to biomechanical disorders in the foot and lower extremity.That is why it is important for the massage practitioner to understand more about the structure, function and pathology of this very important tendon.
The AT is the strongest tendon in the body and needs this strength because of the high force loads required during motions such as walking, running or landing from a jump. AT disorders can occur at any age, but there is an increased frequency in older populations. The increased age of the active baby boomer generation in this country suggests we likely are to see more of this condition in years to come. The tendon is susceptible to a variety of pathologies, such as paratendinitis (also spelled paratendonitis), tendinosis and tendinitis. Some of these different terms can be confusing, so I'll distinguish them below.
Structure, Function and Pathology
The AT connects the gastrocnemius and soleus muscles to the calcaneus. The tendon is surrounded by a thin membrane called the paratenon, which helps facilitate blood supply throughout the tendon. There is a region of the AT near the distal insertion, called the avascular zone that has a very poor blood supply (Figure 1). This region frequently is the site of inflammation and degenerative changes within the tendon.
The term tendinitis is used for overuse tendon pathologies throughout the body. Yet, most of these conditions do not involve inflammation so they truly aren't tendinitis (the suffix -itis indicates inflammation). Yet the AT is one tendon that commonly does have inflammatory activity in the tendon and the paratenon. Consequently, the terms tendinitis and paratendinitis usually are accurate when referring to the AT.
Achilles tendinitis is classified as insertional or non-insertional. Insertional tendinitis involves pathology at the insertion of the AT into the calcaneus. It is prevalent in older individuals and those who engage in activities without proper conditioning. Poor healing of minor tendon damage occurs at the calcaneal tendon insertion due to the lack of blood supply in the avascular region.1
The second category of overuse AT disorders is non-insertional tendonitis - those that don't affect the insertion of the tendon into the calcaneus, but cause problems in other areas of the tendon. Non-insertional tendinitis typically affects athletes and those engaged in vigorous physical activity. The pathologies under the umbrella of non-insertional tendinitis include paratendonitis (inflammation of the paratenon), tendinosis (collagen degeneration within the tendon) and tendinitis (inflammation of the tendon).
Tendinosis is degeneration of the collagen matrix within the tendon, which leads to pain and loss of function. It commonly is categorized as non-insertional tendinitis, even though it is not an inflammatory disorder. The degenerative changes of tendinosis are caused by age, repetitive microtrauma or other factors that lead to collagen breakdown. The collagen degeneration frequently precedes inflammatory conditions such as tendinitis.
Non-insertional tendinitis can be acute or chronic and primarily affects the avascular zone near the base of the tendon. There is tenderness throughout the tendon and fibrous thickening near the distal end, which is apparent when the tendon is compared to the unaffected side (assuming the other side is not affected). In many cases, tendinitis and paratendinitis occur together and both the tendon and paratenon are inflamed. If not treated properly, tendinitis can lead to either partial or complete tendon ruptures.2
Recent studies show a link between certain medications and the onset of AT degeneration and ruptures. Especially implicated are medications in the fluoroquinolone family of antibiotics, such as ciprofloxacin (brand named Cipro).3-5 These medications cause tendon pathology in large tendons of the body, even in the absence of vigorous repeated activity. In addition, systemic disorders such as hyperthyroidism, renal insufficiency, gout or rheumatoid arthritis also can contribute to tendinitis in the AT.6,7
AT disorders are best controlled through rest and activity modification. Rest means stopping offending activities, not immobilization. Lack of movement might lead to the development of fibrous adhesions. Cold applications and anti-inflammatory medication may be used to address inflammatory activity if present. As soon as stretching is tolerable, it is helpful to stretch the AT several times per day.
Massage applications to the calf muscles reduce tension and decrease tensile forces on the tendon. Deep friction, as tolerated in the problem area, is beneficial in stimulating fibroblast proliferation in the tendon to repair the damaged collagen matrix. Cold applications prior to the deep friction reduce the intensity of the discomfort, and reapplying cold after treatment reduces the accelerated metabolic response to the friction. Heel lifts inside the shoe may be recommended to help reduce tension on the tendon. Corticosteroid injections formerly were used with greater frequency and are not recommended now because of long-term detrimental effects on the tendon, such as tendon rupture.8 Massage therapists applying these concepts of evaluation and treatment will be much more effective in helping their clients address this frequent cause of foot and lower leg pain.
Click here for more information about Whitney Lowe, LMT.
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