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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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
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."
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.
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.
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.
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.
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.
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.
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.
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.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
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?."
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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