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Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
September, 2007, Vol. 07, Issue 09
Acid Reflux and Hiatal Hernia
By Don McCann, MA, LMT, LMHC, CSETT
Everybody knows about the "little purple pill." Why? The answer is quite simple. The majority of Americans over the age of 40 are experiencing, the symptoms of acid reflux, which are very uncomfortable.Many people experience acid reflux as a result of hiatal hernias of the esophageal hiatus, which is even worse.
Unfortunately, since many massage therapists aren't aware that there are effective soft-tissue treatments that can eliminate these symptoms without drugs or invasive medical procedures, they have not developed the skills to treat these conditions. In order to be able to effectively treat hiatal hernia and acid reflux, you must first understand how tension in the soft tissue from stress and structural imbalance contributes to them.
One form of hiatal hernia is a tearing in the diaphragm that allows a portion of the stomach to protrude through the tear. There also can be damage to the esophageal hiatus where the esophagus empties into the stomach. When this sphincter valve of the esophageal hiatus is affected by stress or structural imbalance, it is not able to function properly. This improper function allows the contents from the stomach to flow back into the esophagus (acid reflux). This is especially troublesome when a client is prone or supine or has a full, actively digesting stomach. Acid reflux also can occur even when there is no significant damage to the esophageal hiatus. This can be due to overactive digestion taking place in the stomach resulting from spicy food, overeating or the presence of excess stomach acid. How can massage therapy effectively treat these conditions? Let's look at where the stomach is located and what muscles have a major effect on the esophageal hiatus and the stomach.
The esophageal hiatus is located in the center of the diaphragm at the top of the stomach. The diaphragmatic muscle attaches on the sternum and lower ribs, and extends all the way around to the back including the thoracic vertebrae. This makes it extremely reactive to any structural distortion. If the musculoskeletal system is distorted, the resulting misalignment is reflected in contractions and distortions throughout the diaphragm. Stress affecting the sympathetic nervous system can add to structural distortions that affect the diaphragm. If you add extra weight to the structure, you have yet another distortion factor for the diaphragm. When the esophageal hiatus is constantly stressed by these distortions and imbalances, it reacts like an "o" ring with unequal pressure on all its sides, which does not allow it to close effectively. This usually results in acid reflux or a hiatal hernia.
To resolve hiatal hernia problems, massage therapists need to be able to address both the structural distortions and the stresses that involve the diaphragm. My three-step approach to working with deep tissue will treat this area effectively starting with the surface tissue and moving progressively deeper with successive strokes. It is important to remember to follow the principle of "the deeper you go, the slower you go!" As you work deeper into the abdomen, apply just enough pressure to sink in slowly, and only move deeper as the client relaxes and the resistance decreases.
The intent of these abdominal strokes is to release the tension in the diaphragm and stomach allowing the rib cage to expand upward while reducing the distortion and stress on the diaphragm. In releasing the diaphragm, you are releasing the stresses that have accumulated from both the sympathetic and parasympathetic nervous systems. This often results in a calming of the stomach and reduction in the hyperacidity found with acid reflux, nervous stomach and ulcers.
Applying these massage techniques to release the stresses on the diaphragm will treat hiatal hernias and acid reflux very effectively. A relaxed diaphragm allows the esophageal hiatus to function efficiently, which will prevent acid reflux by keeping the contents of the stomach where they belong. A relaxed diaphragm also will allow a tear to heal so the stomach can no longer protrude upward through it. This often is not an overnight solution, but clients usually experience additional relief with each session. This is a great chance to assist your clients with proper therapeutic massage techniques.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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