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Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
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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