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Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
March, 2008, Vol. 08, Issue 03
Medial Wrist Pain
By Ben Benjamin, PhD
Question: If passive radial deviation causes pain on the medial side of the wrist, what structure is likely to be injured?
Answer: The ulnar collateral ligament of the wrist.
The wrist joint is located at the junction where the bones at the base of the hand meet the two long forearm bones, the radius and the ulna. The small bones of the wrist are uniquely shaped and fit together like a jigsaw puzzle in two rows of four bones each. The row closest to the fingertips is called the distal row; the row nearest to the forearm is called the proximal row. These bones are joined to one another and to the radius and ulna by an intricate network of ligaments. The ligaments provide stability while allowing movement among the individual wrist bones and between the wrist and arm bones.
The ulnar collateral ligament of the wrist, also known as the internal lateral ligament, is a fibrous band of tissue located at the medial side of the wrist. (Be careful not to confuse it with the ulnar collateral ligament of the elbow, an entirely separate structure.) This ligament attaches at the styloid process of the distal ulna and inserts primarily on the triquetrum bone, with some fibers running to the pisiform and hamate bones. It functions to protect the wrist joint by limiting radial deviation (i.e., the side-bending movement of the wrist toward the thumb).
To assess the wrist for damage to the ulnar collateral ligament, grasp the forearm a few inches above the wrist with one hand and grip the medial part of the hand with the other. Stretch the ulnar side of the wrist by moving the hand laterally toward the thumb side, while stabilizing the arm with your other hand. Be sure the client's hand is relaxed. Note whether this produces discomfort at the medial side of the wrist. If it does, the ulnar collateral ligament is likely to be injured. (It is also possible for pain in this region to be caused by a fracture of the triquetrum bone or the styloid process of the ulna, so be sure your client sees a physician to rule out those conditions.)
Although injuries to the ulnar collateral ligament may occur throughout the ligament, they most commonly occur at the attachments - and primarily at the origin. To locate the ligament origin, place your thumb or index finger against the styloid process at the distal edge of the ulna. To locate the distal attachment, move distally to the attachments at the triquetrum and the pisiform bones.
The most common cause of ulnar collateral ligament injury is sudden or repeated trauma. Sudden trauma to the wrist often occurs when we try to protect ourselves by extending our hands to break a fall. Jobs or activities that require using the wrist in repetitive actions for many hours each day (long hours working on a computer, for example) make this area vulnerable to injury. Injuries also can result from performing the repetitive motions involved in playing an instrument without adequate rest and recovery.
Ulnar collateral ligament injury is common in karate students who practice hitting objects with the medial surface of the hand. It is also a frequent problem in massage therapists, drummers, carpenters, construction workers, house painters and athletes who use their wrists in stressful positions.
Click here for more information about Ben Benjamin, PhD.
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