resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
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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