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Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
April, 2008, Vol. 08, Issue 04
The Structural Component of Soft-Tissue Rehabilitation
By Don McCann, MA, LMT, LMHC, CSETT
One of the most important factors in understanding and treating clients in pain who need therapeutic massage is evaluating the cause of the discomfort. We often look directly to the area of discomfort and find inflammation, swelling, ischemia, trigger points, buildup of fiber, scar tissue and adhesions, and think treating this is the key factor in our client's recovery. However, when we treat only the symptomatic areas, we are doing our clients a major disservice. There always is a reason for any area of the body to be in distress. One factor that is ever-present is the relationship of structural imbalance to the area of pain.
Structural balance allows the body and its musculature to function with strength and flexibility. When there is an imbalance in the structure, specific areas of the structure will overwork or be weakened to the point of injury or distress. This can be understood when looking at muscles moving bones in a lever relationship. When the structure is balanced, the lever and fulcrum are in an optimal performance relationship. With structural imbalance, the fulcrum/lever relationship is, at worst, totally dysfunctional and subject to breakdown or, at best, weakened and in need of additional support from surrounding soft tissue. This is inefficient and, in essence, the muscle that is supposed to be doing the work only has a third to half of its strength. This leaves that muscle very susceptible to strain or injury. In addition, the joint or spine is unstable and weakened and subject to strain or injury.
Thus, in therapeutic massage, a major treatment goal is to release the structural imbalance. Let's look at what happens when this is not factored into the treatment protocol. One of the easiest ways to understand this is to look at an area where most clients experience pain - the top of the shoulder, which includes the trapezius, levator scapula, supraspinatus and rhomboids. When this area is hot, inflamed, spasmed or strained, clients will present wanting relief ASAP. If the massage treatment is focused only within this area, there might be short-term relief; however, in the long run the condition could worsen. If the soft tissue in the top of the shoulder is released without balancing the shoulder, the muscles in the front of the chest will have less resistance and pull the shoulder farther forward into additional imbalance. The long-term result is that the client will most likely have more pain, discomfort and dysfunction in the area due to the increased distortion. To make matters worse, the soft tissue in the top and back of the shoulder actually are counterbalancing and actively working to hold against the stress in the soft tissue in the front of the shoulder.
So, when therapeutic massage techniques are applied first to the spasmed tissue on the top and back of the shoulder, which is invested in maintaining its holding pattern, the area will be resistant to the technique being applied. The sensation for the client is intensified and the client will experience greater discomfort because of the difficulty in relaxing that musculature. Plus, it will take two to three times the amount of work and pressure by the massage therapist to achieve results in the area. This obviously is a lose-lose proposition.
If the theory of releasing the shoulder into structural balance is applied, the muscles in the front of the shoulder are treated first, releasing the shoulder back into structural balance, and allowing the muscles in the back and top of the shoulder to release their compensation holding pattern that was counteracting the tension from the muscles in the front of the shoulder. The massage therapist will achieve greater results with much less work. In addition, the client will experience less discomfort and will be able to maintain structural balance and long term homeostasis.
Neck problems. Most clients will complain of pain in the back of the neck and at the base of the cranium. The majority of them will be holding the head forward, resulting in a reverse curvature of the cervical spine. In order to achieve structural balance, you will need to first release the soft tissue that is responsible for pulling the head and neck forward before releasing or treating the tissues at the back of the neck where the pain is located.
Low back. When clients present with low back pain, there is an imbalance in the pelvis that includes the legs and feet. This imbalance is not only front to back, but also involves torsion where one ilium rotates anteriorly, and the other rotates posteriorly. The most effective way to move the client into structural balance to relieve the pain is to release the leg and ilium that is rotated anteriorly first, and then the posteriorly rotated ilium/leg side.This concept of structural balancing to achieve long-term results, while working within client comfort levels, can be applied to any musculoskeletal imbalance found in the body.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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