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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.
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.
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.
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...
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.
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.
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.
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.
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.
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.
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.
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.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
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!
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.
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.
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.
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."
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.
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.
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.
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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