resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
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.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
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.
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.
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.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
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.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
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.
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.
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?
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
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.
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.
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.
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.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
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.
June, 2008, Vol. 08, Issue 06
Feel the Read: An Unconventional Approach to Bodyreading
By Raymond Bishop, PhD
When a local Pilates instructor asked if I would be interested in teaching a class in bodyreading to her instructors, I initially was very excited. As I began to contemplate how I might structure such a class, a number of difficulties occurred to me.The most obvious is that teachers in my profession have a very different language for describing and (more importantly) experiencing what we read than Pilates instructors, in part because of very different intentions as to what we wish to teach and accomplish with our clients.
I started imagining what the first steps of such a review process might look like, basing this bit of speculation on my teaching experience, my work in this area and reviewing various texts.1 I decided to start by formulating a basic model for how bodyworkers are taught assessment. The first part of such a protocol had to do with looking at a body standing in an anatomical position in the gravitational field - the most familiar way most of us first learn to evaluate deviations from established postural norms. The type of assessment in which I am interested here is simply the "reading piece," rather than the application of a rigorous set of palpatory and movement tests such as those an experienced physical therapist might perform before developing a treatment protocol or corrective action.2
Such a reading might start with placing a body in front of an actual or imaginary grid and looking at deviations from "true verticals or horizontals," and describing such asymmetries with a simple and consistent language. Conceivably, we would notice such obvious discrepancies as higher or lower with respect to the same structure on the opposite side, or focus on how each side's shape fails to fall precisely where it should on our grid. When considering patterns in the sagittal plane (along the side), we might employ a hypothetical plumb line from the ear lobe to the lateral malleolus. We would then describe those structures that fall farther in front of or behind that line than we would expect.3 Such structures are either too anterior or posterior.
We might finally consider relationships in the transverse plane, focusing on the balance and symmetry of the stacked horizontals from the arches of the foot to the sphenoid or the cranial vault. We can think of these horizontal planes as joints or, to use a term more familiar in the SI community, diaphragms. The latter is perhaps a nicer metaphor in that it allows us to consider soft-tissue planes such as the respiratory diaphragm, the arches of the foot and the floor of the pelvis (the levator ani and related structures), as well as boney articulations (such as the knee) as fluid relationships that become distorted in a number of ways.
Shifting our awareness to relationships in the transverse plane is a bit more conceptual because the actual number of soft-tissue structures that are purely or even largely horizontal is quite small. Yet, "seeing horizontals" actually proves very important for most models of "structural reading."
We now assume all three planes have been studied and the results tabulated. Once the student has completed their model of asymmetries, they would then begin to match the locations of imbalances with specific anatomical landmarks. These would be the boney attachment points for muscular structures4 most likely involved in pulling the body out of alignment. Once the anatomical landmarks are identified, the student then starts laying the muscles on them and formulates a working list of the usual suspects that contribute to any deviations we observe. They do this by organizing groupings based on similar locations and actions, but also should consider relative depth of the structures involved and perhaps extend their seeing to the layer at which this deviation occurs. At the same time, they need to consider not only synergists, but also those antagonists they certainly will find just as compromised by any local fixation.
A further step in this evaluative process involves seeing larger-scale adaptations created as a result of a local strain. For instance, a shoulder girdle torsion and elevation will create adaptations in the cervical and upper thoracic spine, as well as in the ribs. These regions must therefore be studied if we wish to do more than free up a very specific strain pattern. By logical extension, not only will we find adaptive strains in the pelvis both on the ipsilateral and contralateral sides, but we also will find lower thoracic lumbar adaptations that reinforce or counteract the patterns in the upper spine and thorax. Prioritizing and strategizing as we see these larger-scale adaptations snaking through the axillary skeleton adds an inevitable level of complexity.
If you agree with my thinking so far, you will anticipate my next shift in attention from the girdles to the limbs. How is it possible that an elevated and anteriorly displaced shoulder girdle will not shorten and twist the arms in similar or oppositional patterns? Of course they do. Therefore, as we extend our seeing through the appendicular skeleton, we begin to see a more intricate representation of how a local asymmetry sets up multi-level matrices of unique adaptations in the system we began evaluating with our seemingly simple imaginary grid not so long ago. All this makes the process of structuring a single intervention much more complex than if we choose the less interesting option of "just fixing the shoulder."
Such a sobering conclusion begs the question: If I am doomed to be overwhelmed by the complexity of such patterns, what do I do? While any effort to answer such an enormously complex question in a short essay is doomed to failure, there may be another way of attacking this entire problem, one rarely considered in those classes in which we address problems of seeing and strategizing. I will shift my focus and leave such a discussion for another time.
Before proceeding, I need to briefly speak to an important dimension of traditional bodyreading: the study of bodies in movement. Since in my view, this is such a difficult issue, any effort to demonstrate how one might structure readings in motion, even at the most basic level, would take us too far afield. Those interested in this topic might begin by delving into the books by Myers and Maupin.5
Many argue that the real key to creating meaningful and sustainable change begins in having good movement evaluation skills. The notion is that if static release is good, asking for movement while manipulating soft tissue is at least three times as good. Seeing and being able to correct movement patterns in gravity while shifting movement often proves essential for a sustained rehabilitative outcome. Such information is essential if we intend for our therapy to help re-educate and empower the client by giving them a repertoire of simple tools to "keep that tight hip free." Touch therapy without movement education has been repeatedly shown to be of less sustained value. There is no judgment in this opinion; it is simply an important underlying point.
Movement obviously is a kinesthetic experience. It's this underlying notion of the value of kinesthetic sensing that provides us with the key to our alternate approach to reading bodies. There are a few interesting pieces of the puzzle that will prove very useful for the novice "kinesthete." One piece is the value of having some sort of formal training in experiential anatomy. Without such training, how can any student begin to translate what they see to what they feel? Any bodyworker interested in developing such skills has a number of excellent trainings available.
Whatever the source, any interested student wishing to enrich their ability to "feel the read" will quickly find a movement program that fits their needs. Once such training has been successfully integrated into the practitioner's experience of body as movement and self, they will begin applying this knowledge to how they read. Some practitioners of a highly kinesthetic and intuitive orientation will feel drawn to this affective approach to reading and will be quietly working this way, even in their more traditional classes. Such folks will read more by feel than by external descriptive models, although they will lack a coherent level of specificity of language in their readings.
There is an implicit assumption that those who work mostly by feel have different ways they process their sense impressions. We can think of these approaches as falling into two broad categories: literal readings and metaphorical readings. In a literal reading, the bodyworker forms a clear anatomically based three-dimensional image of the client's strain pattern. They easily label the specific muscles that feel compromised and see some approximation of the degree to which the structure deviates from the norm. Certain qualitative issues such as excessive density, the nature and location of adhesion to related structures, and specific movement restrictions sensed locally and more distally will, to varying degrees, reveal themselves during such a reading.
On the other end of the spectrum are those sense impressions that are more "energetic," for lack of a better descriptor. In this type of sensing, the therapist perceives deviations of shape, texture and other properties, but the words employed are less exacting, being mostly more allusive or evocative. We find in such readings qualitative terms such as dense, heavy, sticky, stringy or desiccated.
If I seem to be presenting a rigid "either/or" scenario, then a correction is needed. Sense experience is highly variable and extremely difficult to describe. Also, anyone who reads by feel may receive a series of rapid impressions that contain random literal or metaphorical elements, or both. Certainly, sense impressions have great range, rather than falling into discrete quanta. Our problem in describing such impressions is a function of their volubility and ephemeral nature, and our inability to measure them. We usually are left with only the client's reporting of the accuracy of our descriptions of their pain as confirmation that our descriptions are "right."
As I read my audience now, I fear the kinesthetic intuitive approach remains shrouded in mystery, as if many of you believe only that which we can measure is real. In my view, the mystery is rather that those who work this way remain so timidly silent and cloak their abilities in the language of mainstream bodyreading or esoteric doublespeak, rather than attempting to be as clear, precise, and direct in their wording as the skilled anatomist. This concern is magnified when we learn many scientifically trained practitioners are equally adept in both "kinespheres." Much of the misunderstanding around the intuitive approach comes from a reticence to play esoteric "name that tune" games, because of the difficulty of finding a clear descriptive and, more importantly, the "excludedness" felt by those who do not process this way.
My intent in presenting such ideas is to evoke openness and inclusiveness, rather than elitism and separation. Just as sense experiences exist on a continuum, so does our understanding. We must always aspire to reach beyond ourselves in the search for greater understanding. Fear and intellectual laziness are no excuse, nor is the ego-driven need to appear more intelligent or sensitive than another. We all have our own gifts and distinctive ways of working. No one approach ever trumps another, since decisions based on preference are subjective and individual. In the case considered here, there is no inherent advantage to one approach to reading bodies over another. Our intent is rather to expand the range of possibilities by offering creative alternatives to the more commonplace mode of how we see.
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