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The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
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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