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Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
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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