resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
June, 2008, Vol. 08, Issue 06
The Essence of Palpation: How Do You Feel?
By Leon Chaitow, ND, DO
Palpation lies at the heart of much that we do in manual medicine and bodywork in general, and massage in particular. But how accurate and reliable is it?
What we do therapeutically commonly is determined by prior palpation and the meaning we give to what has been palpated.In other words, we assess and decide what treatment is needed and then apply techniques in order to achieve those ends. If, however, our palpation skills are limited or our interpretation of what it is we are feeling is inaccurate, then the treatment we choose to apply based on such misinformation is likely to fail.
Famous osteopathic physician Viola Fryman said: "Palpation cannot be learned by reading or listening; it can only be learned by palpation."1 Palpation represents a two-way communication between the examiner and the patient. Decisions as to what to do therapeutically often will be based on a variety of palpation and assessment methods, together with the symptoms and the patient's responses to these manual (and sometimes observational) evaluation procedures.
In other instances - I am thinking of methods such as neuromuscular technique or many massage techniques - palpation and treatment are synchronous with decisions over how we should respond by varying the degree, duration and directions of forces. These decisions are determined by what is being assessed/felt by the contact hand(s), and how this is interpreted in real time, moment by moment. What is being done therapeutically in such a setting is directly related to what is being palpated and assessed at that moment, rather than having been planned ahead.
For experienced practitioners and therapists, much of the instant decision-making that results in modifications of application of forces (compression/stretch, etc.) happens without due deliberation. The hands do the thinking - intuitively, so to speak. - in much the same way a tightrope walker makes instant, non-cognitive decisions based on the processing of multiple pieces of information.
In other circumstances, active deliberation and thought are required as to what to do next. How accurate such decision-making is will be based on a combination of experience and learned information, as well as being present in the moment and truly in touch with tissues that offer information requiring interpretation.
So, at the heart of palpation is what I termed palpatory literacy many years ago. Do we know how to read the signs and signals the body and its tissues offer us? Nowadays, with the clamour for "evidence-based" methods, a great deal of effort goes into evaluating how reliable and valid (accurate) palpation and assessment-methods are. These can be looked at in several ways. The most common are studies that try to see how reliable an examiner's findings (and therefore the methods used) are. This is measurement of intra-examiner reliability. The other major focus is on how repeatable findings are when different examiners are involved. This is measuring inter-examiner reliability.
The difference between these is that one (intra-) looks at how competent you are in making judgements about what you palpate, and whether the same findings are repeatable when you apply them to other people or other tissues that display similar characteristics. Do your current findings commonly agree with your previous findings? In this case, there is good intra-examiner reliability.
Inter-examiner evaluation looks at how much agreement there is when others palpate the same tissues. Do they come to the same conclusions you did? In that case, there is good inter-examiner reliability.
It's worth reminding ourselves that such reliability does not necessarily mean accuracy has been achieved. The interpretation of methods of palpation that can reliably be duplicated and which agree with the palpation findings of someone else, does not in and of itself mean the conclusions deriving from the palpation exercise are accurate. You may both be wrong, depending on the basis for your interpretation of similar palpation findings. For example, you could reliably aim and hit a dartboard every time you threw a dart, and this would reflect your throwing reliability. However, only if you consistently or frequently hit the bull's-eye would the dart-throwing be categorised as accurate.
So, how can we ensure better intra- and inter-examiner reliability and accuracy? I've explored ways to do this in my book Palpation and Assessment Skills, which attempts to lead the reader through multiple graduated exercises that should result in enhanced skills. Assessment and palpation methods need to be standardized, well-taught and regularly assessed for both reliability and validity (accuracy). The acronym STAR is used in osteopathic medicine to describe characteristics that commonly are present and assessable when dysfunction exists:
Some of these elements are measurable and some not. In other words, some are subjective (tissue texture, for example) and some are objective (range of motion, for example). One thing is certain: The more you practice palpation methods, the more sensitive and reliable your methods should become. What your palpation and assessment means depends on the degree of knowledge you have acquired and your particular belief system. For example, when palpating the radial pulse, your belief system might cause you to interpret findings as relating to heart rate, whereas someone else who appears to be performing precisely the same palpation might be evaluating qi levels in different meridian systems. I will return to the vast topic of palpation in a future issue.
Click here for more information about Leon Chaitow, ND, DO.
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