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Decompression-Traction: A Core Treatment Method in Chiropractic's Future
We're all competing for new patients. We're competing for new patients with physical therapists, massage therapists, medical specialists and hospital fitness centers. We're even competing with side-effect-ridden medications that quit working every four hours.
Take Care of Your Skin: Tips to Pass on to Your Patients
Many of our patients are not aware that the largest organ in the human body is actually the skin. Accounting for 16 percent of total body weight and covering up to 22 square feet of surface area, the skin is more than just a "covering," as originally thought.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Your Patients' Best Health Resource
There is nothing as powerful as information. The right information has won wars, saved lives and changed hearts; lack of information has led to hesitation, poor decisions and unintended consequences.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
The Life & Legacy of James Sigafoose, DC (1933-2014)
Surrounded by his family and closest friends, Dr. James M. Sigafoose passed away quietly on Thursday, July 3, 2014. With his wife of 60 years, Patsy, along with his children, Tina, Daun, Kieth, Selina and Carey – all chiropractors – at his side.
From the Other Side of the Table
People come to us to gain freedom from pain, to feel better, to live better. As D.D. Palmer stated, "We Chiropractors work with the subtle substance of the soul." Therein also lies the rub.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
Ringing in a Fiscal New Year With a Recommitment to Cost-Effectiveness
Back when the Foundation for Chiropractic Education and Research was in its heyday, I used to send out New Year's greetings and virtual noisemakers to some close friends on July 1 – the beginning of our new fiscal year – wishing for prosperity in the year ahead.
How to Find Your Ideal Patient – and Help Your Ideal Patient Find You
Just imagine: You're at the front desk looking at the scheduler and a smile creeps across your face. Row after row, name after name, hour after hour; you're blessed with an entire day of ideal patients. Every day should be like this, you whisper. Exactly!
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Building the DC-MD Bridge
From MDs practicing integrative holistic medicine to the family internist, many DCs are enjoying unprecedented attention from their allopathic colleagues.
Detoxification for Athletes: The Key to Winning Performance
One of the most dangerous culprits that affects an athlete's ability to perform at an optimum level also happens to be one of the most elusive.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Watch Out for Red Herrings
In clinical practice, when one condition mimics another, it makes it difficult to obtain an accurate and timely diagnosis.
News in Brief
Oregon Gov. John Kitzhaber (a medical doctor, no less) proclaimed October 2014 "Oregon Chiropractic Health and Wellness Month" in an official proclamation signed Aug. 25, 2014.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
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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