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Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
September, 2008, Vol. 08, Issue 09
Early Hours and Shortened Muscles
By Keith Eric Grant, PhD, NCTMB
Getting up too early is a vice habitual in horned owls, stars, geese and freight trains. Some hunters acquire it from geese and some coffee pots from hunters. It is strange that of all the multitude of creatures who must rise in the morning at some time, only these few should have discovered the most pleasant and least useful time for doing it.Orion must have been the original mentor of the too-early company, for it is he who signals for too-early rising. It is time when Orion has passed west of the zenith about as far as one should lead a teal.6
- Aldo Leopold
Back in my college days, I managed to fulfill my biology requirement while escaping hours looking through a microscope by taking a couple of university-sponsored field trips: one to Death Valley, Calif., and the other to Sequoia National Park. During the day, we students would follow professors around listening to them talk about the local mammals, insects and minerals. In the evening hours, among other activities, were some readings from different naturalists. Thus, I became acquainted with Aldo Leopold's A Sand County Almanac and his paragraphs on getting up "too early." Although Leopold was a few decades too early to note it, the quiet, semi-dark hours of the early morning also is a time many runners, including myself, prefer. Runner and writer Joe Henderson expresses well the draw and the disadvantages of rolling out of bed for a run:
After some hours of sleeping and not using our muscles, they often are shortened and unprepared for full exertion or full range of motion. The exertions of the previous several days find their revenge in those first minutes of active wakefulness. This leads us to warming up, cooling down and stretching, which often is an anything but simple discussion. The complexity is exemplified by a "debate" on passive stretching and injury prevention that was hosted in the Journal of Bodywork and Movement Therapies a few years ago.3 Having a dozen authors and an editor involved is, in itself, an indication of the ranges of opinion. A thorough review of stretching is beyond the scope of a short column. For this, I'll refer you to the works of Brad Appleton2 and Michael Alter.1
Some of the complexity around stretching can be at least narrowed, I believe, by looking at contexts and immediate goals. The goal upon getting out of bed for a run, for example, is not to extend one's long-term flexibility but to regain the short-term range of motion (ROM) necessary to begin running without immediate injury. Assuming you possessed this ROM before sleeping, the shortness is going to be an issue of muscle hypertonicity rather than one of actual tissue length. The immediate cure is controlled movement through an increasing ROM, until you reach your homeostatic ROM. The movements both relax the shortened muscles and, by stimulating release of synovial fluid, prepare the involved joints for movement. Essentially, the same goals would apply for pre-event sports massage. It's about facilitating movement within the athlete's normal ROM.
What remains are the effects and benefits of longer-term stretch programs. Michael Alter comments that the most important component of muscle related to ROM is the connective tissues that develop and surround the muscle at its various levels of organization.1 He presents an "overstretching principle" as an analog to the overtraining principle:
By the "overstretching principle," Alter is noting that the tissue both accommodates in length to the regular stretching and in its patterns of neural response. In response to stretching, the muscle-tendon unit becomes more "compliant" (i.e., easier to stretch). Witvrouw, et al., comment that some of the literature disagreements on stretching may result from not considering the types of sports activities.7 They note that sports involving bouncing and jumping, with a high intensity of stretch-shortening cycles (SSCs), require a muscle-tendon unit that is compliant (stretchable) enough to store and release the high amount of elastic energy that benefits performance in such sports. Sports that contain low-intensity of limited SSCs don't require the same compliance, making stretching to increase compliance less beneficial.
Another useful clue comes from Ingraham, who concludes stretching to increase flexibility beyond that needed for sport-specific movements might cause or augment the chance of injury, particularly if time spent in such stretching reduces time spent in general conditioning exercises.5
The pattern that emerges is that we need enough ROM to freely complete the movement a sport requires, but more flexibility than needed may only add instability. We need our muscles to be able to elastically respond to the stress placed on them, which is sport specific. Too little ROM or too little elasticity and we ask for trouble. Balancing strength, flexibility and our activities leaves us free to move - whether "too early" or when the sun is high.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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