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Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Top 10 Fitness Trends for 2016
The American College of Sports Medicine (ACSM) published its annual fitness trend forecast in the November / December 2015 issue of ACSM's Health & Fitness Journal.
The Future of Functional Neurology
Functional is the hot buzzword in health care these days; witness the rising popularity of functional medicine, functional testing and yes, functional neurology.
Elevated Shoulder? Check the QL
As you know, posture reveals a great deal about the body. Posture is a unique mental and physical landscape revealing compensations and adaptations to life. It's a classic mind-and-body story.
News in Brief
A Winner in and Out of the Office; Ready for the "Have-A-Heart" Campaign? New Integrative Medicine Journal.
Spine Surgery: A Tale of Greed and Corruption
All too often, where there's substantial money to be made, greed and corruption inevitably follow.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
The Amazing Clinical Versatility of Milk Thistle (Part 1)
Most of us know that the standardized extract from the seeds of milk thistle (Silybum marianum) is probably the best-proven herb for protecting the liver from chemical and inflammatory damage.
The MRI: When and Why to Order One
As I lecture around the country to both chiropractors and medical specialists, it's clear one of the main disconnects between the two professions is that of an accurate diagnosis.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Osteoporosis Isn't Always the Case
What is your diagnosis? The patient is a 58-year-old female with back pain. I am sure all of you see the compression fracture at L2; however, there are some findings that suggest this is not a compression fracture due to osteoporosis.
We Get Letters & Email
In the Dec. 1, 2015 issue, we have Donald Petersen reporting on "the adapting chiropractic practice," which includes multidisciplinary practice as an option; a ChiroPoll indicating 59 percent of DCs are seeing at least 21 patients per day and 27 percent are seeing more than 40.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Sell Out: Using Research for the Wrong Reasons
The above chorus is from the ska band Reel Big Fish's 1997 hit song, "Sell Out," from their album, "Turn the Radio Off." In the song, the singer sarcastically relates the plight of a musician who is tired of "flipping burgers" and is willing to get "lots of money" by playing "what they want you to hear" in order to get a recording contract.
Preventing ACL Injuries in Female Athletes
For female athletes, the key to optimal athletic health lies in preventing ACL injuries. In medical terms, the anterior cruciate ligament (ACL) is the primary restraint to the anterior displacement of the tibia on the femur at all angles of the knee flexor.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Do You Teach Patients How to Breathe Properly?
Spinal manipulation often produces quick results in terms of pain alleviation and improved range of motion. Unfortunately, once the patient is no longer in pain, they may discontinue therapy, only to be plagued by the same complaint at a future date.
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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