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Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
September, 2008, Vol. 08, Issue 09
Questions With Direction
By David Kent, LMT, NCTMB
One of the most challenging aspects of being a massage therapist is trying to build a thriving practice with repeat clients. So, it's no surprise that many therapists have felt the crunch with the recent downturn in the economy.Unfortunately, services like massage therapy often are among the first to be cut from one's budget in times of economic crisis.
Therefore, it is now more important than ever to convince your clients to stay the course with their massage therapy sessions. This article will show you how asking some simple questions can ultimately lead to repeat clients, whether you work in a spa, outcall, seated or clinical massage setting. Soliciting a client's feedback by way of asking thorough questions will better help you understand your client's needs and deliver results. Even more important than asking questions, however, is listening and responding to the information your client provides.
One way to organize your questions is to make use of the wide range of forms available for these purposes. In fact, your questions will, to a degree, be directed by the information you obtain using forms. I have my clients complete intake forms prior to therapy. These help me develop targeted questions to clarify my knowledge about their health history, specific areas of pain, stresses in their life, ergonomics of their activities of daily living, medications they are taking, and to identify any precautions or contraindications before the session begins. Using intake forms helps me develop goals for the client's current and future sessions, which also is useful in persuading my clients to commit to ongoing treatment.
There are various types of questions. However, this article will focus on two primary categories: general and those related to a client's pain. General questions are great for helping you understand your client's expectations no matter what kind of practice you have.
Question: What are your goals for today's session?
Reasoning: If you don't ask this question, you won't know if a client wants a relaxing Swedish massage or a vigorous sports massage that integrates stretching. This also is important so you're responding to your client's needs and not responding to your perception of your client's needs.
Question: What areas would you like me to focus on today?
Reasoning: This question also relates to the previous question. At one time or another, we've all probably had an experience with a therapist who seemingly ignored the very thing that brought us to therapy in the first place. When you ask this question, it's very important to listen closely to the answer. When you listen to the client and deliver results, it increases the odds your client will reschedule and/or refer others.
Question: Have you received massage therapy before?
Reasoning: Regardless of the client's answer, this is the ideal time to communicate to the client how you will perform the session. For new clients, you might advise the client to disrobe to their level of comfort and then discuss draping techniques. For veteran clients, you might ask if they'd like you to do something extra special, such as incorporate essential oils into the session.
Question: If you have received massage therapy previously, please tell me where you received it, by whom, and which treatments were the most beneficial?
Reasoning:This information can help you understand how to adapt the session to the types of massage therapy that have produced positive responses for the client in the past. You might also ask the client what they think makes a great massage - and then do what you can to meet the client's expectation.
Question: What type of pressure do you prefer?
Reasoning: Keep in mind that levels of pressure are subjective for each client. What you perceive as light pressure and what the client perceives as light pressure could be entirely different. It's important you check in with the client at the start of and during the session.
Question: Have you ever had any negative effects and/or experiences from receiving massage in the past?
Reasoning: People respond to massage in different ways. Some get ill or are sore for several days after they receive a deep massage. This is where intake forms and questions can be very useful. Some questions might include what medications the client is on, if they bruise easily, what the client's diet is like, as well as questions related to general health and exercise.
Question: Is there anything else I should know?
Reasoning: I intentionally keep this question open-ended so the client can add additional information at their discretion. It's up to me to connect the dots. I am frequently amazed by how many clients will tell me about a traumatic accident and/or major surgery in the past that they didn't mention previously.
Questions About Pain
Question:What other health care providers have you seen recently and for what?
Reasoning: This question immediately informs you if your client has seen a doctor or if the client has self-diagnosed. I can then quickly perform a postural analysis (See "Getting Comfortable with Postural Analysis" in the July issue), check range of motion and perform relevant muscle tests and orthopedic assessments to determine if it's appropriate to proceed or if the client needs to first follow up with a physician.
Question: Have you tried different health care practitioners over time? If so, which one(s) provided the most relief? What did they do and how long did the results last?
Reasoning: Understanding more about the treatments a client has sought for pain relief will give you insight into how you can best help them. For example, if the client sees a chiropractor on a regular basis, you might suggest they schedule an appointment with you immediately before the appointment with their chiropractor for maximum results.
Question: What do you do for pain relief?
Reasoning: I am always surprised by how many people buy topical pain relievers at a drug store. Why should the drug store get the money? Consider selling topical ointments in your practice. Integrate a topical into the therapy session, then send the client home with a sample. The next time the client buys a topical ointment, it might just be from you.
Question: What aggravates your condition?
Reasoning: If the client reports increased back pain when standing or straightening after bending down, it might indicate lumbar and hip flexor or extensor involvement. A muscle movement chart can help you determine exactly which muscles to assess. Trigger-point charts are useful for educating clients about referred pain. Additionally, using the postural analysis information combined with photos helps show the client how stressed or shortened muscles have contributed to the formation of trigger points. This further leads into a discussion of how a series of treatments can be beneficial.
Asking the right questions can help your practice tremendously. I am looking forward to learning how the questions in this article worked for you. I encourage you to read my other articles that can help during these challenging economic times.
Click here for more information about David Kent, LMT, NCTMB.
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