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Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
May, 2009, Vol. 09, Issue 05
Prevention and Rehabilitation of Conditions Leading to Hip Replacements
By Don McCann, MA, LMT, LMHC, CSETT
If you are doing therapeutic work, there will be clients who are in pain from hip problems, with hip replacements being the most severe.Unfortunately, many clients, especially the elderly, never fully recover proper alignment, full range of motion or pain-free function after having surgery for hip replacements. The criteria for hip replacements involves waiting until the client experiences constant and/or severe pain for a period of time before the surgery is performed. The tragedy here is that these clients are offered little, if any, intervention other than drugs for their pain, even after chronic or acute arthritic or degenerative changes are noted in the hip joint. This is very short-sighted especially when deep-tissue therapy, properly applied, can relieve and rehabilitate much of the problem. I have had clients who were told they were in need of a hip replacement due to pain and degeneration who, after rehabilitative massage techniques, were pain-free for years without having this drastic surgery.
Conditions Leading to Hip Replacements
A very basic condition is a pelvic imbalance (an anterior/posterior rotation of the iliums) resulting in the contraction of the musculature of the hip which often involves compression of the nerves. This may occur in the gluteals (maximus, medius, minimus), the piriformis or rotators. Other muscles that directly affect the rotation of the iliums and cause a tightening of the gluteals in compensation are the quadriceps, adductors, hamstrings, quadratus lumborum, TFL, iliacus and psoas. These muscles are all involved either in compensation for, or in support of, the pelvic distortion. I have found that when the pelvic imbalance is released, the tension in these muscles is reduced and there is a marked improvement in any hip condition.
To facilitate the release of the pelvic imbalance, the deeper tissues of the pelvis and hip need to be treated. Often these muscles and other soft tissue are inflamed and painful. Even so these tissues can be effectively treated by using a three-step approach that releases fluids and toxins and surface tensions; unwinds the myofascial holding patterns; and releases deep fibers and adhesions. This sequence not only directly affects the musculature and structure of this area, but reduces the amount of sensation that the client will experience while the contracted tissue is being treated.
It is important to release the tissues responsible for the anteriorly rotated ilium in a hip problem before releasing the compensating contracted or overstretched muscles that counter that rotation. I find the best results are produced when following this sequence: quadriceps, adductors, hamstrings, gluteals, quadratus lumborum, rotators, TFL and abdominals. If the pain and problem is in the hip joint of the posteriorly rotated ilium, it is still necessary to release the anteriorly rotated ilium first. Otherwise, the pelvis will slip into compensation for the anteriorly rotated ilium, and little will be gained for long-term recovery.
Don't hesitate to work with the hip if it is arthritic or the cartilage is degenerated. I have had many clients come to me with severe pain from arthritis and hip degeneration who are presently walking and fully functional. The soft tissue changes from the balanced pelvis took the stress off the hip. So, my message to you is: By all means do intervention therapy before surgery is ever considered. Unfortunately, many clients will not believe you can make a significant change because a medical doctor has diagnosed a problem, and they feel medical treatment such as surgery or cortisone is the only way to treat the pain. However, people want to feel better. Usually, that is enough of a reason for them to allow you to work with deep-tissue therapy on this type of problem.
Treating Clients With Hip Replacements
Many clients who have had hip replacement surgery will still be in considerable pain. Once again, proper soft-tissue therapy can release that pain and facilitate rehabilitation. Limiting factors from the surgery are pelvic imbalance, misalignment of leg and hip, leg-length difference from an inappropriate length of surgical apparatus, scar tissue and adhesion, and improper gait while walking.
Oftentimes the pelvic imbalance that existed before surgery that was responsible for the degeneration of the hip will not have been addressed and will be a stress factor on the surgically repaired hip. It is therefore necessary to bring the hips into structural alignment by balancing the anterior/posterior hip distortion. When this is accomplished, the structure supports the hip and the pressure is equal on the hip joints. Many times, this is the key component for the client's recovery. This process is similar to the pelvic balancing that we would have applied before surgery as previously described in this article. The complications are increased scar tissue and adhesions from surgery, uneven leg length due to surgical apparatus and misalignment of the leg/knee/ankle being nonsupportive.
I hope this has opened your eyes to the very real possibility of successfully treating hip problems using deep-tissue massage therapy techniques.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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