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Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
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."
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.
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.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
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.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
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.
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!
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
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.
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.
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.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
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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