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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.
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.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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 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.
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.
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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."
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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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