resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
July, 2009, Vol. 09, Issue 07
Spotlight on Palmaris Longus
By Judith DeLany, LMT
The forearms and hands are the most important tools used in massage therapy. Preventing the development of career-ending conditions, such as Dupuytren's contracture, is a critical, yet often overlooked, step in self-care.When these muscles are neglected, consequences can range from nagging, aching arms, wrists or hands, to debilitating chronic pain.
Palmaris longus (PL) is a great example. This long (extrinsic) muscle courses from the medial epicondyle to attach broadly onto the palmar fascia which, in turn, spans into five directions, each of which projects toward a digit (ray). Its tendon is the only anterior forearm tendon to remain outside the flexor retinaculum at the wrist, making it distinctly visible when the wrist is flexed and the hand is curled upon itself.
Although the muscle belly may be absent on either arm or both, its palmar fascia is always present.1 Its tendon may be more easily distinguished from the carpal (wrist) flexors by having the person place all five digital pads together, with the metacarpophalangeal joints flexed and the fingers and thumb extended (as if picking up a marble with all five digits). It may be necessary to simultaneously flex the wrist to make the tendon more distinct.
PL may be strained with loaded wrist flexion. The associated palmar fascia may be injured with the use of hand tools that can inflict trauma, such as when pounding on an ice pick, sculpting tool, or kitchen chopper, when twisting with pressure while using trowels in gardening, or when applying pressure with hand-held tools in massage therapy. Associated trauma can result in shortening of the connective tissue of the palm, similar to that seen in Dupuytren's contracture.
Indicators for treatment of PL include:
Dupuytren's contracture is a hand deformity in which the palmar fascia contracts and thickens over time. The characteristics of Dupuytren's contracture2 include:
Due to slow progression, observation and minimal or no treatment are often indicated initially for Dupuytren's contracture. A non-surgical intervention of injection coupled with forceful finger extension may be indicated.3 Surgical excision of the fascia may be necessary and the hand may lose up to 25 percent of its grip power as a result.
Heredity may be a factor in Dupuytren's contracture, however, it is important to rule out trigger points as part of the problem.4 Trigger points in this muscle may simulate Dupuytren's contracture and may even produce flexion contracture of the fingers. A distinguishing feature is that while Dupuytren's may cause a painful palm, only trigger points in PL produce the prickling sensation. Simons, et al., describe a spray and stretch technique that covers the anterior forearm and hand that is often beneficial to this condition. NMT hand and forearm protocols are also effective. (For hand and forearm treatment protocols, visit www.nmtcenter.com/articles.)
The value of contrast hydrotherapies should not be underestimated, especially when followed with stretching. Not only is this therapy readily available and very inexpensive, it can easily be self-applied, especially to the forearms and hands.
Prevention of injury is the foremost key to maintaining healthy hands. Particular care should be exercised when using tools that can damage the palmar fascia. Work gloves, alternative tools and employed help should be considered for jobs that might place stress on the tissues of the palm.
Judith DeLany serves as director of NMT Center, writes textbooks for Elsevier Health Sciences, and lectures internationally in the field of neuromuscular therapy. For more information regarding her work, visit www.nmtcenter.com or call toll-free at (866) 571-7942.
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