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Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
July, 2009, Vol. 09, Issue 07
The Risks of Vascular Compression in Soft-Tissue Therapy
By Whitney Lowe, LMT
The muscles in the anterior neck can become hypertonic or develop myofascial trigger points as a result of injury, poor posture, or simple overexertion. Some anterior cervical muscles are superficial and easily accessible, while others are deep and difficult to access with soft-tissue therapies.Because of sensitive neurological and vascular structures in the neck, it is important to reconsider the wisdom of applying treatments to the deep anterior neck muscles.
The two main muscles that lie closest to vascular structures in the anterior neck are the longus colli and longus capitis. Practitioners applying manual treatments to these deep neck flexors could run the risk of causing a serious injury to their client, such as stroke or drop in blood pressure, due to the proximity of the vascular structures.
One of the structures that can be impacted with pressure from soft-tissue treatment to the anterior neck is the carotid sinus, which is located at the division between the internal and external carotid arteries (Figure 1). There is a slight enlargement of the arterial diameter at this juncture where the two arterial branches separate. A group of very important sensory cells, called baroreceptors, are also located in the carotid sinus. The baroreceptors play a primary role in the regulation of blood pressure and heart rate.
Carotid Sinus Hypersensitivity
In a condition called carotid sinus hypersensitivity (CSH) or carotid sinus syncope, the carotid sinus develops an increased sensitivity to pressure. Syncope is a term meaning loss of consciousness or postural tone caused by a decrease in blood pressure to the brain. Unintentional pressure on the carotid sinus from massage treatment of deep anterior neck muscles could cause adverse effects on blood pressure or heart rate in a person with CSH.
For a person with hypersensitivity in the baroreceptors, even a mild stimulation to the neck can result in bradycardia (reduced heart rate) and a drop in blood pressure.1 However, CSH is not common so clients may not have any problem with pressure applied in this region. For the few that do have this sensitivity, the consequences of pressure on the baroreceptors could be serious. Unfortunately, a massage practitioner would not know if their client had this sensitivity in advance. It is also unlikely that the client would know they have the condition either. Consequently, it is a bit of a statistical gamble to perform massage on the deep anterior neck muscles. There are many practitioners moving away from this type of treatment for safety reasons.
There is another concern with pressure applied in the region of the carotid sinus. In addition to housing the baroreceptors, the shape of the carotid sinus allows this structure to be a repository for arterial plaque buildup. Plaque that has collected on the inner walls of the arteries is a well-known danger. Unintentional pressure applied to the carotid sinus could dislodge some of these plaque concentrations causing them to migrate through the arteries and cause a stroke.
Practitioners may think that by avoiding pressing on tissues with a pulse, they can feel confident that they are not pressing on vascular structures. However due to the multiple layers of soft-tissues, massage can put pressure on other nearby structures that subsequently press on the arteries, so this method is by no means foolproof.
The possibility of adverse affects for anterior neck treatment should lead the practitioner to explore alternatives in soft-tissue treatment for the deep anterior cervical muscles. Reducing hypertonicity can be accomplished by techniques that do not apply direct pressure, such as facilitated or static stretching. Facilitated stretching can be very effective in reducing tightness in the deep neck flexors without putting pressure on the carotid sinus. A position such as that shown in Figure 2 is used for these facilitated stretching methods.
However, the practitioner should be cautious even with stretching. Ironically, there is a risk of a different arterial compression with the neck flexor stretching position shown in Figure 2. The vertebral arteries run through the transverse processes of the cervical vertebrae on each side of the neck. They join to form the basilar artery, which then extends into the cranium to supply blood to the brain (Figures 3,4).
When the head is held in hyperextension or rotation (or a combination of both) the vertebral arteries can be compressed, causing a reduction in blood flow to the brain.2 Compression of these arteries is a condition called vertebrobasilar insufficiency (VBI). Symptoms of VBI include vertigo, dizziness, seeing stars, disorientation, ringing in the ears, or general feelings of sensory disturbance. If the practitioner is working in this area or moving the client's head into rotation or hyperextension and they report any of these symptoms, treatment should immediately cease and the client's head should be brought back to neutral.
The majority of problems with VBI result from hyperextension or rotation movements of the head. However, due to the location of the vertebral arteries it is possible that VBI could also occur from common massage techniques in which pressure is applied to the suboccipital region. While it is a rare occurrence, some people could have VBI from techniques such as those depicted in Figure 5, with only the weight of the head applying pressure. Techniques such as those used in CranioSacral Therapy where pressure is on the occiput and not the suboccipital soft tissues will not cause VBI. Problems occur when pressure is applied directly into the suboccipital soft tissues.
There is a way to test for the possibility of vertebral artery compression prior to performing massage techniques. This procedure is called the vertebral artery test and it is considered an accurate means of predicting VBI.3 To perform the test, the practitioner has the client in a seated position and instructs the client to hold their head in extension or extension with rotation (as if looking over the shoulder). If within about 30 seconds, the client reports the beginning of VBI symptoms, the practitioner should consider the client susceptible to arterial compression. Techniques that would put the client in a position that could aggravate the compression should then be avoided.
Massage is one of the safest interventions for treating soft-tissue pain and injury conditions in the cervical region. However, soft-tissue therapy is not benign. As these examples show, there are times when massage or other soft-tissue therapies could have serious detrimental effects and that requires the practitioner to think carefully about appropriate treatments to these sensitive areas.
Click here for more information about Whitney Lowe, LMT.
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