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Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Giving Chiropractic Some Much-Needed PR
Public relations has not always been the chiropractic profession's strong suit, a shortcoming that has subjected the profession to countless attacks on its legitimacy and seemingly perpetual confusion among the public and the health care world as to the skills and services doctors of chiropractic provide.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
"Turn, Turn, Turn"
Many people are credited with saying, "If you remember the '60s, you really weren't there." Given the fact I didn't become a teenager until 1970, I actually do remember the '60s (or at least part of it). And as a child of the '60s, I was, of course, influenced by the music.
Alcohol Consumption Strongly Linked to Risk of Colorectal Cancer
Alcohol intake is one of the primary risk factors for many human cancers, and is strongly associated with cancers of the oral cavity, pharynx, larynx, esophagus, liver, breast, and notably, the colon and rectum.
The Bottom Line ... From a Surgeon Who Knows
Regardless of individual relationships between providers, there continues to be a type of Hatfield-McCoy feud between the philosophies of medicine and chiropractic, particularly when it comes to musculoskeletal ailments.
The McGill Approach to the Lower Back (Part 1)
Stuart McGill, PhD, brings a unique combination of tools to the table. He is a scientist who also functions as a clinician. He describes himself as a medical consultant who is referred challenging patients. He is both evidence based and practical.
Drug War Rages in Wisconsin
Based on its actions over the past 15 years (review the sidebar in the app version of this article), controversy and the Wisconsin Chiropractic Association seem to go hand in hand.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Correcting Dysfunctional Movement Patterns – Is Local Treatment Enough?
It is widely believed that mechanical, non-traumatic back pain is largely related to dysfunctional or compensatory movement patterns the body has adopted over time.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
News in Brief
Foundation for Chiropractic Progress Enrolls Second Group Member; Focus on Chiropractic Education at WFC-ACC Conference in Miami; Are You Ready for Another "Have-a-Heart" Campaign?
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
August, 2009, Vol. 9, Issue 08
Trigger Points and Treatment of the Serratus Posterior Superior
By David Kent, LMT, NCTMB
Trigger points in the serratus posterior superior frequently cause pain near or under the shoulder blades, or in other regions throughout the upper extremities. This article will discuss ways to identify trigger-point patterns in the serratus posterior superior, as well as provide tips for treating the area.
Symptoms: Pain from the serratus posterior superior is often described as a constant "deep ache" under the upper portion of the scapula. Pain can extend down the posterior aspect of the shoulder and arm to the ulnar side of the forearm, hand and little finger (Fig. 1). It sometimes manifests as numbness into the C8-T1 distribution of the hand.
The pain often increases when the patient performs movement that causes the scapula to press against the trigger points of the serratus posterior superior. Movements include lifting objects with outstretched hands, such as placing dishes or other objects on a shelf. Sleeping on the same side can also cause the scapula to press against the trigger points.
Perpetuating Factors: To determine if the serratus posterior superior is involved in producing a patient's pain, it is important for therapists to make use of the tools at their disposal, including intake forms, questionnaires, postural analysis, trigger-point charts and physical assessment. Once it has been determined that serratus posterior superior is involved, you will be able to develop a treatment plan.
Common causes of trigger points in the serratus posterior superior muscles include illness and certain movements and postures. According to Simons and Travell, "Trigger points in the serratus posterior superior muscles are activated by overload of the thoracic respiratory effort because of coughing...and by paradoxical breathing (use of diaphragm and abdominal muscles out of phase)."1
Trigger points in the region can also be brought on by poor movements and postures caused by "sitting for long periods writ-ing at a high desk or table, when the shoulders are elevated and rotated forward to permit the arms to reach the high surface; repeatedly reaching to the rear of a high work surface...and protrusion of the thorax against the scapula by scoliosis," among other things.1 However, "scalene trigger points may mimic, in part, the pain pattern of the serratus posterior superior [Fig. 2]. The neck should always be examined for scalene trigger points if a trigger point is found in the serratus posterior superior."2
Anatomy: The serratus posterior superior is cover by two layers of muscle. The superficial layer is formed by the trapezius. The second layer is formed by the rhomboid minor that covers the upper half of the serratus posterior superior and the rhomboid major that covers the lower half. (Fig. 1)
The serratus posterior superior attaches at midline to the lower portion of the ligament nuchae, the spinous processes of the C6-T2 vertebrae and the intervening interspinous ligaments. The muscle fibers run at an approximately 45-degree angle, inferiorly and laterally, to attach on the 2nd-5th ribs. The lateral portion of the serratus posterior superior is covered by the scapula. (Fig. 1)
The serratus posterior superior also crosses over two muscles of the erector spinae group: the longissimus thoracis and iliocostalis thoracis. Some describe the serratus posterior superior and serratus posterior inferior acting as retinacular tissue directly super-ficial to the erector spinae; functionally this would help increase the force generated by the erector spinae.
Function: The serratus posterior superior raises the ribs to which it attaches, subsequently expanding the chest and aiding respiration. Other muscles that act synergistically with the serratus posterior superior include the scalenes, diaphragm, intercostals and levator costae muscles.
Treatment: It may be difficult for you to palpate any trigger points or taut bands of tissue in the serratus posterior superior muscle because it is covered by skin, adipose, and the trapezius and rhomboid muscles. If referred phenomena like pain, burning or tingling are present, it is likely that you have located a trigger point. Pay attention to pressure, as these areas can be painful. Patients who reflexively pull away, hold their breath or clench their teeth are acting out protective responses. In these situations, you should immediately decrease pressure, leave the area for a few minutes, then return using less pressure.
If you have applied oil or lotion, your fingers will slide when attempting to apply a friction technique. Place a tissue or linen on the skin first then apply the technique through the tissue. Treat the muscle attachments at midline along the lateral aspects of the spinous processes from C6-T2 (Fig. 3).
To treat the muscle attachments on the 2nd-5th ribs, abduct the scapulae and move it laterally to uncover the entire serratus posterior superior. Use with fiber and cross-fiber friction movements to release the rib attachments. (Fig. 4) Apply lubrication and glide on the muscle belly using multidirectional movements to ensure thorough treatment.
Education: Postural analysis photos can help display stresses on the muscle from poor posture. Use trigger point charts to show pain referral patterns, especially those which display the muscles in columns, superficial to deep. This makes it easy to show clients the layers of muscle you must work through to address the condition.
Review proper breathing techniques with patients and become familiar with their activities of daily living. Review proper ergonomics so that they can prevent the perpetuation or return of their symptoms.
The serratus posterior superior muscle is quick and easy to treat. This article reinforces the key information necessary to ensure a thorough treatment.
Click here for more information about David Kent, LMT, NCTMB.
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