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One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
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.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
November, 2009, Vol. 9, Issue 11
An Alternative Approach to Stretching
By Whitney Lowe, LMT
Clinicians, athletes and rehabilitation specialists advocate stretching as a means for injury prevention and treatment. The primary purpose of any stretching technique is to enhance pliability and flexibility in the soft tissues. It is also routinely incorporated with massage in the treatment of pain and injury conditions. There are many different stretching techniques, which all fall into one of three primary categories: static, ballistic or active-assisted stretching.
Static stretching is the most common. In static stretching, you bring the target muscle into a lengthened position and hold it there until you have achieved the desired stretch. The ideal length of time to hold a static stretch is debated in the literature and the results appear inconclusive. Somewhere around 15 to 20 seconds is a common time frame that achieves good clinical results.
Ballistic stretching is used most commonly in the athletic environment. During a ballistic stretch, you bob or bounce into a stretch to encourage tissue elongation in the muscle. Ballistic stretching works by using the momentum of the moving limb to extend past the initial limitation of range of motion. Many people oppose the use of ballistic stretching because the rapid elongation of muscle tissue in the bouncing motion can activate the stretch reflex, which would be counterproductive to stretching.
In active-assisted stretching, the client actively engages a specific muscle contraction prior to, or during, the stretching procedure. There is a variety of active-assisted techniques and they go by different names such as PNF, muscle-energy technique, active isolated stretching or facilitated stretching. There are slight variations in each of these methods, but they are all based on the neurological principles of post-isometric relaxation (PIR) and reciprocal inhibition. Experiments that compare active-assisted methods with static or ballistic stretching show the greatest range of motion gains with active-assisted methods.
Immediately following an isometric contraction, there is an increased degree of relaxation in that same muscle. This immediate reduction in neurological activity is called the post-isometric relaxation (PIR). The methods of active-assisted stretching use the window of reduced neurological activity during the PIR to engage a stretch of the target muscle after it has isometrically contracted. Stretching during the PIR is more effective than stretching without the prior isometric contraction.
The other neurological principle that is of important in active-assisted stretching methods is reciprocal inhibition. When an agonist (target) muscle contracts, there is a neurological inhibition of its antagonist (opposite) muscle. The reduction in neurological activity in the antagonist muscle is called reciprocal inhibition. Because reciprocal inhibition decreases neurological activity in muscles opposite the ones being contracted, it is helpful to use during stretching procedures. Stretching of the target muscle is enhanced when its opposite muscle is contracted at the same time (Fig. 1).
The various techniques of active-assisted stretching advocate different lengths of time to hold the isometric contraction prior to stretch. Initial research has indicated that a relatively short period of nonmaximal isometric contraction (about 3 seconds) seems most effective for holding the contraction prior to stretch.1 These methods also vary in the length of time that the stretch is held. A study investigating active-assisted stretching compared stretch duration times of 3 seconds and 30 seconds and found no significant difference in the outcomes between the two time periods.2 More research is needed to determine the ideal stretching method(s). It may turn out that the optimum stretching method depends on the situation in which it is being used.
Effective Stretching Procedures
Each of the stretching procedures mentioned above must take into account the biomechanical and neurological properties of the myofascial unit. Therefore, all stretching procedures engage two primary components: the physical stretch of muscle and connective tissue (mechanical effects) as well as the reduction in neurological resistance to stretch (neuromuscular effects).
Fascia is interwoven throughout muscles in an extensive network. It has viscous properties that respond better to slow, sustained tensile loads and resist rapid elongation.3 The process of connective tissue gradually lengthening when a sustained stretch is applied to it is called creep. The extensive fascial network running through all muscles suggests greater benefit for longer-duration stretching methods to take advantage of connective-tissue creep.
The neurological resistance to stretch is primarily governed by a specialized proprioceptor called the muscle spindle. It is responsive to both the rate of muscle stretching and the amount of stretch in the tissue. If the muscle is stretched too fast or too far, the muscle spindle sends signals to the central nervous system and an immediate muscle contraction is engaged to prevent overstretching. This immediate muscle contraction is called the myotatic (or stretch) reflex. Stretching procedures attempt to minimize any recruitment of the stretch reflex.
An Alternative Method
Manual-therapy practitioners have been excited by recent research studies enhancing our understanding of the physiological properties of fascia. We have recently learned that fascia contains contractile cells and is capable of releasing its contraction and further elongating when a prolonged tensile load is applied to it.4 Armed with this new understanding, we can use the physiological properties of fascia to enhance stretching procedures. Combining active-assisted stretching methods with fascial-elongation methods would address both the neuromuscular and connective-tissue components of the stretching process.
Consider hamstring stretching as an example of how this works. Engage the hamstrings in a short 3-second nonmaximal contraction. Release the contraction and bring the hamstrings into a stretched position (Fig. 2). Have the individual attempt to further stretch the hamstrings by attempting to flex the hip as far as possible (as they did in Fig. 1). This movement engages the reciprocal inhibition process and encourages further lengthening. While this position is held, apply a myofascial-stretch technique (with the hand or back side of the fist) to the hamstrings and hold it for about 30 to 60 seconds. Holding the myofascial stretch encourages relaxation of the fascial contractile cells and enhances connective tissue creep.
Both the neuromuscular and connective-tissue components of the stretch are emphasized by combining these myofascial and active-assisted stretching techniques. I have found this stretching method helpful with a number of chronically tight muscles. In the future, it will be valuable to perform comparative studies with this and other stretching techniques to find out which ones are most effective under various clinical circumstances.
Click here for more information about Whitney Lowe, LMT.
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