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International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
February, 2010, Vol. 10, Issue 02
Sources of Neck Pain
By Anita Boser, LMP, CHP
Clients usually think that pain is the "X" that marks the problem spot. As therapists, we know the source of pain is often somewhere else. In other words, "Where it is, is where it ain't," a colloquialism attributed to Ida P. Rolf. In the realm of a connective tissue matrix, internal pulls and compensations often create a symptom distant from the source of dysfunction.
As the pinnacle of the spinal cord, the neck has to accommodate for every weakness, imbalance and misalignment below, in addition to resolving direct trauma such as whiplash. There literally are thousands of sources of neck pain. In my practice, two are the most common: limited range of motion in the shoulder girdle and restrictions in the thorax.
Scapular Restrictions Limit Arm Flexion
When raising the arm overhead, the scapula must rotate 60 degrees to achieve full range (180 degrees of flexion). Not only does scapular rotation make full flexion possible, the glenoid cavity is then also in the proper position to provide support to the humerus. See Figure 1. The serratus anterior and upper and lower fibers of the trapezius contract to rotate the scapula. The costal fibers of the pectoralis major, the latissimus dorsi, and levator scapula also need to lengthen.
If the scapula can't fully rotate, the body will get the job done another way, usually by elevating the entire shoulder girdle. The levator then activates when it should release, and the scalene muscles often contract in an effort to assist. See Figure 2. The result is rigidity in the neck at the trapezius, levator and scalene cervical attachment sites, and often trigger points in the rotator cuff muscles which have to work through abnormal alignment.
Allow for Extension, Latissimus Dorsi
With your client on your table in a side-lying position, ask him to raise his upper arm in front of him and then up alongside his ear. Observe the rotation of the scapula. When the inferior angle stops moving anteriorly and superiorly assist the movement with a stroke to lengthen the latissimus and increase proper rotation of the scapula as you direct your client to rotate his elbow toward the ceiling. See Figure 3. (If the client's movement is very limited and/or his arm is weak, place a pillow under the upper arm to help support the weight.)
Scapula Coordination, Serratus Anterior
Turn your attention next to the serratus anterior. Have your client bend his elbow and place his hand on the table in front of his face or even under his head. With the back of your hand or soft fingertips, contact the fibers of the serratus on the lateral ribs. Ask your client to press into his entire hand so that the elbow moves slightly away from the shoulder joint. Feel for where the serratus is stuck or inhibited and use your touch to facilitate functional involvement. See Figure 4.
That's the Spot, Levator Scapula and Trapezius
Your client will certainly appreciate it if you address the adhesions that have most likely developed between the upper trapezius and the levator scapula. First release the superior edge of the trapezius from any underlying adhesions. Then, as your client extends his arm overhead again, release the levator, starting at its tendinous attachment to the scapular superior angle and directing it inferiorly. It also helps to work the length of the levator to its attachments on the transverse processes of the cervical spine, which are just posterior to the attachments of the scalene muscles, which will want some attention, too.
Thoracic Spine Immobility
While restrictions in the shoulder girdle place extra stress on the neck, lack of mobility in the thoracic spine often causes the cervical spine to exceed its range of motion. For example, if all of the motion to look over the shoulder, to side bend, or to look down comes from the neck, then the cervical spine muscles and ligaments get overworked and overstretched. The result is increasing stiffness as a means of protection.
Get in the Laminar Groove
The answer is to mobilize the thoracic spine and ribs, usually from T1 to T8. With your client in a sidelying position, you can use your knuckles to extricate the spinalis and paraspinal muscles at their attachments to the transverse and spinous processes. As you work, have your client make small unstructured movements under your hands. Use your pressure to stimulate the erectors and paraspinals and encourage more glide in the layers of tissue. Follow through to release restrictions in the myofascia between the ribs from their attachments to the transverse processes all the way to the sternum.
Shoulder restrictions and thoracic spine immobility are obviously not the only sources of neck pain, but adding these two assessments to your tool chest will expand your therapeutic potential and maybe even your reputation as a miracle worker.
Anita Boser graduated from the Institute of Structural Medicine and practices in Issaquah, Wash. She is the author of Relieve Stiffness and Feel Young Again With Undulation and Undulation Exercises. The exercises in this article are excerpted from her book. You can contact Anita at
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