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Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
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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