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Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
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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