resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
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!
March, 2010, Vol. 10, Issue 03
The Silent Progression of Kidney Infections and Stone Formation, Part 2
By Dale G. Alexander, LMT, MA, PhD
The first article in this series postulated that kidney stone formation and chronic kidney infections may be possible causes of your clients' chronic ailments, especially those that relate to the low back, groin, knees, ankles and feet.This article will add more depth and breadth to your comprehension of these two disorders and how we may encourage our clients to seek appropriate medical testing. One point to consider is that individuals who seek out massage therapy on any regular basis may be subconsciously driven by an instinctual sense that they possess an anatomical anomaly or an avoidance of regular medical check-ups. It is our collective responsibility to make referrals when our common sense suggests it.
Let's begin by noting that there are five different kinds of kidney stones that have been identified. These include: calcium oxalate, calcium phosphate, uric acid, struvite (magnesium ammonium phosphate) and cystine. Knowing the type of stone may be especially helpful with an individual who experiences recurrent stone formation. The most common types of kidney stones are calcium oxalate and calcium phosphate.1
There are some questions we might ask to determine if clients have a greater-than-average susceptibility to kidney stone formation.
Have you or other family members have ever had an attack of gout? Kidney stones caused by uric-acid crystals occur in approximately 15 percent of people with gout. This compares to an 8 percent risk of kidney stones in people without gout.2
Have you had any surgery involving the large or small intestine? Conditions that increase the absorption of oxalate from the gastrointestinal tract (short bowel syndrome, chronic diarrhea, previous bowel surgery or gastric bypass surgery) may contribute to kidney stone formation.1 People with Crohn's disease also often have more susceptibility to kidney stones.3
Have you ever been diagnosed with hyperparathyroidism? This is a condition where one or more of the parathyroid glands becomes overactive. As a result, the blood calcium rises to a level that is higher than normal (called hypercalcemia).1 Once a person is identified with this condition, the usual medical protocol is to check for kidney stones via ultrasound or CAT scan of the kidneys. By asking if these tests were done, we can serve our clients.
Another question that is pertinent to ask clients is whether their urine has a foamy head like freshly poured beer? This is a sign that the kidneys are leaking protein.7
In hot weather, we all sweat more, which concentrates urine. "Concentrated urine is a breeding ground for kidney stones."4 Encourage clients to drink more fluids and eat more vegetables, fruit, and grains, which naturally contain water. The goal is to increase the amount of urine that flows through the kidneys and ureters and to lower the concentration of substances that promote stone formation."1 One suggestion is for clients to drink half of your weight in ounces per day. Thus, if you weigh 180 lbs., drinking 90 ounces of water is recommended.5
Two ironic items turned up in my research, suggesting that coffee drinkers have fewer kidney stones whereas those who drink excessive amounts of grapefruit juice have more kidney stones.4 This reminded me of a client from about 20 years ago who came to me with a right knee problem. I asked him if he had ever had a kidney stone and he replied, "about 50." I asked how much grapefruit juice he drank, to which he responded, "about two gallons a day."
Human physiology is an integrated whole. I postulate that few instances of kidney stones express themselves without a tendril of connection to other subtle physiologic progressions. According to NYU's David Goldfarb, director of the Kidney Stone Prevention Program At Saint Vincent Medical Center: "I tell my patients that the kidney stone that brought them to my office may be the least of their problems, and that any stones are the harbinger of their increased risk for diabetes, high blood pressure, and osteoporosis."4
Remember that the physiologic role of the kidneys includes re-absorption of glucose, amino acids and other small molecules; regulation of sodium, potassium, and other electrolytes; regulation of fluid balance and blood pressure; maintenance of acid-base balance; and the production of various hormones including vitamin D and erythropoietin (a hormone produced by the kidney that promotes the formation of red blood cells in the bone marrow).6 The kidneys also allow surplus concentrations of excess calcium or protein to be excreted in the urine. In this case, the most important question is why isn't the body absorbing and using these substances in a balanced metabolic fashion? An excess or shortage of biochemicals in our bodies can push our homeostatic capacity over the edge into the beginnings of pathology.
Statistically, more men will develop kidney stones, but my clinical experience is running 50-50. This variation may be a function of my specialization in working with chronic problems. An important revelation for me in researching this article is that kidney stones in children are on the rise.8 Children are less able to describe what they feel inside, so we are challenged to let their behavior and bodies speak to us.
Let's shift our attention to some pertinent anatomy. The functional workhorses of the kidneys are the nephrons. The two kidneys contain about 2 billion nephrons, each capable of forming urine. The nephron is basically a glomerulus through which fluid is filtered from the blood and a long tubule in which the filtered fluid is converted into urine on its way to the pelvis of the kidney. Most kidney difficulties relate to the destruction or damage of the nephrons so that they simply cannot fully perform their normal functions.9
There are many progressive disorders that may lead to this deterioration of nephron function: chronic glomerulonephritis, traumatic loss of kidney tissue, congenital absence of kidney tissue, congenital polycystic disease (in which large cysts develop in the kidneys and destroy surrounding nephrons by compression), urinary tract obstruction resulting from renal stones, pyelonephritis (infections) and diseases of the renal vasculature.9 Many of these difficulties can brew for years until pressure, obstruction or infection begins to affect the capsule of the kidneys or the ureters, or until infection spreads beyond the kidneys.
Chronic kidney infections may also morph into chronic kidney disease. A number of my clients have been medically diagnosed with kidney infections. These clients tend to be between the ages of 50 and 75, and often note that they have one or two of the conditions often associated with the decline of kidney function, kidney disease in their family, urinary tract infections, hypertension, diabetes or a beginning decline in their bone density. If a client says, "yes" to two or more of the questions from Parts 1 and 2 of this series, encourage them seek regular medical check-ups.
Medical tests that may be more sensitive to the early stages of progressive kidney disease include a 24 hour urine collection, a creatinine clearance test and a microalbuminuria test. These tests may be more appropriate because the standard screening for creatinine and blood urea nitrogen (BUN) for analyzing blood plasma "will not be raised above the normal range until 60% of total kidney function is lost."9
If a client's somatic complaints are consistently associated with the low back, groin, knees, hips or feet this raises my alert flag. Such complaints will often move between these areas during a series of sessions. I translate this as the body's attempt to distribute the internal strain of vascular and neurological congestion. It is also not uncommon for clients to respond quickly to bodywork only to have different, similar or the same complaints return. The quicker the reassertion of somatic difficulties, the more urgently I encourage clients to seek medical testing. My interpretation is that the body is signaling from the "inside-out" that there is more afoot than meets the eye.
Yes, people do have lumbar disc problems, accumulated strains, injuries or previous surgeries. However, if their history suggests that they have already been to competent physicians, orthopedists, chiropractors or physical therapists, this is another alert flag. By educating our clients to what possible difficulties exist empowers them with the capacity to choose, to select among the options to improve their quality of life.
Editor's Note: Join Dale as he teaches the pre-convention workshop (The Inside-Out Paradigm/Visceral Mobilization/Gall Bladder Dysfunction/Disease) for the AMTA National Convention in Minneapolis, Minn. Register at www.amtamassage.org after April 1. Inquiries can be sent to . Reading his Gall Bladder Article Series via www.masagetoday.com is a pre-requisite to attending the course.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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