resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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.
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?
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?
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
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.
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.
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.
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.
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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