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Flexion-Intolerant Lower Back Pain (Pt. 3): Mobilization & Soft-Tissue Treatment
What is the biggest challenge to the chiropractor in treating discogenic pain? You have to completely reframe the purpose of your manipulation. It is rarely about unlocking a stuck segment at the disc involvement level; it is not about putting a joint back in alignment.
Leaving a Lasting Legacy: Donna Liewer
For the past 31 years, Donna Liewer has been on a personal mission "to comfort the afflicted and afflict the comfortable." In her role as executive director of the Federation of Chiropractic Licensing Boards, Liewer has accomplished that and much, much more.
Resilience is the New Longevity
Sometimes we must enter a room through one door and not another, even though they both lead into the same space. I am talking now of the recent cachet with the concept of "resilience" regarding health, chronic pain and longevity.
AAAOM – The Beginning of the End (Part II)
In 2012, the AAAOM board members met in Chicago for their annual meeting. The goal was to come to a consensus on a long list of issues the AAAOM needed to work on including a functional board and budget.
Green Tea Catechins Lower PSA, Other Biomarkers in Men With Localized Prostate Cancer
A 2006 study (Cancer Research) was the first human investigation to show that green tea catechins (GTC) are highly effective in reversing premalignant prostate lesions (high-grade prostate intra-epithelial neoplasia), an established precursor to prostate cancer.
Risk Factors for Heel Problems
Heel pain and gait disability are common occurrences in adults, often the result of thinning heel pads and a lifetime of exposure to heel-strike shock. One condition experienced by many people is plantar fasciitis.
Successful Strategies in Integrating Acupuncture and Shiatsu in a Hospital Oncology Program
Colleagues from the Network of Researchers in Public Health in CAM recently published an article of interest to our Traditional Asian Medicine community.
The Healing Properties of Light: An Interview With Researcher Anna Cocliovo
This interview is with Anna Cocliovo, a light researcher and Acupuncturist in Arizona. During my own research in light, I came across the article she published for the American Journal of Acupuncture and sought her out as a result.
Are You Guilty of Paternalism in Your Approach to Patient Care?
Einstein is purported to have said, "When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity." In some way, everything is relative to one's point of view.
What is a Discipline in Medicine?
In my now prolonged dialogue with physicians, one question emerges with enough regularity to deserve mention and naming: what is a discipline?
Steven Rosenblatt: Birthing A Cross-Cultural Acupuncture Profession
The existence of a cross-cultural acupuncture profession in the United States, one that is legalized, licensed, supported by formalized, academic training and inclusive of non-Asian practitioners, is an important part of the medical landscape in this country and is responsible for improving the lives of hundreds of thousands of Americans.
Why DCs Need to Understand the Principles of "Inclusive Design"
In the past few columns, I've written about the negative effects of prolonged sitting at work. I've attempted to make the point that prolonged sitting (or prolonged standing) takes a toll on workers. Now let's discuss a related issue: the concept of "inclusive design."
Stress in the Modern Age: Impact on Homeostasis and What You Can Do (Part 1)
In 1926, Hans Selye first used the word stress in a biological context, referring to the nonspecific response of the body to any demand placed upon it.
Epigenetics: The Western Science Supporting Essence
Since the days of Darwin, western medicine has touted that our genes were set in stone, that our genetics were our destiny. We were told that the diseases that ran in our family were likely coming to us as well.
Collaboration for a Cause
The Patient Protection and Affordable Care Act strongly encourages the formation of multidisciplinary practitioner teams called Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs).
AAAOM – Making Promises They Can't Keep
When the AAAOM first formed in 2007, their mission was clear: to support the profession through education, resources and legislative advocacy. The first years of the organization were filled with promise and hope.
News in Brief
Hamm Elected New President of the ACA; WFC / ACC 2014 Education Conference: Call for Papers; F4CP Recognizes Standard Process as $1 Million Supporter; Texas Chiro. College Begins Search for New President; League of Chiropractic Women Hosts Women's Success Summit.
Chiropractic Prevents ADHD? Research Shows...
Now that I have your attention, let me tell you what the latest study actually states. As you may have noticed, research over the past few years has begun to reveal that acetaminophen (the primary ingredient in Tylenol) is not as safe as once thought.
One and Done: Keeping Patients From Vanishing After Just One Appointment
What happened to my 3:30 p.m. ROF? They may have rescheduled, but there are two common answers no one wants to hear: 1) "She called to cancel. I tried to get her to reschedule, but she refused." 2) "She no-showed.
Monoculture of the Mind: Part II
Cases are built within boundaries. Such bounds may be a program, event, activity or individuals. In this instance, a medical case has boundaries that include clinical interactions that are comprised of history, signs, symptoms, diagnoses, treatment plans and treatments.
Creating Child-Friendly Clinics with ABT
The Zurich Dojo was scattered with toy ducks, dolls, trains, exercise balls and teddy bears during my recent pediatric workshop.
April, 2010, Vol. 10, Issue 04
Pain Caused By Low Back Ligaments
By Ben Benjamin, PhD
Q: An injured sacrotuberous ligament can cause pain down the back of the leg. True or false?
A: True. This is its referred pain pattern. The sacrotuberous ligament is a thin, fan-shaped structure that runs obliquely downward from the posterior-superior and posterior-inferior iliac lines and the lateral margins of the sacrum and coccyx, inserting on the ischial tuberosity of the pelvis (the bone you sit on). (Figure 1)
Each structure in the low back has a specific referred pain pattern associated with it (Figure 2). For example, the sacroiliac ligaments generally refer pain straight across the lowest portion of the back. The ilio-lumbar ligament refers pain on one side of the low back across the top of the ilium, the lateral hip, and the groin area. The sacrotuberous ligament has a distinctive pattern. It refers pain down the central portion of the back thigh, and if more severe, down the central portion of the calf into the heel. This injury is frequently confused with a hamstring injury when the pain is felt only in the lower buttock and down the back of the thigh.
There are a few easy steps to check whether this type of pain is originating in the hamstring or in the sacrotuberous ligament. First, have the person bend forward with the knees straight. Note the pattern of pain. Pain down the back of the thigh can be caused by either structure, but only the sacrotuberous ligament refers pain into the calf.
Now, have the client lie down and hold the knee at a 90° angle. Ask them to pull the heel toward the buttock as hard as they can while you resist with equal force (Figure 3). If this test is painful in the hamstring region, you know there is a hamstring injury, because resisted tests place stress on muscles and tendons, not on ligaments.
If you suspect an injury to the sacrotuberous ligament, a final step in assessment is direct palpation. Injury to this structure usually occurs at the lateral margins of the sacrum, rather than the attachment to the ischial tuberosity. You can access the ligament with the client lying prone, but it is more easily accessible with a client in a side-lying position with the knees drawn up.
Click here for more information about Ben Benjamin, PhD.
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