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Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
April, 2010, Vol. 10, Issue 04
Multifidus: The Multitasker
By Judith DeLany, LMT
Back pain is one of the most frequent complaints by massage therapists and their clients. In fact, 15 percent to 20 percent of Americans report back pain yearly, and 80 percent will suffer from at least one episode of back pain during their lifetime.2
A number of risk factors have been determined, including smoking, being overweight and poor physical fitness. Common causes of back pain include spasm, tension, disc degeneration, scoliosis, spondylosis, spondylolisthesis, arthritis, spinal stenosis, pregnancy, kidney stones, infections, endometriosis, fibromyalgia, tumors, stress and trauma.3
Back pain divides into simple backache, nerve-root pain and serious pathology. Although it is easy to blame work as the culprit, pain originating from the latter two may stem from sinister causes, including visceral disease. Beware of the following red flags, as they might indicate advancing pathologies. Further investigation is needed if the sufferer:
Simple backache, on the other hand, often emerges from a compounding of minor predisposing myofascial factors, such as tight muscles, trigger points and muscle weakness. After considering the muscles that lie in the region of the low back, investigation moves to the anterior and lateral abdominal muscles, muscles of the lower extremity that attach to the pelvis, habits of use, posture and gait. Tucked away deep to the erector spinae (Figure 1), the multifidus (Figure 2) often is overlooked as potentially a substantial source of lumbar dysfunction.
The obliquely oriented thoracic multifidi are undoubtedly associated with rotational movements or perhaps as stabilizers during rotation. This is consistent with the angulation of the zygopophysial (facet) joints of the thoracic vertebrae, which allow rotation, while discouraging flexion, extension and lateral flexion.
In the lumbar, lying deep to the erector spinae, multifidus is considerably thicker, more vertically oriented and significantly more powerful. The vertical orientation of the fibers of most of the lumbar multifidi implies that they would not be involved in direct vertebral rotation. This is consistent with the orientation of the lumbar facets, which allow flexion, extension and lateral flexion and discourage rotation.
Since the line of action of multifidus lies posterior to the lumbar curve, it extends the lumbar spine and increases lumbar lordosis with a "bowstring" effect. As the oblique muscles fire to rotate the upper body, lumbar flexion would be mandatory if it were not for the action of multifidus, which prevents flexion from occurring.1 This allows the spine to remain vertical (rather than flexing forward) when pure rotation is desired.
Multifidus fibers are the only muscle fibers posterior to the lumbosacral transitional point (L5-S1). Therefore, multifidus must produce enough tension to ensure that L5 does not slide forward on the sacral plateau (spondylolisthesis), even though this surface naturally, sometimes significantly, slopes downward. Fortunately, multifidus presents its mass precisely in this segment of the spine. Unfortunately, it often suffers from disuse atrophy, appearing as "moth-eaten" and infiltrated with fat.
The lumbar multifidus is particularly thick and almost completely fills the lamina. Although repetitiously applied gliding strokes can influence multifidus, the thick, overlying tendinous elements of the superficially placed erector spinae, latissimus dorsi, and associated dense fascia impede results.
The most lateral fibers are usually available by approaching them more directly; lateral and deep to the erector spinae (Figure 1), particularly at the level of L2-L4. However, careful hand placement helps to avoid compressing (and potentially bruising) tissues against the lateral aspect of the transverse processes, which lie deep to the lateral fibers of multifidi (Figure 3).
Multifidus contracts with contralateral rotational movements. Twisting at the waist, while maintaining a vertical upper body can help to strengthen it. A stationary bicycle or glider equipment that incorporates the arms and mandates upper body rotations will help to keep multifidus healthy and help to avoid low back pain associated with weakness of this muscle.
Judith DeLany serves as director of NMT Center, writes textbooks for Elsevier Health Sciences, and lectures internationally in the field of neuromuscular therapy. For more information regarding her work, visit www.nmtcenter.com or call toll-free at (866) 571-7942.
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