resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
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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