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Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
June, 2010, Vol. 10, Issue 06
The 42-Pound Head
By Erik Dalton, PhD
"For every inch of Forward Head Posture, it can increase the weight of the head on the spine by an additional 10 pounds." Kapandji, Physiology of Joints, Vol. 3
It's not uncommon to have clients walk into your office sporting a 12-pound head that's migrated three inches forward of their shoulders. You know prior to palpation that their cervical extensors (semispinalis, splenii, longissimus and upper traps) are in a losing battle attempting to isometrically restrain 42 pounds against the unrelenting force of gravity. (Fig. 1) Rene Cailliet, MD, former director of the department of physical medicine and rehabilitation at the University of Southern California wrote:
The body follows the head. Therefore, the entire body is best aligned by first restoring proper functional alignment to the head".1
The effects of poor posture go far beyond just looking awkward. In fact, the January, 2004 issue of the American Journal of Pain Management reported on the relationship of poor posture and chronic pain conditions including low back pain, neck related headaches, and stress-related illnesses. "The extra pressure imposed on the neck from poor posture flattens the normal cervical curve resulting in abnormal strain on muscles, ligaments, fascia and bones."2 Research presented at the 31st International Conference of the IEEE EMBS Minneapolis (2009) stated; "Over time poor posture results in pain, muscle aches, tension and headache and can lead to long-term complications such as osteoarthritis. Forward head carriage may promote accelerated aging of intervertebral joints resulting in degenerative joint disease."3 (Fig. 3). It appears posture impacts and modulates all bodily functions from breathing to hormonal production. Spinal pain, headache, mood, blood pressure, pulse and lung capacity are among the many conditions influenced by faulty posture.
Additionally, Dr. Roger Sperry demonstrated that 90 percent of the brain's energy output is used in relating the physical body to gravity. Only 10 percent has to do with thinking, metabolism, and healing.4 Consequently, a FHP will cause the brain to rob energy from thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing. The March 2000 Mayo Clinic Health Letter expounded on Sperry's findings by reporting that prolonged FHP also leads to "myospasm, disc herniations, arthritis and pinched nerves." Degenerative neck pain goes hand-in-hand with balance problems especially in the elderly. Sensitive cervical spine mechanoreceptors govern the body's ability to balance and must be perfectly coordinated with the inner ear's vestibular balance system to stabilize equilibrium in both static posture and gait. Keeping the eyes looking forward is a basic life-preserving reflex, and as such, dominates nearly all other postural considerations. Proprioceptive signals from the first 4 cervical vertebrae are a major source of stimuli for regulating the body's pain-controlling chemicals (endorphins). FHP dramatically reduces endorphin production by limiting the cervical spine's range of motion. Inadequate endorphin production up-regulates the central nervous system causing non painful sensations to be experienced as pain. Figure 4 shows a couple of good mobilization techniques to restore joint-play to upper cervical fixated facets.
Dr. Alf Breig, a Swedish neurosurgeon and Nobel Prize recipient coined the termed 'adverse neural tension' to describe the mechanism by which loss of normal cervical lordotic curve creates dysfunction and disease.5 Through cadaver studies, Dr. Breig demonstrated that neck flexion could stretch the spinal cord 5-7 cm causing tensioning of the meninges (covering of the brain and spinal cord) and elicit measurable pressure on brain-stem nuclei (nerve control centers) which control all basic life functions. The increased compression led to dysregulation of basic metabolic control functions. Recall that the spinal cord is actually only "tethered" to the bony skeleton in the upper cervical and lowest sacral areas (top and bottom ends of the spine). In between these polar attachments, the spinal cord is relatively free to move up and down. Free-floating mobility of the cord is essential in allowing bending and twisting of our bodies. Anything that reduces that freedom, i.e., exaggerated or flattened spinal curves, dural impingement, etc. increases cord and brain stem tension. Increased tensile stress on the cord and brain stem not only interferes with the control of basic body processes such as breathing and motor control but in cases of dural impingement, may encourage painful cervical radiculopathies.
Identifying Common Compensatory Patterns
Fortunately, the legendary biomedical researcher Vladimir Janda, MD has helped simplify assessment of commonly seen muscle imbalance patterns consistent with FHP. Janda's Upper Crossed Syndrome (Fig. 5) is characterized by overactivity or tightness in the upper trapezius, levator, suboccipitals. sternocleidomastoids and pectoralis major and reciprocal weakness of the deep neck flexors and lower scapular stabilizers. Trained therapists visually recognize this aberrant pattern through postural and gait analysis and kinesthetically through tissue palpation and muscle length testing. Unfortunately, as normal movement patterns are altered by persistent pain, joint fixations or muscle imbalances, new neuronal pathways are burned into the central nervous system and gradually memorized as normal (neuroplasticity). Any deviation of normal head and neck movement alters precise firing order patterns causing the prime mover to be slow to activate. Substitution patterns develop as synergistic stabilizing muscles are recruited to do the job of the prime mover. Some believe the first step in restoring proper muscle balance is to mobilize dysfunctional joints to help reprogram these garbled neuromuscular pathways. Once normal joint play is established and muscle splinting removed, structural integrative soft tissue work creates functional length/strength balance. Correction of Upper Crossed neck posture is key to stopping and possibly reversing decay, degenerative changes and pain from headaches, rib dysfunction, TMJ, and Dowager's Humps...but it takes time and a concerted effort to repair the damage caused by faulty neck posture.
Often seen as a structurally subtle body segment, the neck is burdened with the challenging task of supporting and moving the human head. Because of tension, trauma and poor postural habits inherent in today's workplace, it comes as no surprise that head-on-neck and neck-on-thorax disorders rank high among the most common pain generators driving people into bodywork practices. When spinal tissues are exposed to continued compression, they deform and go through a transformation that can become permanent. Correction of Upper Crossed neck posture is key to stopping and reversing degenerative joint disease and pain from headaches, rib dysfunction, TMJ, and Dowager's Humps. English philosopher Bertrand Russell once stated, "A physical system expresses its energy through function". Any loss of function sets off reactions within the body's open, dynamic system which manifests as structural abnormalities...and vice-versa. When treating functional problems such as loss of joint play, therapists must look beyond the symptoms and the artificial dividing of the body into systems and treat the whole.
Click here for previous articles by Erik Dalton, PhD.
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