resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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."
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.
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.
Get That Shoulder to Move: Restoring Internal Rotation
How many times have you mobilized, performed ART, Graston, FAKTR and PIR, and stripped a patient's posterior capsule, yet on re-exam, discovered it was still blocked?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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?
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.
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.
July, 2010, Vol. 10, Issue 07
Osteoporosis: Another Insidiously Silent Progression
By Dale G. Alexander, LMT, MA, PhD
At the age of 83, my mother died on July 25, 2009, five days after fracturing her left hip. Her silent progression of osteoporosis had shown itself many years before, but I failed to fully comprehend its true implications.This series is dedicated to the memory of Shirley M. Lloyd. Her life has provided me with many significant lessons and has served as a case study for me to write about the subject.
To my sensibilities, our role as massage therapists is to educate our clients and to refer them for medical testing when their physical histories or chronic somatic problems indicate it. It is my intention to offer our profession the perspective and information that would have helped me to be a more effective health advocate. And, to further explore how normal age-related bone loss may progress into what is called osteopenia (bone thinning) and then into osteoporosis (porous bone). This progression is considered silent because we do not feel the weakening of our skeleton.1
After six months of research into this subject, I am unable to offer any definitive answers. Yet, there are markers of the progression for us as massage therapists to consider. There exists a broad continuum of opinion of how to prevent, treat, and/or how one might stabilize or reverse this progression.
As we age, our ability to absorb nutrients becomes less efficient, the bone remodeling process (breaking down old bone and building new bone) slows down. Other health-related difficulties, associated medical procedures and lifestyle choices can influence the speed of this progression. The reasons for these changes are many and certainly include genetic predisposition.
In fact, one of the questions to ask clients over age 50 and especially those dealing with chronic somatic difficulties is whether their parents experienced any bone fractures and whether their posture became stooped forward and lost height as they aged. The postural decline was true of my mother's mother. Also, it is important to inquire with your clients as to whether they have had any bone fractures.
Fractures are the most severe complication to the progression of osteoporosis. Then, for some, as was the case for my mother's hip fracture, it heralds the beginning of a slide toward the end of their life. According to the National Osteoporosis Foundation (NOF): "Hip fractures result in 10 to 20 percent excess mortality within one year. Approximately 20 percent of hip fracture patients require long-term nursing care, and only 40 percent regain their pre-fracture level of independence."2
The most common osteoporosis related fractures tend to occur at the wrists, within the thoracic or lumbar vertebrae (commonly referred to as compression fractures) or, as fractures of the pelvis and/or the femoral neck. Other fracture sites are of the ribs, the ankle and the foot. These are especially correlated if the fractures occur after the age of 50 and the intensity of the trauma seems unlikely to have induced a broken bone.1
My mother's trauma history is as follows: At age 71, she fractured her wrist and left foot in a fall; at 79, she fractured her left ankle and foot in another fall; at 81, she experienced a T7/8 compression fracture while bending over; and finally, at 83, she experienced an inter-trochanteric fracture (the base of the femoral neck) in a lateral fall to her left side.
I assure you that you are currently working with clients over the age of 50 and some even younger who are affected by this insidiously silent progression of osteoporosis. According to NOF, more than 10 million Americans have osteoporosis (about 2 million men and 8 million women) and an additional 33.6 million have low bone density of the hip.
As the demographics of our aging population increases, there will be more who come to you with this as an underlying difficulty in their somatic profile. "The Surgeon General estimates that the number of hip fractures and their associated costs could double or triple by the year 2040."2
Very often clients come to us seeking to relieve their pain and to improve their function, yet have little or no understanding of how these somatic complaints may reflect the subtle physiological degradation of their skeleton or, other degenerative progressions.
It is with some humility and humor that I share that Shirley only tolerated my more holistic orientation to preventative care. She was a fiercely independent person who, like many in her generation, did mostly what her physician(s) told her to do. She had taken the hormonal replacement therapy during her post-menopausal years until that was officially deemed risky, then was given Fosomax after her bone mineral density (BMD) test showed that her bone density was declining. Not unlike many who have taken such medications, she developed esophageal and gastritis difficulties for which proton pump inhibitors were prescribed. The functioning of the osteoblasts (the cells in the bone remodeling process which build new bone) depend on the proton pumps to do their job.3
Gillian Sanson, author of The Myth of Osteoporosis,4 states that most individuals who do experience osteoporotic-related fractures do not die of this as a primary cause if they are otherwise healthy. Shirley's health was compromised at the time of her death. Her gall bladder was removed in her early 40s which resulted in severe scar tissue formation. She had been diagnosed with COPD in 1999 and with cirrhosis of the liver in 2004. These and other health challenges, the medications to manage them and surgeries are considered to be secondary causes, which accelerate the progression of osteoporosis.1
The three most common lifestyle factors associated with the progression of bone loss are lack of exercise, smoking, and drinking alcohol. Yes, Shirley did smoke cigarettes and did drink alcohol for most of her adult life. (Food, or the lack of, and its possible contribution will be addressed in a future article.)
In short, Shirley's stooped posture, thinness, additional health problems and being a female reflect a poster-child picture of someone at risk for a severe osteoporotic related fracture.
Encourage your clients who show indications of bone loss, as discussed, to request their physician to do a complete review of their medical history. Next, we will discuss the bone remodeling process and will touch on the sea of controversy surrounding what we may do to prevent the onset of osteoporosis.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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