resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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."
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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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