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Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
Acupuncture Points: Broadening Our Scope and Diagnostic Work
As every practitioner knows, the correct diagnosis is everything. Most healing disciplines rely on the use of symptomatology for their treatment implementation. Beyond symptomatology, we have clinical tests to provide more objective findings.
July, 2010, Vol. 10, Issue 07
The Initial Treatment: Generating Thousands to Your Practice
By David Kent, LMT, NCTMB
After nearly two decades of owning a clinic, managing therapists and treating patients to this day, I have learned to never underestimate the potential income of a new client, when their initial treatment includes the appropriate education.A client who is well-educated on the tremendous benefits of consistent massage will more than likely become a regular client. And potentially, after an initial treatment, one client can generate tens of thousands of dollars to your practice.
In the early 1990s, a client was referred to my clinic with symptoms of pain and restricted range-of-motion (ROM) in their neck and low back. During that initial treatment, I provided pain relief along with education to help the client understand why he was in pain and how continued treatments would help improve his quality of life. To this day, that same patient spends hundreds of dollars in monthly self-care treatments when he visits Florida. This adds up to thousands of dollars annually, and tens of thousands of dollars since his initial visit.
Whether you work for yourself or someone else, the initial treatment often determines the number of future appointments scheduled, the purchases of other products or services, future referrals and possibly the amount of your gratuity or bonus. This article will cover various ways to educate patients during their initial treatment to build your practice and attract patients who will spend tens of thousands of dollars.
During the initial treatment the patient is evaluating whether they should invest future time and money on more treatments. Since you only get one chance to make a good first impression, make it count. Start by being thorough and have clients complete health intake and pain intensity scale forms to document their past and current conditions. On a diagram of the body have the patient shade the areas that hurt, indicate the pain type (e.g. aching, dull) and intensity (0 = no pain / 10 = excruciating pain) they are experiencing. (Fig. 1)
These essential forms will help the patient to clarify and the therapist to quickly understand: When the pain started and what may have caused it? What has been tried in the past for relief and the results? Do they believe the condition is temporary or permanent? What movements aggravate the pain? If there has been a medical diagnosis: when, by whom, and what tests or imaging were performed? What activities of daily living (ADL) is this pain effecting and how has the pain modified those activities? What are their goals for today's treatment? (Read "Questions with Direction" MT, September 2008.)
Clients should feel confident that you understand the origin of their pain and have the information needed to implement an effective treatment. It only takes a few minutes to ask clarifying questions regarding information on their intake forms, check range-of-motion, perform prudent orthopedic assessments and take postural analysis photos.
Postural analysis grid charts make it easy for clients to see asymmetries of the body. While large charts are appropriate to hang on a wall, digital versions of charts are perfect for when wall space is limited or when you perform outcalls. And along with the digital age we live comes various digital applications to choose from. I show patients the correlation between their posture and their pain by using the screen on my cell phone. (Fig. 2) (Read "Getting Comfortable With Posture Analysis" MT, July 2008.)
A muscle movement chart allows you to immediately identify the muscles causing their postural distortions, limited range-of-motion and pain. This chart lists the muscles that shorten and contract producing movement in every joint of the body so you can breakdown any postural pattern. It also allows you to confirm the normal degrees of range-of-motion for each joint.
Review the trigger point (TrP) referral patterns that mimic their symptoms. If a client reports they have headaches that start in the temple or behind the eye, which then radiates behind the ear and into the neck, they are describing the referral pain pattern for TrP #1 in the trapezius muscle. This is one of the most common TrPs found in the body. Showing clients their pattern on a trigger point chart lets them know you understand the pain and have a plan to help. (Fig. 3)
Portable trigger point flip charts provide a professional presentation in any environment and are easily moved from one location and/or treatment room to another. The best flip charts on the market have laminated pages to prevent oils and lotions from damaging them. Note: Look for chart systems that are logically designed, easy to use and includes a muscle movement chart. (Fig. 4) (Read "Tools to Succeed for Massage Therapists" MT, May 2009.)
Training and Treatment
A solid knowledge of anatomy is key to delivering effective hands-on treatment techniques. Dissection seminars are the ultimate learning experience allowing you to see, touch and understand every tissue of the body. Attending this level of education sets you apart from other therapists. Physicians and other health care providers in your area will respect this level of study and be more willing to refer. Your therapist bio should be updated to reflect your advanced trainings. Certificates should be placed in your reception area, treatment room and/or your Web site.
Homestudy DVD programs are excellent support tools. The best dollar valued programs cost more; however, they come with accompanying photo manuals. This allows you to watch the DVD while reviewing your manual. Some systems include cross-referencing to trigger point, muscle movement and other charts.
Review and Recommend
Upon completion of the treatment, explain that it makes sense to you that they felt the aches, pains and symptoms that caused them to seek your services. Share that during the treatment you palpated the muscles, assessing and confirming your other objective findings. Review very briefly their postural analysis photos, correlating the photos to their pain intensity scale and trigger points that were identified during the treatment. Conclude your treatment with a few tips and recommendations to help them avoid this pain from returning. Show them stretches, the proper use of ice, and the ergonomic modification to be integrated into their daily routine. Now that they feel the relief of one treatment, explain that a series of four, six or more would provide much greater benefit. This is the time to explain the specials or packages that would be best for them.
Clients also realize we have extensive experience using various creams, lotions and topical analgesics. They respect our judgment and purchase the same products we use during their treatment as gifts for themselves, family or friends. Most products have a 50 percent markup and can add significantly to your annual bottom line without requiring you to perform any additional hours of therapy.
Never underestimate the future potential income a new client can generate. Be proactive and prepared by investing today for the tools and knowledge you need to educate yourself and your clients. Before you can expect clients to make a large long-term financial investment in your treatments, you must show and tell them all the reasons this is a wise and worthwhile investment. Integrating the proper patient education into your initial treatment can reap patients that spend tens of thousands of dollars with you over the years.
Good luck and please let me know about your experiences in the treatment room.
Click here for previous articles by David Kent, LMT, NCTMB.
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