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Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
September, 2010, Vol. 10, Issue 09
What About My Feet?
By Sharon Puszko, PhD, LMT
During a recent session with a regular client of mine, we ended up having a conversation about feet. I cannot remember how the topic came up - maybe he was having particularly bad pain in his feet that day - but we ended up discussing what kind of shoes we wear the majority of the time.
The conversation made me realize that for as much time as I spend working peoples' feet, I have not yet written exclusively about feet and massage, or self-care of feet for practitioners.
Massage therapists are one of the groups of professionals who spend most of their time working on their feet; in addition to pulling, pushing, bending, leaning and lifting. We have a rather "physical" job, and after giving five to eight massages in one day, I know my feet have frequently felt the effects of this.
I can also admit I rarely do anything more than stretch my feet out and give myself a mini-pedicure before I go to bed. The following morning, my feet seem to recover, and I go about my day as usual. However, after the aforementioned conversation, I started discussing footwear and lower body pain with colleagues, and I decided this topic would be extremely useful to write about.
According to the American Podiatric Medical Association (APMA), almost 75 percent of people experience foot pain at some point in their lives, and only one out of every six sufferers seeks help from a podiatrist. Research from the APMA also demonstrates that those who spend four or more hours a day working on their feet suffer from chronic foot pain more than any other group of people. Even more important is the fact that nearly 78 percent of Americans suffer from foot pain because they are wearing ill-fitting shoes. So now I'm wondering, have I recently been properly fitted for shoes? In fact, have I ever been properly fitted for shoes? Since we fall into the category of people who stand for more than four hours a day while we work, it is crucial that we pay attention to our feet, and what we are putting on them. Here are some tips from the APMA on how to purchase shoes that will both fit you well and serve you well:
There is one category of shoes that is so controversial I feel like we need to address it all on its own: flip flops. Just mentioning them in front of physical therapists and orthopedic doctors elicits snarls and frowns. At first, I was amused by the reactionary tendencies these summer shoes evoked in the health care community. But after reading up on them, it is clear that frequent use of flip flops can cause long-term foot problems for people, such as tendonitis, blisters, plantar fasciitis and sprained ankles. The more immediate consequences of wearing flip flops in place of other shoes include cuts, bruises and injuries because they do not offer your feet good protection or support. Visit the APMA Web site for their recommendations on finding a good pair of flip flops for the summer. I stress this, because all current research says they should not be worn for work, and should not be worn on a daily basis.
Strength & Flexibility Exercises
Now that we've discussed footwear, I would like to share some stretches with you that I came across on Runner'sWorld.com. They focus on your foot, ankle, and lower leg, and if done daily, will increase your strength and flexibility, which can help prevent injury in the future.
The Monopoly Game: Put 10 small objects on the floor (i.e. marbles or Monopoly pieces) and place a small cup nearby. Using your toes, pick up the pieces one at a time and put them in the cup. Do two sets of 10 with each foot. Compete with your spouse or kids to see who can do 10 in the fastest time.
The Drunk Flamingo: Standing on stable ground, balance on one foot with your eyes open. Once you can do that for one minute, try it with your eyes closed. Master that and then move to an unstable surface such as: a mini-trampoline, foam block, wobble board or Bosu trainer.
Toe Tug: Loop one end of an exercise band around a sturdy table leg or bedpost. Sit with your legs straight in front of you, and loop the other end around the top part of one foot. The band should be anchored straight in front of you, and it should be taut when your foot is pointed away from you. Pull your toes toward you, keeping your leg straight. Go as far as your ankle will let you. Release slowly, returning to the starting position. Do two sets of 20 on each leg.
Bent-Knee Wall Stretch: Runners often forget to stretch the soleus - a muscle deep in the calf that attaches to the Achilles. "Doing a calf stretch with a straight leg hits the gastrocnemius, but that's only half the battle," Schneider says. Here's how to target the soleus: Stand with your palms against a wall, one leg forward, one leg back. Lower into a "seated" position with legs bent. Lean into the wall until you feel it in your back calf. Hold 30 to 45 seconds then switch legs.
Negative Calf Raises: Stand on a step with your toes on the edge and your heels hanging off. Push up with both feet into a calf raise. Lift one leg off the step, and lower your other leg so that your heel drops below the step. Take at least 10 seconds to lower it all the way down - that's the eccentric part of the move and has been shown to help prevent Achilles tendinitis.
Plantar Stretch: Sit down barefoot and cross your right leg so that your ankle rests on your left thigh. Hold your toes and bend them back toward your shin, stretching the plantar fascia. A study showed that people suffering from plantar fasciitis had a 77 percent chance of returning to full activity within three to six months after performing this stretch. Researchers suggest that you do the stretch 10 times at least three times a day (once or twice a day doesn't produce as strong of an effect).
I've always been selective when it comes to buying shoes, and after researching for this article, I am certainly happy for that trait. I am also looking forward to staying up on current research regarding footwear and foot health; I will continue to be careful before I stand on my own two feet!
Sharon Puszko is the owner/director/educator for Day-Break Geriatric Massage Institute. She may be contacted at
or through her Web site: www.daybreak-massage.com.
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