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The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
October, 2010, Vol. 10, Issue 10
The Mambo of Golfing
By Erik Dalton, PhD
We see it all the time on sports channels. How do they do it? That golf swing is really a work of art. Requiring such a complex array of finely coordinated movements, it's no wonder a golfer's body is considered a ticking time bomb for acute injury or chronic pain.
Recent stats: 53 percent of male and 45 percent of female golfers suffer low back pain; 30 percent of professional golfers play injured; 33 percent of golfers are over the age of 50; and playing golf and another sport increases chance of injury by 40 percent.1
Researchers agree that a majority of injuries affecting male golfers manifest in the low back and are related to improper swing mechanics and/or the repetitive nature of the game.2,3 The amateur or weekend golfer typically experiences injuries due to improper swing mechanics, whereas the sports professional is more likely to fall victim to overuse injuries from obsessive repetitive movement patterns. When a high velocity rotary force couples with trunk sidebending (the crunch factor), the golfer's spine and deep paravertebral tissues take a beating. No wonder low back pain (LBP) is the most common golfer complaint! (Fig 1)
To hit the ball a great distance, the body must have the ability to rotate into and maintain a wide arc throughout the swing. (Fig 2) Manual therapy techniques that increase range of hip turn allow a decrease in the amount of shoulder turn, thus reducing the amount of trunk flexion and sidebending during the downswing (the most damaging moment of the swing). If golfers lack full range of hip mobility due to an adhesive capsule, powerful torsional forces will travel up the kinetic chain through lumbopelvic ligaments, joint capsules and intervertebral discs. Motion-restricted facets and damaged ligamentous tissue can neurologically inhibit deep spinal groove muscles such as rotatores, multifidus and intertransversarii leading to substitution patterns and low back instability.
Reported in the Journal of Science & Medicine in Sport (2008), University of South Australia researchers found that golfers with LBP were overly dependent on erector spinae muscles for spinal stabilization rather than allowing load transfer to be distributed among more efficient lumbopelvic stabilizers such as quadratus lumborum, transverse abdominus, multifidus, hip extensors, and thoracolumbar fascia.4 They theorized that the brain, sensing weakness, is forced to recruit global muscles (lumbar erectors and obliques) to compensate for the weakened deep spinal stabilizers. The question is, "What mechanism causes the deep lumbopelvic stabilizers to weaken?"
Reconnecting the Disconnect
The body's myofascial system is built from a continuous arrangement of tissues designed to function in organized patterns, not as isolated muscle groups. When operating properly, energy is efficiently transmitted via force-coupling through a reaction chain rooted in the ground. Motor unit recruitment only becomes isolated to a particular muscle group when the brain senses a system disconnect and calls in "the subs." For example, during a golf swing, if a fibrosed hip capsule were blocking energy transfer up the kinetic chain, normal force-coupling would suffer due to lack of mobility of the femoral head in the acetabulum. (Fig 3) The therapist must first mobilize the fixated joint in all three cardinal planes, and then move up the kinetic chain to assess and correct any sacroiliac or lumbar compensation that may be driving the golfer's back pain.
Successful treatment of golf-related injuries not only requires golf swing modifications and functional rehab, but, in most cases, restoration of proper lumbar lordosis. Too much or too little curve results in excessive torsional and compressive loads through the thoracolumbar and lumbosacral junctions. The myoskeletal approach begins by correcting lower crossed muscle imbalance patterns followed by restoration of "joint-play" to fixated low back, sacroiliac and thoracic articulations.
Lower Crossed Syndrome
Developed by the legendary neurologist and rehab specialist Vladimir Janda, MD, the lower crossed syndrome represents a grouping of weak muscles and overactive or tight muscles that, together, produce a predictable low back movement pattern which often leads to injury. (Fig 4) Janda's EMG research recorded a significant number of people developing a distinct pattern of muscle imbalance due to prolonged static posture. He noted that when a muscle is left in a shortened or contracted state for an extended period of time, reciprocal inhibition (reflex weakening of muscles on the opposite side of the body) occurs.
Many "weekend warrior" golfers sit at their job for hours on end in a hip flexed position. Day-by-day the hip flexors tighten and shorten causing reciprocal weakness of glute-max - a crucial hip stabilizer during the golf swing. No longer able to aid in pelvic stabilization, the weakened gluteals force the brain to recruit synergistic muscles like the hamstrings and lumbar erectors to assist in hip extension. When golfers present with a flabby protruding abdomen, flat buttocks and excessive lumbar lordosis, the first order of business is restoring a healthy length to hypertonically shortened hip flexors followed by hands-on fast-paced spindle-stim techniques to wake-up the weak gluteals. (Figs 5 & 6)
It's easy to spot "lower crossed" golfers by observing their set-up posture from down-the-line. The swayed low back forms an anterior curve and, with the head down in set position, the thoracic cage becomes convex. This posture is often referred to in golfing circles as the "S-posture". Oddly, many golfers consciously stick their buttocks out because some golf pro told them they could generate more power on the downswing. In reality, once the thorax is arched and the back is swayed during set-up, the golfer can no longer "hinge" from the hips and is unable to maintain the spine in a stable neutral position. Loss of deep and middle layer core support sets the stage for future damage to lumbar and SI joint ligaments, articular cartilages, and intervertebral discs.
Rarely do humans move one muscle at a time along a single plane. Modern science reveals the brain does not recognize individual muscle activities because there is no need. Instead, the cerebral cortex maps movement patterns and coordinates the neuromyofascial net to meet the specific activity. All is well so long as information entering the central nervous system is not garbled by noxious stimuli from fixated joints, damaged ligaments, trauma or faulty ergonomics. Since the primary function of synovial joints is to transmit stress when stabilized by muscle contraction, anything that disrupts this action prevents muscles and enveloping fascia from achieving maximum leverage to move the body through a desired action such as a smooth golf swing.
The greater control the golfer has over new and diverse movement patterns, the better she will perform with decreased odds of injury. In the presence of a revitalized and functionally balanced neuromyofascial system, joints and muscles operate at optimal levels of motor recruitment and synchronization. As the rate of force production and maximum acceleration improves, so does the golf swing and the natural love of the sport.
Click here for more information about Erik Dalton, PhD.
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