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Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
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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