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Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
November, 2010, Vol. 10, Issue 11
Advanced Stretching: Using Neural Inhibition to Enhance the Stretch, Part 2
By Joseph E. Muscolino, DC
In part 1 of this series, we discussed contract relax (CR) stretching, which involves neural inhibition to augment the mechanical stretch of the target musculature.Here, in Part 2 of this series, we will discuss agonist contract (AC) stretching, which also uses neural inhibition to augment the mechanical stretch of the target musculature.
Similar to CR stretching, AC stretching also relies upon a neurologic reflex. However, whereas the Golgi tendon organ (GTO) reflex is the proposed neural mechanism for CR stretching, reciprocal inhibition is the proposed neural mechanism for AC stretching. The mechanism of RI is that whenever a mover muscle contracts and shortens to create a joint action, the antagonist musculature (that is usually located on the other side of the joint) must lengthen to allow that motion to occur. RI reflex acts to facilitate the lengthening of the antagonists by inhibiting them from contracting. This inhibition causes a relaxation so that the antagonists more effectively lengthen. As with the GTO reflex, we can take advantage of this reflex to create a better stretch.
AC stretching is performed by creating a scenario in which the target muscle that will be reciprocally inhibited is the antagonist to the joint motion that is performed. The usual AC stretching protocol steps are carried out as follows. The right lateral flexor (RLF) musculature of the neck are used as the example (Fig. 1):
a. Have the client begin in a neutral starting position.
b. Ask the client to actively concentrically contract the left lateral flexion (LLF) musculature, moving the neck into LLF. By doing this, the target RLF musculature is the antagonist of the motion. Their stretch is begun and the RI reflex is triggered. The client usually exhales during the contraction (think "e" for exhale and "e" for exertion).
c. The client then relaxes and we further stretch the client into LLF. The client usually completes the exhale during this step.
d. The client continues to relax as we passively bring the client back to the starting position. The client inhales during this step so she is ready for the next repetition.
Typically eight to 10 repetitions are performed, and we progressively increase the force of the stretch with each repetition. Because a large number of repetitions are performed with AC stretching, each repetition is usually performed fairly quickly. An entire repetition takes approximately 3-5 seconds.
Comparing CR and AC Stretching
To more easily learn these techniques, it can be helpful to compare CR with AC stretching. With CR stretching, the target muscle group isometrically contracts against our resistance. (Note: Part 1 of this series, the target right lateral flexors isometrically contract.) With AC stretching, the target muscle group is turned into the antagonist of the joint motion. Note that in Figure 1a, the left lateral flexors concentrically contract (again the right lateral flexors are the target musculature). It can help to remember that with AC stretching, the client's contraction actually begins the stretch of the target musculature.
Contract Relax Agonist Contract Stretching:
CR and AC stretching can be combined to create contract relax agonist contract (CRAC) stretching. As its name implies, a CRAC stretching repetition is done by sequentially performing the CR and then the AC stretching techniques. The benefit of CRAC stretching is that it triggers both the GTO and the RI reflexes, therefore potentially creating a more powerful inhibition/relaxation of the target musculature. The usual CRAC stretching protocol steps are carried out as follows. The RLF musculature of the neck are again used as the example (Fig. 2):
a. Have the client begin in a neutral starting position.
b. Ask the client to gently isometrically contract the target RLF musculature against our resistance for approximately 5-8 seconds to trigger the GTO reflex. The client holds in the breath during this step. This is the CR portion of the stretch.
c. Then ask the client to concentrically contract the LLF musculature to move into LLF. This begins the stretch the RLF musculature and it triggers the RI reflex. The client exhales during the contraction. This is the AC portion of the stretch.
d. The client then relaxes and we further stretch the client into LLF.
e. We then passively bring the client back to the starting position as the client inhales. This completes one repetition.
Three to five repetitions are usually performed, each one beginning from the same neutral starting position, as is done with AC stretching. Typically, the client is asked to increase the force of contraction with each repetition, and we progressively increase the force of the stretch with each repetition.
Most every stretch can be performed as a CR or an AC stretch, or even a CRAC stretch. Both CR and AC advanced stretching techniques are equally effective. Which one you choose to use will most likely depend upon client preference and which technique is logistically easier for that particular muscle and the position that the client is in. Advanced stretching techniques might take a little more time, effort, and practice to master, but the benefits to your clients are well worth it.
Joseph E. Muscolino, DC, has been a massage therapy educator for 24 years, teaching both core curriculum and continuing education classes. He currently teaches anatomy and physiology at Purchase College, SUNY. He is the owner of The Art and Science of Kinesiology in Stamford, Conn., and is the author of The Muscle and Bone Palpation Manual, with Trigger Points, Referral Zones, and Stretching; The Muscular System Manual, 3rd edition; and Kinesiology, The Skeletal System and Muscle Function, 2nd edition (Elsevier, 2009, 2010, 2010), as well as other publications. For more information or to contact Joseph, visit www.learnmuscles.com.
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