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Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
December, 2010, Vol. 10, Issue 12
Soft Tissue Manipulation and Pelvic Pain
By Leon Chaitow, ND, DO
There is accumulating evidence for clinical focus on key muscular and fascial structures with the potential to influence pelvic pain and dysfunction.
Lee, Lee & McLaughlin (2008) have noted: "The abdominal canister is a functional and anatomical construct that synergistically work together [involving] the diaphragm, including its crura, and by extension the psoas muscle, whose fascia intimately blends with that of the pelvic floor and the obturator internus muscle, the deep abdominal wall including transversus abdominis, and its associated fascial connections, anteriorly and posteriorly, the deep fibres of multifidus, the intercostals, the thoracolumbar vertebral column (T6-12 and associated ribs, L1-L5) and osseus components of the pelvic girdle (innominates, sacrum and femora)."
The pelvic floor and the respiratory diaphragm are seen to be structurally and functionally bound together by fascial and muscular connections; and just as dysfunctional breathing patterns influence pelvic function, so the reverse is true. Rehabilitation of the functions of the thorax, pelvic girdle, and pelvic floor may be enhanced by more normal physiological breathing patterns, while improving these patterns is aided by pelvic functionality, whether achieved through exercise, breathing retraining, postural reeducation, manual therapy, or other means. (McLaughlin 2009, Chaitow 2007)
Within the patterns of overuse and misuse that characterise chronic and acute insults to the body in general, and the low back and pelvic regions in particular, the evolution of myofascial trigger points is a common feature within a background of hypertonicity, induration and fibrosis. (Travell & Simons 1999, Anderson 2009, Key 2008, Fitzgerald 2009)
In this same context Prather (2009), Cox (2005), Janda et al (2007), Fitzgerald (2009) and many others, have implicated dysfunction involving: psoas, iliacus, quadratus lumborum, piriformis, hip adductors, rectus abdominis, abdominal obliques, scalenes and intercostals.
A focus on these and other adaptive soft tissue (and inevitably joint) changes, without due regard to etiological features, would offer short-term benefit at most. However, it is suggested that postural or other functional rehabilitation, without attention to such soft-tissue changes, would offer equally short-term results. (Chaitow et al 2002, Fitzgerald 2009)
Bialowsky (2009) reports that the effects of soft-tissue-focused manual therapies includes:
Manual Therapy Approaches
The listing below of a selection of currently utilised manual therapy approaches that address fascial and myofascial dysfunction takes for granted that there would be simultaneous or subsequent focus on etiological features. Also, the seven modalities listed should not be regarded as definitive, as there are many other variations. However, those listed (and briefly discussed) represent a variety of validated biomechanical approaches, some of them novel and others well established.
Click here for more information about Leon Chaitow, ND, DO.
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