Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
I just got finished with a ...
resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Use Technology to Gain New Patients and Improve Efficiency
From the smartphone in your pocket to your microwave oven, advancements in technology have made almost every aspect of our lives easier.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients, in May 2014, researchers showed that drinking the equivalent of 2 to 4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
Calculating Billable Units
I recently learned of an office that was audited based on the number of acupuncture sessions performed in one day. Is there a maximum number of sessions that can be performed in one day?
Acupuncture in the U.K. Today: A Personal View
When asked to write a short piece on the current state of the U.K. acupuncture profession, my first response was to say it has all been relatively quiet.
The Year to Make Things Happen
It is hard to believe that the Year of the Ram – 2015 is half over. Time seems to be moving especially fast. This is the year for things to happen for the acupuncture profession.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Acupuncture and the Pulse
In 1991, I attended a martial arts workshop hosted coincidentally by Sung Baek, a martial artist and the head of his lineage as a Korean trained acupuncturist. I was enamored by the details Sung could attain from the pulse, as told to me by some of his apprentices.
What Does Success Mean to You?
Recently, I was asked to speak to young, budding businesswomen about running a successful business — and at first I thought, "Me? You want me to speak to others about success?!"
How One Little Symbol (#) Gets You More Patients
Are you struggling to get more fans or followers for your acupuncture practice? Or are looking for ways to simply connect with your patients? Or do you just want to know how to keep them engaged (comments, retweeting, liking and sharing)?
The Source-Luo Point Combination
The luo collaterals are part of the acupuncture channel system presented in the Su Wen and the Ling Shu (The Nei Jing). The function and clinical application of the luo mai are primarily presented in chapter 10 of the Ling Shu, however, they are also found in others chapters in the Su Wen and the Ling Shu.
Marijuana, Apathy and Chinese Medicine, Part 2
A talented young woman presented herself with emotional mood swings, which included being nervous, anxious and jittery.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
The Nectar of Plants: Essential Oils and Chinese Medicine
Essential oils are a very hot topic these days, especially with the likes of the Ebola virus and the resurgence of measles lurking in our awareness, but when I first became interested in Chinese medicine, essential oils weren't on the radar screen for acupuncturists.
TMF 2015 Scholarships
The Trudy McAlister Foundation (TMF), a nonprofit organization established to support students who are on track to make contributions either to clinical practice and/or to the understanding of the role of Traditional Oriental Medicine, has announced the 2015 scholarship recipients.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
Breath: The Movement of Oxygen and Energy
I remember with surprising clarity the first time a patient started crying during an acupuncture treatment I was giving. This is now quite a long time ago, back in 1999, when I was a student.
The Modern Acupuncturist
You studied ancient Chinese medicine, but I'll bet you don't practice it! Contrary to popular belief, our medicine has evolved A LOT over the years. Let's take a brief walk through history and discover the differences between ancient and modern acupuncturists.
February, 2011, Vol. 11, Issue 02
The Bike Body
Working With Cyclists
By Erik Dalton, PhD
It's astonishing the money and time many elite and "weekend-warrior" cyclists devote to retrofitting racing bikes to conform to their bodies rather than first restoring function to the most critical piece of racing equipment: the rider's body.When muscle imbalances, faulty movement patterns and joint fixations distort the body's bony framework, the cyclist is led on a never-ending journey searching for that perfect bike fit. (Fig. 1)
My personal mantra: "Fit the body to the bike, stupid!"
Bodyworkers and functional movement trainers whose practices cater to amateur and elite cyclists are keenly aware of the clinical and performance advantages gained by restoring optimal mobility, flexibility and stability to the biker's muscle/joint complex. It makes sense to first get the kinks out before sending the client off for an expensive and sometimes useless bike retrofit. Without hands-on maintenance and functional fine-tuning, cyclists often unknowingly reinforce dysfunctional movement patterns ingrained from long-forgotten micro- or macro-traumatic injuries.
Confusion and controversy over this chicken-or-egg (bike-or-body) thing is primarily due to lack of understanding of the Law of Cause and Effect. For instance, let's say a bike shop performs a retrofit and Bob, the cyclist, smilingly pedals away on his newly reconstructed machine feeling secure and pain-free. Life is good... or is it?
Unfortunately, if Bob is one of many "flexion-addicted" Americans with a sedentary job that keeps him glued to the computer terminal day-after-day, gravitational exposure will gradually drag his body into a big "C" curve. (Fig. 2) In time, Bob's brain relearns this aberrant posture as normal and on weekend outings his "hip-flexed" desk posture morphs into a similarly distorted riding posture. (Fig. 3)
To make matters worse, stubborn pain-spasm-pain cycles often appear as the hip stiffens and the imposed stress destabilizes sacroiliac and low back structures. In the presence of lumbar spine instability, the brain may decide to lock down the low back and ribcage with protective muscle guarding. Thoracic cage rigidity not only inhibits proper diaphragmatic breathing but also sends shock waves through the thoracolumbar and pectoral fascia and into the upper extremity joints where reverberations are met with strong resistance from habitually locked hands, elbows and arms. (Fig. 4) Meantime, compensations from adhesive hip capsules also traverse down through Bob's knees, ankles and feet searching for a weak link in the lower kinetic chain.
Cyclists who opt for a bike retrofit prior to receiving manual therapy to release fibrotic hip capsules and hip flexors, soon notice a loss of endurance and may develop soft tissue or joint sprains associated with lumbopelvic imbalance. Oddly, many flexion-addicted cyclists attempt to work through the injury despite sensing a noticeable reduction of speed, power and efficiency. "No pain, no gain" is an unacceptable working model for those seeking longevity in the cycling sport.
Does decreased hip angle equal less power?
One of the most common bike positions used by "flexiholics" has the hip flexors locked short and the hams and glutes overstretched and weak. This imbalance pattern as described by Vladimir Janda in his lower crossed syndrome, forces the pelvic bowl to be drawn too far forward creating a decrease in hip angle. (Fig. 5)
Cyclists who consistently ride with an anteriorly rotated pelvis and decreased hip angle are subject to capsular and ligamentous adhesions and a subsequent loss of economy and power. To accommodate the loss of hip extension, many recreational and competitive racers compensate by posteriorly tilting their pelvic bowl and rounding their backs into a hyperkyphotic posture just to increase hip angle and power. The famed cyclist Andy Pruitt believes that changing the seat height by a mere inch alters mechanics and motor control patterns of every joint in the lower extremity. By decreasing seat height, excessive force is transferred to the patellofemoral joint, while raising the saddle too much strains the hamstrings, low back and hands.
Stand and try this: Lift one leg with the knee bent about 90 degrees as high as possible without straining or rounding the back and forcing hip flexion. Most people are able to comfortably hip-flex about 90 degrees. Try this maneuver again except this time forward-bend your trunk about 50 - 60 degrees, while raising the knee. Notice a dramatic reduction in the amount of hip flexion? Try both tests again and this time, measure available hip flexion by observing how high your foot raises off the ground. This test illustrates what can happen to hip-impaired cyclists: decreased hip flexion = greater effort = more work = poor performance.
Riding Postures and Rehab
The first order of business when treating adhesive (motion-restricted) hip flexors and capsules is to mobilize the hip in all three cardinal planes. (Fig. 6a) To restore myofascial balance, fast-paced "spindle-stim" maneuvers such as those shown in Fig. 6b help tonify weakened (neurologically inhibited) gluteal and hamstring muscles. Once the therapist manages to increase hip angle and establish proper functional balance and range of motion, the cyclist is free to decide which type of riding posture (he believes) suits him best.
Some cyclists prefer a high seat so they can posteriorly rotate the pelvis to increase hip angle. Other riders find greater mechanical advantage by putting a little curve in the low back, engaging the core, and then slightly backing off the curve to allow a neutral lumbar spine. Either way, both groups should avoid:
The Yin-Yang of Muscles and Joints
To perform well in such a challenging event, cyclists like Bob would greatly benefit from a well-constructed manual and movement therapy program that focuses on restoration and maintenance of proper intrinsic/extrinsic muscle balance and diaphragmatic breathing patterns. Fluid and dynamic body movement during cycling events is dependent on the ability of muscles and fascia to stay strong, yet flexible. A healthy lumbar spine is the driving engine in most athletic endeavors and length/strength balance between muscles, ligaments, joint capsules, and thoracolumbar fascia is essential for providing that stable platform. Any weakness or motor control issues are magnified by traumatic shocks from funky road conditions or recurring bike injuries. Eventually, excessive neurological input cannot be handled at the spinal cord level and the information is "fast-tracked" to the brain for interpretation via pain-signaling nociceptors. If the brain decides to "splint" the vulnerable area to prevent further insult, pain-spasm-pain cycles may ensue.
Ingrained muscle and motor imbalance patterns such as those discussed by Vladimir Janda, Gray Cook, Craig Liebenson and others, often require a concerted team effort to reestablish normal movement behavior. In most cases, the ideal treatment protocol is to first restore lost mobility to impaired structures and then address stability issues via functional movement training.
Like many of America's other popular, but abnormal, athletic endeavors such as golf, tennis, bowling, etc., cyclists bring with them a complex biomechanical downside that's often hard to completely fix. The "arched back" model is generally the most problematic. In an attempt to level the eyes, the rider must hyperextend occiput on atlas. The cervicothoracic junction is also forced to hyperextend (neck-on-shoulders) causing chronically locked intervertebral joints and rib jamming. This area is particularly affected by road vibrations due to the stationary position of arms, shoulders and hands. Additionally, ligamentous laxity may develop from excessive thoracolumbar and lumbosacral bowing which, in time, sets the stage for low back pain and disability.
The good news is that the human body is both adaptable and dynamic; the bad news is that our biker clients often bring along a lot of baggage including flexion-addicted sitting postures, old injuries, compensations, poor training habits, etc. Once the skilled manual and movement therapist makes necessary corrections, the bike can then be retrofitted to conform to the rider's optimally functioning body. A properly fitted bike combined with a revitalized and functionally balanced neuromuscular system allows muscles and joints to work at optimal levels of motor unit recruitment and synchronization. As endurance and performance improve, so does the natural love of cycling.
Click here for more information about Erik Dalton, PhD.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.