resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
April, 2011, Vol. 11, Issue 04
How to Help People With Parkinson's
By Ben Benjamin, PhD
Those readers familiar with my column will know that my articles typically deal with pain and injury conditions. This month, I'm excited to address a very different type of ailment, Parkinson's disease (PD), and a type of exercise therapy that can dramatically reduce the symptoms of this disorder.Seeing the effectiveness of this work with clients has been a wonderful surprise and a great learning experience, as well as being deeply gratifying.
What is Parkinson's Disease?
Nearly one million people in the United States are living with PD, a chronic, progressive, neurological disorder with no known cure. Most PD is idiopathic (of unknown cause), but some cases are thought to be caused by genetic factors or exposure to environmental toxins.
PD affects the brainstem, the lowest part of the brain, which connects directly with the spinal cord. Specifically, it affects the neurons (nerve cells) in an area called the substantia nigra. When they are functioning properly, these neurons produce dopamine, a chemical responsible for transmitting movement-related messages. In a person with PD, 60 to 80 percent of those cells become damaged and no longer produce enough dopamine. As a result, the person begins losing the ability to initiate and control their movements.
While brain scans can reveal whether a person's substantia nigra is damaged, there is still no single test or exam that proves the presence of PD. The primary indicators of the disease are four characteristic symptoms: tremor, rigidity, bradykinesia (slowness of movement), and postural instability. As the disease progresses, these movement conditions ultimately result in paralysis. Additional symptoms often associated with PD include fatigue, sleep disorders, cognitive impairment, depression, speech problems, gastrointestinal issues, impulsive behaviors and pain. The development and advancement of PD is somewhat of a mystery and varies by person. For instance, although tremors are commonly a primary symptom, some individuals experience no tremors but instead have problems with balance. While some people quickly become severely physically disabled, others live with a much slower disease progression over 20 to 30 years.
Treatments for PD vary depending on the stage of the disease and the symptoms the individual is experiencing. The medications currently prescribed do not reverse symptoms but can slow their progression. Unfortunately, some drugs may lose their effectiveness over time, cause an allergic reaction, or cause disconcerting side effects, such as dsykinesia (sudden involuntary movement). However, in many cases, finding the right combination of medications can dramatically improve a person's quality of life.
In cases where medication is not sufficient, PD is sometimes treated with deep brain stimulation (DBS). This is a surgical procedure in which a neurostimulator (essentially a "brain pacemaker") is implanted in the brain. The device sends electrical impulses to the specific areas of the brain that control movement, while also blocking the abnormal nerve impulses that people with PD often experience. It can sometimes take up to three months for this treatment to significantly reduce symptoms, but the success rates are high.
In addition to pharmaceutical and surgical treatments, speech and physical therapy are usually helpful. Physical exercise in particular appears to help some of the movement symptoms by improving balance and flexibility and reducing joint stiffness.
As an experienced therapist, I concluded long ago that there was little that hands-on practitioners could do for people with degenerative neurological conditions such as PD. I'm happy to say that over the past few years, I've been proven wrong. As increasing numbers of massage therapists and bodyworkers are discovering, active isolated stretching (AIS), can be enormously helpful in reducing PD symptoms and restoring normal motor function.
Several aspects of AIS help to explain its unique ability to provide neuromuscular benefits. First, every AIS stretch includes a gentle assist. At the end of the client's active range of motion, the practitioner provides just enough assistance to push slightly beyond what the person could do on his or her own, typically adding two or three degrees with each repetition. This means that the muscles are continually moving into new territory. The brain-muscle connection keeps learning to do something new and different, which means new neural pathways are always being created.1
In addition, the stretches in AIS are active, rather than passive. Although the practitioner supports and assists the stretch, each movement is initiated by the client. This further reinforces the connections between the brain and the muscles.2 Repetition of the stretches also promotes nerve development. Instead of a single stretch held for a prolonged period of time, AIS involves six to 12 repetitions of each movement, performed for just two seconds.
Another relevant factor is the reduction of muscle spasticity, which is excessive tone in a muscle that leads it to involuntarily contract when it is stretched or lengthened. It can vary in severity from mild muscle stiffness to severe, painful spasms. In many cases, AIS can effectively resolve spasms and lessen spasticity.
Beyond these specific neuromuscular effects, some of the more general benefits of AIS are very helpful for individuals with degenerative neuromuscular diseases. AIS helps restore the supply of oxygen and nutrients to chronically contracted, blood-starved tissue. Some of the most affected tissues in Parkinson's patients are the "two joint" muscles that act across more than one joint. These include the hamstrings and rectus femoris (hip and knee joints); gastrocnemius (knee and ankle joints); and the psoas (hip joint and multiple joints in the low back). AIS allows for focused stretching on each of these muscles, working toward restoring normal posture and gait. After flexibility has been restored, the focus shifts to building strength through Active Isolated Strengthening.
My First Client With Parkinson's Disease
It's one thing to have a theoretical understanding of how AIS can reduce neuromuscular symptoms; it's quite another to see this in action, with real people who are suffering from progressive degenerative disorders. When I first heard that AIS could help clients with PD, multiple sclerosis, and other neuromuscular conditions, I was extremely skeptical. Only after seeing dramatic improvements in my own clients did I fully accept that this was possible.
My first client with PD, whom I'll call Mary, was a college professor whose symptoms had begun four-and-a-half years earlier. After receiving a critical evaluation from one of her advisees that she thought was unfair, she became distressed and started shaking. This is common; while life stresses do not cause PD, the first signs of the disease often occur during a stressful event. Although she had no problems with balance, she experienced both tremor and rigidity, which interfered with her daily life.
I began treating Mary with hour-long AIS sessions, twice a week. She began to feel increasingly looser, stronger, more flexible, and less rigid. Within about three months, there was a drastic reduction in her symptoms. Previously, her right foot had dragged, and now she could lift it up, even on days when she was under stress. For several years, she hadn't been able to brush her hair with her right hand; now she could do that regularly. She also credits AIS with eliminating an extreme, acute pain in her arm and an annoying pain in her fingers and toe joints, as well as with improving her ability to write. As the years went by, her writing had become smaller and smaller, and she had lost the capacity to write "N"s and "M"s. After several sessions, she could write an "M". Currently, she can write almost as well as she could five years ago.
The AIS work also seems to have affected Mary's sleep. For four years, she had experienced severe sleep troubles that would cause her to get up in the middle of the night, even with the help of medicine. A month and a half after starting AIS treatment, she began sleeping through the night. After about three months, she told me that for the first time in years, she had woken up feeling truly rested and refreshed. Both she and her doctor (a neurologist who specializes in movement disorders) believe that this improvement is due to AIS. Another benefit was being able to halve the dosage of a medication she was taking, which made her sleepy. Before Mary started with AIS, her doctor wanted to put her on the strongest possible medication. After seeing the progress she was making, he decided to postpone this measure.
One of the most inspiring changes to witness was that as Mary's symptoms decreased, she regained her self-confidence. Because her tremors have diminished significantly, to the point where they are usually unnoticeable by others, she is less self-conscious in stressful meetings or other public interactions. (Mary was impressed when her neurologist told her that her PD could be noticed only during a physical exam performed by a specialist.) She also feels much more comfortable eating with her right hand in public than she had in many years.
Mary has participated very actively in her own recovery. I taught her AIS stretches and strength-building exercises for her neck, arms, hands, fingers, legs, feet and toes, and she has continued to do these regularly at home. When she feels any pain coming back in her arm, she does the arm exercises right at that moment, and it goes away again.
In this way, I have found AIS work to be empowering for Mary and for other individuals with neurological conditions (including multiple sclerosis and muscular dystrophy). It is also empowering for me. It has given me the ability to help an entirely new set of clients who don't respond to the other forms of treatment I offer. I find it exciting to see more and more massage therapists and other health practitioners learning these valuable skills.
Click here for more information about Ben Benjamin, PhD.
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