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News in Brief
Patriot Project: Serving Those Who Served; CTCA Chiropractor Receives Clinical Innovation Award.
The Importance of Staying Focused
Our world is so full of over stimulation and constant information. We live in a fast paced, ever-changing society. If you seek you will receive.
Managing Hallux Hypomobility Disorders (Part 2)
In part one of this series we discussed the unique properties and significance of the first toe in the propulsive phase of gait. In particular, we discussed the importance of the first metatarsophalangeal joint (MPJ).
Don't Believe It
One of our staff came into my office last week, very concerned about an article she had just read on a news media website. The article suggested researchers found "no health benefits" associated with taking multivitamins.
The Urinary Bladder Official
The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the kidneys.
Diagnosing Flexion-Intolerant Lower Back Pain (Part 2): Exercise Rehab
One of the things that has puzzled us for years is the presentation of the flexion-intolerant patient. We have realized there is a large overlap with sacroiliac indicators. In acute lumbar pain, the SI often twists, subluxes, goes haywire.
Gaining an Independent Occupational Code with the U.S. Bureau of Labor Statistics
One of the most important national activities currently taking place in relation to the development of the field of AOM profession is the Department of Labor's Bureau of Labor Statistics' (BLS) revision of the 2010 Standard Occupational Classification (SOC) system.
Common Disorders of the Temporomandibular Joint
The evaluation and management of craniofacial pain is a complex endeavor, which often encompasses the presence of temporomandibular joint disorders.
Peer Points: Spreading The Word
Pedram Shojai describes his venture into Traditional Chinese Medicine as a journey led by various "mystical experiences." Shojai decided to change the course of his career when he looked deeper into the basics of TCM.
Gallop Confidently Into The New Year
Happy New Year! As you may know, this is the year of the Wooden Horse. I received a wonderful gift for Christmas. It is a beautiful glass sculpture of a horse, by Luili Gong Fong, a Chinese artist.
Grape Seed Extract: A Multifaceted Herb for Promoting Healthy Circulation
One of my favorite herbs is grape seed. Modern research has identified some intriguing health benefits attributable to the seed of this ancient fruit. I particularly use grape seed as an extract standardized for OPCs (oligomeric procyanidins).
Giving Testosterone Levels a Boost (Part 3)
Since testosterone and insulin status are inversely correlated, it's important to keep insulin low so testosterone will remain high.
Preserving the Natural Resources and Culture of Chinese Herbal Medicine
As the world experiences unprecedented population growth and ever-increasing ecological pressures, the topic of preserving Chinese medicine's natural resources has attracted steadily increasing attention from practitioners.
An Alternate Method For Choosing The Right Formula For Your Patients
A constant question for us in the clinic is when to make adjustments and when to stay the course. A patient comes in and says, "Things are the same as last week."
Qigong to Empower Our Youth
Qigong is an ancient form of exercise and meditation used to promote longevity and health. This practice has traditionally been used by adults to balance the body through mindfulness, focused breathing and gentle movements.
Weighing in on Weight Loss
If your practice trends anything like the U.S. population, you are probably noticing over two-thirds of your patients could benefit from weight reduction, particularly if their main complaints include chronic back or joint pain.
Ever Heard of the Lateral Raphé?
We have all had acute patients enter our offices listing laterally to the side at the level of the lumbar spine or expressing pain on lateral lumbar bending.
Acupuncture Ambassadors: A Chat with Leader Anthony M. Giovanniello, MSAc,LAc
When you first meet Anthony Giovanniello, you realize he's a humble practitioner, yet is bursting with a type of dedication that you can't help but be overwhelmingly inspired by.
Eucommia Bark Helps Maintain Strong Bones
Eucommia bark is a major tonic herb used in Asia, and now throughout the world, that supports and helps mend the skeletal structure and its related tissues. Eucommia bark is collected from Eucommia ulmoides trees that are more than 10 years old.
Using Facial and Scalp Acupuncture To Treat Neuromuscular Facial Conditions
As a practitioner and instructor of facial rejuvenation acupuncture I have gotten many calls over the past 10 years from individuals seeking help for various conditions affecting the facial muscles, nerves, and overall function of the face.
VA Names Sites for Pilot Chiropractic Residency Program
The Veterans Administration has announced the five VA medical facilities that will serve as initial sites for the administration's recently established pilot chiropractic residency program.
Asymmetrical Pronation: Effect on Adjustments
When your patients don't respond as well as expected to their chiropractic adjustments, oftentimes there is a source of interference in the pedal foundation – asymmetrical pronation.
The Deficiency Myth
If you went to the same kind of medical school I did and took the same kind of licensing exam I took, you were trained to seek out and expect to find primary deficiencies here in the U.S.
Embracing the Light
Four years, ago I was diagnosed with a labral tear in my hip that was excruciating and "required surgery" according to an orthopedic surgeon. I tried everything and although the symptoms had mostly abated, I had to give up Yoga practice and everything that could exacerbate the tear.
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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