Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
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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