Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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."
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.
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?"
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!
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.
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.
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.
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.
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.
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.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
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.
May, 2011, Vol. 11, Issue 05
Does Fascial Research Alter Assessment?
By Whitney Lowe, LMT
Tom Myers recently wrote an article highlighting some outstanding research published by the Dutch osteopath and anatomist Jaap van der Wal. I was intrigued by the concepts Myers highlighted in this article and looked for more of van der Wal's publications.
In addition to his previous papers on the subject of fascia, van der Wal also published a paper in the International Journal of Therapeutic Massage and Bodywork in 2009 that explores these anatomical concepts in great detail.
It is interesting to note that van der Wal wrote of these very important findings almost 20 years ago, but did not find acceptance of those ideas within the traditional scientific publishing community until recently.
The essence of van der Wal's research points out that dissection and anatomical science has for centuries focused on a very reductionistic and mechanistic view of the musculoskeletal system. However, he suggests it is a much more complicated and intricately woven web.
In his dissection studies, van der Wal demonstrates that ligaments are not discrete structures separated from muscle and fascial connective tissue. His research shows that at least some ligaments around the body's joints are actually connected in series with muscular tissues - meaning that muscles have fascial connections with ligaments and thus may not act independently.
Does this information impact our practice?
For years the dominant model of orthopedic assessment has been the foundation of James Cyriax's model of contractile and non-contractile (inert) tissues. Contractile tissues included muscle and its associated tendon, because the tendon was strongly pulled once the muscle contracted. Inert tissues were all the soft tissues other than muscle and tendon. They are called inert because they don't actively contract and they are only passively lengthened or shortened during motions of the joints.
Clinicians used this structural format to establish a systematic process of evaluating soft-tissue dysfunction. The central point of this evaluation method is that certain evaluation procedures produce pain or discomfort if a contractile tissue is at fault, while other methods produce pain if an inert tissue is at fault.
As an organizational system it makes very good sense and works quite well in the evaluation process. But there are times when the pattern of pain or discomfort does not seem to fit this classical formula. That leaves the clinician to discover and interpret what the anomaly means. Now, we may have an explanation that helps unravel some of these inconsistencies.
If there are direct fascial connections that tie ligaments and muscles together in series, then ligaments will have tensile loads applied to them when muscles contract. Traditionally, we have said that a manual resistive test applied to a particular joint motion isolates the muscle-tendon tissues, but not the inert tissues. The muscle-tendon tissues are engaged in a contraction generating a tensile load. Because there is no movement at the joint the inert tissues are not stressed at all.
With this new research, that axiom no longer holds true. If muscles have direct serial connection with ligaments, a manual resistive test with no movement could still put a tensile load on a ligament. If that ligament was damaged, pain could ensue. Under the old paradigm one would assume pain during a manual resistive test is only a muscle-tendon injury, but now we see it could be a ligamentous injury. What does this mean?
For the therapist in clinical practice these concepts have tremendous importance in attempting to identify which tissues might be the source of the client's pain. There are very important implications for both assessment and treatment from these exciting research findings.
From the assessment perspective, it means we must consider the possibility of a greater number of tissues causing client pain if muscle contraction or stretch is involved, especially if that pain is localized near a joint. From the treatment perspective, it means we must look at the extensive functional relationships between different tissues and consider how treatment of one type of tissue (muscle for example) may affect the function of another (ligament).
I have always been an advocate of staying current with research findings and looking for innovative ways to apply them to clinical practice. It is exciting because we're constantly learning new things, and these new concepts and ideas help us become ever more effective with the clients who come seeking our help for pain and injury complaints.
Click here for more information about Whitney Lowe, LMT.
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