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Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
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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