Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
I just got finished with a ...
resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.