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Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
June, 2011, Vol. 11, Issue 06
Are we all on the same playing field?
By James Waslaski
I just returned from attending an incredible seminar sponsored by Performance Health. Manual therapy participants included industry leaders and pioneers from the fields of Chiropractic, Physical Therapy, Occupational Therapy, Athletic Training, and Massage.Many of the participants had multiple certifications, such as chiropractors that also had degrees in physical therapy and personal training That was followed the very next week by teaching a seminar in Drogheda Ireland, just outside Dublin, to an international group of manual therapists.
The awesome thing is that most of the people, from both groups, left their titles and egos aside, to learn and share manual therapy techniques that would benefit all of our patients. Presentations were designed to bridge the gap within the manual therapy profession, for the best interest of every client that walks though our door suffering from a musculoskeletal problem.
So this article has been written to not only help bridge the gap between all manual therapists in the health care system, but bridge the gap and give respect to all advanced disciplines in the massage industry.
This year we are releasing a book with Pearson Publishing to share the work that has positively changed the lives of thousands of patients throughout the world with musculoskeletal pain. Therapeutic work that blends multiple advanced massage therapy modalities, with other manual therapy disciplines. We avoided the word medical massage in the title, because we felt a need to honor other great advanced modalities that have an amazing effect in eliminating complicated medical conditions including: Posturology, Myoskeletal Alignment, Visceral Manipulation, Lymphatic Drainage, Cranial Sacral Therapy, Structural Integration, Anatomy Trains, Myofascial Release, Neuromuscular Therapy, Energetic Therapy, and this list goes on.
We realized that although the term medical massage is one of the biggest buzz words in the massage industry, it is also one of the most controversial words in our industry. Some industry leaders would tell you we are not doing medical massage unless the client we are treating is referred by a physician. That would mean that the majority of the clients that recovered from complicated musculoskeletal medical conditions from my work in the past 20 years did not get medical massage. At least one state has told their therapists they cannot call what they do medical massage unless they are certified in neuromuscular therapy. I love neuromuscular therapy, but there are a whole lot of medical conditions that respond better to other modalities. What good can we do if the medical client has a visceral, lymphatic, and/or cranial problem if we limit our work to just one modality?
So, to respect the many great advanced disciplines in the massage therapy industry, we chose to call our new text book Clinical Massage: A Structural Approach to Pain Management. Throughout, it stresses the importance of combining science, with presence in therapy, intention, and intuition. We also talk about the importance of knowing when to refer certain clients to therapists in other modalities, and to medical practitioners in other disciplines. Since I have received advanced training over the years in many other modalities such as Functional Assessment, Posturology, Myoskeletal Alignment, etc., I realize the importance of blending multiple modalities and multiple disciplines to better treat the wide array of medical conditions we see in our offices and clinics.
I also found out that the more we know, the more we realize we don't know. We need to align with leaders in the manual therapy industry for the best interest of each client. We also need to combine eastern and western philosophies of medicine. Clinically based practitioners need to stop putting down energy healing, just because of their lack of knowledge, or insufficient training in that particular area. There is a lot of scientific proof out there in regard to our negative thoughts and negative energy creating pain, disease, and illness all the way to the level of the DNA.
It really bothers me when I hear a massage therapist say things like "What does the doctor or physical therapist know?" Or that energy work is "woo woo stuff." It is time we all put our egos aside, and work together in the best interest of the clients we serve.
In summary let me share a medical condition we see with our clients. Let's look at a client that presents with thoracic outlet or adhesive capsulitis (frozen shoulder). Is that a neck problem, a shoulder problem, compensation from a true leg length discrepancy problem, or an emotional problem? Will it benefit more from manipulative therapy, posturology, massage, or energy work? What muscle groups are pulling bones onto nerves and blood vessels? Will the client benefit more from a flexibility program or a strengthening program? Should we work on balancing the muscle groups of the neck and shoulder first, or release the fascial adhesions in the joint capsule? What modality or discipline will have the greatest effect on resolving the clinical symptoms? Can the client completely recover if they just get treated with manipulative therapy, and not have the muscles in the neck and shoulder balanced out? Is there an emotional component to this condition that could benefit from energy work?
The training with Performance Health, and the six day training in Ireland, focused on function, form, balance and movement. Assessment and clinical reasoning was important. Blending of disciplines was important. It was also crystal clear that each manual therapist had to teach the client better postural awareness and proper ergonomics. The client needed to get involved in a self care program to help themselves.
I have always encouraged therapists to constantly blend multiple massage modalities and manual therapy disciplines. Even just in the area of Orthopedic Massage, Whitney Lowe and I have decided to blend our uniquely complimentary certification programs in Orthopedic Massage, to raise the bar, and make a Master Level Orthopedic Massage Certification available. It will still be just considered one branch of the medical massage umbrella. It scares me knowing our industry is moving towards an advanced certification in massage. I wonder which advanced manual therapy disciplines will make it into the exam. Maybe we should back up a bit and first come to agreement on what medical massage is?
The time has come that manual therapists need to be on the same page when treating clients with complicated clinical conditions. I believe if we took all the incredible healing modalities in the massage or manual therapy profession and put them in one big toolbox, we would revolutionize medicine.
For now, let’s work together in the manual therapy profession, without turf wars. Stop criticizing other medical practitioners and start sharing the brilliant modalities they got in medical or PT school for the best interest of clients who have been given no hope for pain-free living.
Artwork furnished by Pearson Publishing from the book Clinical Massage Therapy: A Structural Approach to Pain Management.
Click here for previous articles by James Waslaski.
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