resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Alcohol Consumption Strongly Linked to Risk of Colorectal Cancer
Alcohol intake is one of the primary risk factors for many human cancers, and is strongly associated with cancers of the oral cavity, pharynx, larynx, esophagus, liver, breast, and notably, the colon and rectum.
Drug War Rages in Wisconsin
Based on its actions over the past 15 years (review the sidebar in the app version of this article), controversy and the Wisconsin Chiropractic Association seem to go hand in hand.
The McGill Approach to the Lower Back (Part 1)
Stuart McGill, PhD, brings a unique combination of tools to the table. He is a scientist who also functions as a clinician. He describes himself as a medical consultant who is referred challenging patients. He is both evidence based and practical.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
The Bottom Line ... From a Surgeon Who Knows
Regardless of individual relationships between providers, there continues to be a type of Hatfield-McCoy feud between the philosophies of medicine and chiropractic, particularly when it comes to musculoskeletal ailments.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
News in Brief
Foundation for Chiropractic Progress Enrolls Second Group Member; Focus on Chiropractic Education at WFC-ACC Conference in Miami; Are You Ready for Another "Have-a-Heart" Campaign?
Giving Chiropractic Some Much-Needed PR
Public relations has not always been the chiropractic profession's strong suit, a shortcoming that has subjected the profession to countless attacks on its legitimacy and seemingly perpetual confusion among the public and the health care world as to the skills and services doctors of chiropractic provide.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Correcting Dysfunctional Movement Patterns – Is Local Treatment Enough?
It is widely believed that mechanical, non-traumatic back pain is largely related to dysfunctional or compensatory movement patterns the body has adopted over time.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
"Turn, Turn, Turn"
Many people are credited with saying, "If you remember the '60s, you really weren't there." Given the fact I didn't become a teenager until 1970, I actually do remember the '60s (or at least part of it). And as a child of the '60s, I was, of course, influenced by the music.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
July, 2011, Vol. 11, Issue 07
Human Silly Putty
By Erik Dalton, PhD
Although "creep" is an engineering term, it also applies to human tissue...the lumbopelvis in particular. Spinal and sacroiliac ligaments, joint capsules, facet cartilages and especially intervertebral discs are viscoelastic and are somewhat similar to silly putty.Leave a ball of putty on a table overnight and by the next morning it's deformed into a flattened pancake. So be it with humans. We're taller in the morning than at bedtime, primarily due to disc and fascio-ligamentous deformation that occurs throughout the day. Of course, silly putty is much creepier than discs, fascia or ligaments but, in time, gravity will deform and sometimes strain all these materials.
As ligamentous creep turns to strain, soft tissues are no longer able to prevent separation of bone and that's when our problems begin. Contrary to what many docs tell their patients, most low back and pelvic pain does not result from a single traumatic lifting, bending or sports injury, but rather from cumulative viscoelastic creep due to lack of rest between loading cycles. According to Bogduk and Twomey, "After prolonged strain, spinal ligaments, joint capsules, and IV discs of the lumbar spine may creep, and may be liable to injury if sudden forces are unexpectedly applied during the vulnerable recovery phase."1 Bottom Line: Once viscoelastic tissues are strained, they're less likely to return to their original length and, therefore, are more prone to future injury.
I often scratch my head in wonder when reading research that dismisses the effects of gravitational exposure on human viscoelastic tissues. It's even more frustrating when scientists and clinicians discount the role distorted postural faults such as pronated feet, crooked SI joints, and forward heads play in commonly seen pain syndromes.2 Each-and-every day, the weight of gravity (14.7 pounds per square inch) pushes straight down on our bodies. These compressive forces should be equally distributed throughout the neuro-myo-skeletal system...but are they? Prolonged one legged standing (excessive weight bearing on one limb, i.e., performing bodywork) is an oft-overlooked culprit creating ligamentous creep that might be a precursor to more serious conditions like joint laxity, lumbopelvic instability, sprains and osteoarthritis. To demonstrate the phenomena of creep, let's look at the myo-mechanics of a fairly common pain-generating disorder called iliosacral upslip or "shear."
What Is An Upslip?
In those presenting with true iliosacral upslips, joint apposition between the ilium and sacrum is altered, i.e., "the sacroiliac grooves ain't grooving". Since these superior shears are more affected by gravity than other iliosacral dysfunctions, they have almost a zero chance of self correction. During history in-takes, clients often report the symptoms to be much more painful than expected from the injury they describe. In fact, many can't recall any precipitating event.
Typically, when we see this upward shearing force of ilium on sacrum, the person's SI joints are lacking either form or force closure. In form closure, SI joint stability is dictated by a series of ridges and complimentary depressions that produce friction and help interlock the two bones. But synovial joints like a little movement (joint play), not only to provide spinal shock absorption, but also to enhance lower extremity torque conversions and transverse rotations that travel up the kinetic chain and propel the body through space.3 Fortunately, Mother Nature has accommodated this functional demand by installing a back-up system researchers call force closure. Force closure stability is generated by contractive action of core musculo-fascial tissues such as the pelvic diaphragm, transverse abdominis, multifidus and thoracolumbar fascia. Together, they provide a sophisticated neurologic feedback mechanism that reflexively interacts with the brain to provide joint stability and coordinated movement...or lack of it as is the case in chronic upslips.
In the presence of chronic upslips, prolonged cyclical loading can deform SI joint ligaments to a point where an act as innocent as slamming on the brake, tumbling on one hip, or clumsily stepping off a curb, can jostle the joint enough to cause the ilium to "jump-a-notch" on sacrum. Here's a good "upslip" case study of a client named Marion who called complaining of stabbing buttock and low back pain.
Marion The Hairdresser
I'd treated Marion off-and-on for several years for neck, jaw and rib pain resulting from a severe whiplash injury, but today was different...her low back and hip were in a world of hurt. This was her first visit since becoming a momma a year earlier and her history in-take revealed two related factors contributing to her injury: 1) Cumulative viscoelastic creep (hypermobility) left over from the relaxin birth hormone, and 2) Prolonged one-legged cyclical loading at her hairdressing job.
A classic upslip case, Marion presented with acute right-sided lumbopelvic pain, funky gait and anatomical landmarks showing a 1 1/2" short right leg, lax sacrotuberous ligament right, OL and psoas spasm right, and superior/posterior right ilium. Spring testing of the right ilium (supine and prone) revealed no inferior glide. Marion's right QL fired before gluteus medius on the hip abduction test and she lifted the swing leg with the spasmed QL as she tried to walk. Although all her anatomical landmark and gait evaluations pointed to an iliosacral upslip, why do you think she could not identify a traumatic perpetrating event?
The books tell us iliosacral upslips are traumatically-induced injuries, but Marion first felt the excruciating pain when she got out of bed. Turns out, the incident that most likely pushed Marion over the edge occurred the night before as she stepped off a foot stool. That slight jar caused the hypermobile pelvic ligaments and restraining muscles to collapse and explode into a full-blown crippling hip spasm. Over the years, I've seen many cases like Marion's and I've noticed that in the early stages of ligamentous creep, the brain down-regulates nociceptive pain signals. But when the joint finally jams, the brain lights-up the central nervous system with pain and protective guarding to prevent further insult to the damaged area.
Fixing The Fixation
Here are a couple of techniques that helped fix Marion's upslipped hip. In Figure 4A, she's pulling the knee to her chest to inferiorly drag the ilium while I slowly elbow my way through the lumbodorsal fascia, QL, and iliocostalis myospasm. Once these hypertrophied (hip-hiking) soft tissues regain flexibility and mobility, a maneuver is used to get the sacroiliac "grooves-a-groovin." But before proceeding to the upslip correction, Marion is asked to do a couple minutes of deep abdominal breathing to help neurologically reset and relax the deep spasmed core muscles.
In Figure 4B, Marion lies supine and I apply an inferior tractioning force to drag the ilium to the first restrictive barrier feeling for neutral leg and hip alignment. By taking the limb into a bit of internal rotation, I'm able to bony-lock the hip allowing the tractioning force to travel through the SI joint. Using my body weight with her thigh securely arm-locked, a distraction force is applied as Marion forcefully contracts the QL and hip-hikes against my resistance. After a few seconds, she is asked to cough vigorously to help jostle the joint and reposition the soft tissues. Traction combined with the forced exhalation allows Marion's ilium to drop down into the groove "from whence it came." Note: The pain should immediately ease except in those with hypermobility issues or core stability problems in which case a referral to a good functional movement therapist is recommended.
Lastly, here's an effective home-retraining exercise I gave Marion. Lying supine, with her heels circling an exercise ball, she lifts her buttock and slowly rolls the ball side to side. I've found this simple routine helpful in normalizing neuromuscular firing patterns while evenly tonifying damaged ligaments. Rest, ergonomic retraining and regular follow-ups are mandatory until pelvic stability is established. Remember, the first couple weeks are critical; even the slightest jar can turn the ligaments back into silly putty.
Click here for more information about Erik Dalton, PhD.
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.