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Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
November, 2011, Vol. 11, Issue 11
Joint Capsular Patterns
By Whitney Lowe, LMT
Passive and active range-of-motion tests are routinely used to identify soft-tissue pathologies. Unfortunately, practitioners often do not derive the full benefits of the information they can acquire through these tests.An expanded understanding of joint biomechanics will help you gain much more valuable information in your range of motion evaluations that will greatly improve your treatment strategies. When certain soft-tissue pathologies are present, many joints have a characteristic pattern of limited movement. Each pattern of movement limitation is unique to a particular joint. This movement restriction is caused by dysfunction in the joint capsule. Consequently, it's called the joint's capsular pattern.
Diarthrodial (freely moveable) joints have a space between the two articulating bones. The joint capsule is a fibrous connective tissue that holds the two bones together. It is composed of two different tissues. The outermost layer is a tough connective tissue called the fibrous capsule and is mostly made of ligamentous fibers. Inside the fibrous capsule is another layer of tissue called the synovial membrane (Figure 1). This membrane is responsible for secreting synovial fluid, which helps to lubricate the joint, supply nutrients and remove metabolic wastes from the area.
The fibrous capsule is richly innervated so it can produce a great deal of pain if there is any damage to it. The synovial membrane, however, has very little, if any, innervation and so it is rarely a source of pain. However, any irritation or restriction of the synovial membrane may also affect the fibrous capsule and therefore cause pain. In fact, stretching a fibrously adhered or restricted joint capsule is thought to be the chief cause of pain in osteoarthritis. Damage or dysfunction to the fibrous capsule or synovial membrane is then likely to produce a capsular pattern of motion restriction.
Not all joints have capsular patterns. The pattern appears to be more characteristic of joints with significant range of motion. For example, the sacroiliac joint, which is more of a tight and fibrous articulation with very little movement, does not have a capsular pattern. It makes sense that joints with very limited movement would not have a capsular pattern because it is very difficult to measure range of motion in them anyway. If the pattern of motion restriction in a joint is not the characteristic capsular pattern for that joint, the restriction is referred to as a non-capsular pattern. A non-capsular pattern would exist in a situation where there was joint or soft-tissue pathology but the joint capsule was not the primary tissue at fault.
The shoulder (glenohumeral joint) has the greatest range of motion of any joint in the body. Consequently this is also the joint where the capsular pattern is most important to evaluate, and where capsular pattern evaluations are used most frequently. Capsular patterns are also very important in the shoulder because unlike most other joints where motion is first limited by muscles becoming taut, it is actually the joint capsule that can limit shoulder motion in certain directions before the muscles become fully stretched.
In the shoulder, the capsular pattern dictates that motion restrictions occur first in lateral rotation, then in abduction, and third in medial rotation. In the early stages of a capsular restriction you may only see limitations to external rotation. As the condition progresses, there would be further limitations including abduction and eventually medial rotation. If an individual has a significant limitation to abduction, but no problem with lateral rotation, this would be considered a non-capsular pattern. As a result, this pathology is probably not primarily a joint capsule pathology. A much more likely cause would be some type of external structure causing the movement restriction such as an impingement problem under the acromion process.
Putting The Information To Use
In many cases, massage practitioners are not likely to be treating internal joint pathologies that involve joint capsule damage. However, certain conditions such as adhesive capsulitis (frozen shoulder), directly involve the joint capsule. There are effective massage treatment strategies for adhesive capsulitis, so it will be very helpful to identify if the joint capsule is involved. One of the big advantages of understanding the capsular pattern in this condition is you can continually monitor range of motion in the capsular pattern to measure how successful your treatment is at improving range of motion and reducing the capsular restriction.
Muscles are also a common limiting factor in joint range of motion. Consequently, muscular restrictions could mimic or magnify the capsular pattern of restriction. When performing range of motion evaluations, be sure to consider the musculotendinous unit, as well as ligamentous/capsular restrictions. There are a number of resources that have lists of capsular patterns for specific joints. The resources indicated here have charts or lists of capsular patterns that are very informative.
Click here for more information about Whitney Lowe, LMT.
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