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Building Kidney Yang and Jing
Kidney yang, if we include mingmen fire, is the energy and heat source for the whole body. Jing is the essence of yang, and is stored in the kidney, extraordinary channels, and in the bone marrow, which in TCM also includes the brain.
A Very New Year: It's Time to Track
As we enter 2017, we find "affordable care" is not so affordable for many individuals. They are discovering what employers learned long ago: Health care is expensive – and keeps getting more expensive.
Change on the Horizon? New White House Spells Shift in Health Care Policy
On the morning after Election Day, many in our country were surprised to learn that not only did the Republican nominee win the White House, but also that the House of Representatives and the Senate remain under GOP control.
The Key to Recovery
Starting in the 1970s and developing over a decade of assessment and improvement, the South Bronx's Lincoln Recovery Center staff refined the method of using five basic ear-points, which became the NADA protocol for the treatment of addiction.
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.
What Are Prebiotics – and Why Should You Care? (Part 1)
In previous articles, I spoke about the different kinds of fiber and their effects, and the potential risks of taking probiotics without also consuming prebiotic soluble fiber (PSF) in foods and/or supplements [see August & October 2016 issues].
Case Study of Benign Hand Tremors
Patients without degenerative diseases causing tremors are often given the diagnosis of essential tremors, for which treatment options are limited to lifestyle changes and medications.
Increase Your Practice Income With Retail Products
With only so many hours in a day, there is a cap on the revenue an acupuncturist can generate by way of appointments. Once your appointment book is filled, you can't really add more without burning yourself out.
The Mysterious Divergent Channels
The divergent channels are among the most mysterious entities in all of Chinese medicine. They are rarely mentioned, lacking reference in modern TCM study, and rarely used within popular Chinese medical treatment.
Losing Your Mind? Try Coconut Oil
Alzheimer's disease (AD) is currently the 6th leading cause of death in America according to the CDC. It affects over 5 million Americans and 50 percent of nursing home residents (2014), and is projected to spike to 16 million by 2050.
Top 2017 Health & Fitness Trends
We really did sign up for a career of learning and development. Now that you have built a strong foundation of your manipulation skills, nutrition base, movement assessments and business knowledge, it's time to keep up with the American College of Sports Medicine's 2017 worldwide health and fitness trends.
MD-DC Affiliations Under Fire
I am George P. McAndrews, lawyer for the chiropractors in the Wilk, et al., v AMA, et al., antitrust suit that resulted in an injunction against the AMA and others, banning them from interfering in lawful professional relationships between medical physicians and doctors of chiropractic.
Your Patients With Cancer Need You
It was a chilly Minnesota morning in March 1999 when she asked to speak to me alone. My then-busy chiropractic practice wasn't built for much privacy, but I quickly scooted the 60-some-year-old, white-haired patient to my exam room, as the open adjusting area was buzzing with excitement.
An Education in Stroke Risk and Chiropractic
Dr. Steven Shoshany's ninth appearance on "The Dr. Oz Show" may prove to be his most significant, as he addressed questions related to the death of Katie May, who suffered two strokes in February 2016, hours after her third visit to a chiropractor for what she described in a Twitter post as a pinched nerve in her neck experienced during a photo shoot days earlier.
Scope of Chiropractic Practice: Time for Change?
The University of Bridgeport, College of Chiropractic Student Government Association sponsored a panel discussion on Oct. 25, 2016.
Acute Locked-Back Syndrome: Cause and Correction
As we all know, occasionally a patient will present with acute-onset low back pain with or without a precipitating incident. A distinguishing feature of the presentation is visible lateral antalgia, both standing and walking.
Scar Reduction With Acupuncture & Microneedling (Part 1)
Applied correctly, modern skin needling techniques can form part of a holistic treatment and incorporate the principles of Chinese medicine.
Clinical Outcomes & Safety for TCHM
The practice of Traditional Chinese Herbal Medicine (TCHM) may appear archaic to those who misunderstand the theories and principals that guide it. In fact, TCHM continues to evolve and new systems are consistently being discovered and applied within the tradition.
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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