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Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
November, 2011, Vol. 11, Issue 11
Gastrocnemius: A Cramp in the Calf
By David Kent, LMT, NCTMB
At some point, patients with posterior leg cramping and pain will seek your services. A multitude of factors produce these symptoms, from dehydration, overuse, poor conditioning, muscle fatique, to low levels of potassium, sodium and or carbohydrates.Let's focus on the gastrocnemius muscle, reviewing key points, showing its four myofascial trigger point locations, pain referral patterns and treatment techniques. If the gastrocnemius muscle is the cause of the pain and not properly treated, the pain will become more persistent and intense.
Gastrocnemius is a two-headed muscle that crosses two joints, the knee and ankle. The medial head is slightly larger and longer than the lateral head. The two heads of the gastrocnemius merge to form the inferolateral and inferomedial boundaries of the popliteal fossa. The gastrocnemius, along with soleus, and plantaris comprise the superficial group of muscles in the posterior compartment of the leg. (Image 1) A three headed calf muscle formed by the two-headed gastrocnemius and soleus. This large muscle merges into the calcaneal tendon or achilles tendon. It plantar flexes the ankle joint, raising the heel off the ground against body weight, as when a person is walking or balancing on their toes.
Complaints from myofascial trigger points in the gastrocnemius muscle include: night cramps and might be activated by climbing up steps, steep slopes, running uphill or riding a bicycle with the seat is adjusted too low. Patients with active trigger points may complain of pain while walking in the soft sand of a beach or on a slanted surface. Any of these activities coupled with cold air temperature, might contribute to the development of trigger points in the gastrocnemius. Other factors that might promote the development of trigger points include having the ankle in a cast, wearing clothing that restricts circulation or reclining chairs that reduce blood flow.
While you may know the location of trigger points and their specific pain referral patterns, your patients do not and they will respect the professional level of patient education you are providing. For example, in photo 2, "X" indicates the common location of trigger points within a muscle. When a trigger point is activated during treatment, it will produce referred phenomena (pain, tingling, pressure, etc) which is shown in red. (Image 2) Solid red areas indicate an essential pain zone or area of pain experienced by nearly every patient that had that trigger point activated. The red dots indicate spillover pain zones. These are areas of pain experienced by some, but not all, patients outside of the essential pain zones.
Locations and Patterns
The most common trigger point (TrP ) in the gastrocnemius is TrP 1. It is located just distal to the posterior knee, near the medial border of the medial head. It has a strong referral pattern to the ipsilateral instep with a spillover pattern that extends from the distal posterior thigh, along the medial aspect of the calf to the medial maleolus. The next most common trigger point is TrP 2, which is located slightly more distally then TrP1, in the lateral head and refers mostly in a regional pattern near the trigger point. (Image 3) TrPs 3 and 4 are located just distal to the knee and also refer very regional patterns near the location of the trigger point.
There are numerous techniques for releasing myofascial trigger points. The patient must always be comfortable with your treatment pressure, so communicate before, during and after the session. If during a treatment session, your patient is reflexively contracting muscles, pulling away, holding their breath or cinching their teeth because the therapy hurts, then your pressure should be released immediately. Assume the treatment pressure was too much, discontinue treating the sensitive area and return a few minutes later with less pressure.
Muscle Belly: Patient's knee is flexed. Glide distal to proximal, starting at the calcaneus treating the muscles of solues and gastrocnemius. (Image 4)
Lateral Head: Patient's knee is flexed. Using pincher compression, treat the lateral head. (Image 5)
Medial Head: Patient's knee is flexed. Using pincher compression, treat the lateral head. (Image 6)
Tendon: Shorten the calcaneal tendon. Useing pincher compression, treat the lateral, medial, anterior and posterior aspects of the tendon. (Images 7) Next, flex the knee and ankle slightly to lengthen the achilles tendon. Glide distal to proximal, starting at the calcaneus treating the posterior, lateral and medial aspects of the calcaneal tendon. (Image 8)
Calcaneus: Treat the tendon attachment on the calcaneous. Check for sensitivity first by treating with your fingers. If necessary a pressure bar can be used to assist the treatment of this attachment. (Image 9)
The gastrocnemius can be a "real" cramp in the calf. It can produce a great deal of pain and dysfunction for your patients. Educate your patients of the contributing causes and symptoms of gastrocnemius trigger points.
Click here for more information about David Kent, LMT, NCTMB.
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