resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
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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