resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
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!
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
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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