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Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
December, 2011, Vol. 11, Issue 12
By Ben Benjamin, PhD
Question: Which assessment test helps you differentiate an injury to the infraspinatus muscle-tendon unit from an injury to the rotator cuff?
Answer: Resisted Lateral Rotation
Resisted lateral rotation is the definitive test for verifying an injury to the infraspinatus muscle-tendon unit. For more refined assessment, and even when the injury is slight, the test can be performed at varying angles. This places more or less stress on the structure you are testing. The strength and flexibility of the infraspinatus muscle varies greatly from person to person. In the average individual, this muscle is fairly weak, but in a tennis player or weight lifter the infraspinatus can be very developed and strong.
You use the infraspinatus muscle-tendon unit fully in backhand motions in tennis, or when swinging a baseball bat or golf club. If it's injured, it often hurts when you do simple tasks such as write, open a door or reach behind you.
The infraspinatus muscle covers the lower portion of the scapula beneath the spine of the scapula, and its tendon attaches to the back of the greater tubercle of the humerus at the posterior upper arm. (Image 1) The infraspinatus muscle-tendon unit is responsible for lateral rotation of the shoulder. The infraspinatus tendon has a very large and broad tendon attachment, about a half-inch wide or more depending upon the size of the person, and a body range of one to two inches long.
Some people may have a minor strain of the infraspinatus tendon that remains barely noticed for years. They may experience slight discomfort when reaching up for something on a high shelf, or back for something toward the back seat of their car. However, when this minor strain does not heal properly, it can set the stage for a more severe injury later. If it starts to hurt when you pull your shirt off overhead, put on your socks, or when you lie on your side to go to sleep, then it means things are getting worse. Often, an infraspinatus tendon injury persists for years, defying all attempts at treatment. It can be a very painful and tenacious injury. If the strain is mild, it can be difficult to assess. But there is a special test that uncovers the injury, even if it is very mild.
Test 1 - Resisted Lateral Rotation (Images 2, 3 and 4)
Have the person stand with their legs at least shoulder-width apart so they feel stable while doing the test. Place one hand on the upper arm, just above the elbow, and press the upper arm into the body to stabilize it. With the person's arm bent at a right angle in front of their body, place your other hand just above their wrist on the dorsal aspect of the client's lower arm. Now ask the client to push laterally toward you while you resist with equal and opposite force. This test is done at 90 degrees to the body.
If that test gives no positive result, you may need the more subtle test which is applied at 30 degrees. In this position, the client's wrist is situated about four inches from the person's navel. Putting the muscle into the stretch as you test it places much more stress on the structure and usually yields a positive result. A positive test means pain is felt, which indicates that the infraspinatus is injured
Click here for more information about Ben Benjamin, PhD.
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