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Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
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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