resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
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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