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Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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!
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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