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Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
December, 2011, Vol. 11, Issue 12
Back Pain: Signs and Symptoms of the Iliopsoas Muscle
By David Kent, LMT, NCTMB
Patients come to you concerned about their back pain, looking for answers and relief. The pain started when they tried to get out of bed or reached for the keys that fell onto the floor. Your ability to quickly assess your patient's symptoms and communicate your objective findings can determine if they schedule additional appointments, upgrade services or a treatment package, refer others and in some cases the amount of your tip.(Read "Practice Building: Getting Inside Your Patient's Head" MT, January 2011). The iliopsoas muscle can refer pain into the back that ranges from a mild ache to a severe debilitating level of intense pain. We will explore the signs and symptoms that indicate involvement of the iliopsoas muscle and ways to communicate your findings.
Patients will report pain and difficulty when attempting to stand erect after extended periods of hip flexion after driving or reading, seated at a desk or computer, sleeping in a hip flexed or side lying fetal position. The iliopsaos is the primary flexor of the thigh. So pain is often experienced from the iliopsoas when the patient contracts the muscle to perform hip flexion or a sit up movement when rising from a lying position.
Now, lets look at the function of this muscle from another perspective. When the thigh is in a fixed position, as when weight bearing, the iliopsoas acts as a trunk flexor. This is easily spotted during your postural and gait analysis. Postural analysis photos make it easy to document and educate patients of a shortened iliospoas muscle that is causing them to stand in a hip flexed position, bearing weight on the uninvolved side, while keeping the knee bent on the painful shorten side to shorten and reduce tension on the iliospoas (Image 1). The iliopsoas plays an import roll in maintaining upright posture when standing by preventing hyperextension of the hip joint. (Read "Getting Comfortable With Postural Analysis" MT, July 2008)
The iliopsoas is also active during gait. When the iliopsoas is shortened, patients will walk with a stooped posture, tilting their pelvis forward creating a hyperlordosis of the lumbar spine and limping when bearing weight on the involved side.
Proximally, the psoas major muscle attaches to the 12th thoracic and to all of the lumbar vertebral bodies and the corresponding intervertebral discs and the transverse processes of the lumbar vertebrae. The iliacus attaches proximally to iliac fossa, the sacrum and the anterior sacroiliac ligaments. Distally, the two tendons merge forming the iliopsoas tendon to attach onto the lesser trochanter of the femur. (Image 2)
One simple way to check the length of the iliopsoas is to have the patient sit on the edge to the therapy table, extending the hip of the iliopsoas being assessed, while flexing the opposite hip, bring the opposite knee and thight toward the chest to flatten the back, stabilize the pelvis and avoid creating a hyperlordosis of the lumbar spine. Using a photo, it is easy show the right iliopsoas length appears normal and how the shortened left hamstrings are limiting range of motion, preventing the left knee and thigh from moving closer to the chest. (Image 3)
Myofascial trigger points in the psoas muscle refer pain along the spine ipsilaterally from the lower thoracic to the sacral and upper gluteal regions. (Image 4) Patients will point moving their hand up and down or encircle one side of their back, near the spine. When trigger points are referring from both iliospoas muscles, patients will point moving their hand side to side. Iliacus produces the same back pain as psoas and referrers to the anterior thigh and groin.
While trigger points can arise in the iliopsoas from acute overload, they are usually associated with trigger points in other muscles. It will be important to assess and treat the lumbar paraspinal muscles, quadratus lumborum, tensor faciae latae, pectineus, rectus femoris, rectus abdominus (Read "Back Pain Caused by Rectus Abdominis Trigger Points" MT, June 2009), and the contralateral iliospoas muscle.
While it is easy to identify involvement of the iliopsoas, it is necessary to ruled out any precautions and or contraindications prior to performing any stretching or manual therapy. The iliopsoas is clinically important in relation to the kidneys, ureters, pancreas, appendix, sigmoid colon, lumbar lymph nodes and nerves. A clear understanding of the anatomy and proper hands-on training is necessary prior to treating this muscle. Many patients find yoga be a great way to provide self care for the iliopsoas muscle while lengthening and strengthening their entire body.
The treatment of back pain is common and hopefully easier now that you know many of the signs and symptoms of the iliopsoas muscle. Here are a few other articles I encourage you to read "Iliosacral Pain You Can't Touch" (MT, April 2011), "Back Pain: Often a Pain in the Gluteus Medius" (MT, March 2009), and "Pseudo-Sciatica and Gluteus Minimus Trigger Points" (MT, May 2011).
Click here for more information about David Kent, LMT, NCTMB.
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