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Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
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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