resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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."
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
February, 2012, Vol. 12, Issue 02
Giving a Big Thumbs Up for Healthy Thumbs
By Judith DeLany, LMT
The thumb is one of the most practical and necessary implements of the body. It is the first self-comforting tool to be used, often seen thrust into the mouth of a fetus in the womb. Throughout life, the thumb is constantly used without conscious thought, making it easy to forget just how vital the thumb is in daily life. That is, until it is injured.
Imagine holding a glass of water without a thumb, or pulling up your pants, writing with a pencil or using a paintbrush. Although those who are thumb-challenged can usually improvise, one can readily experience the difficulties by simply duct-taping the thumbs to the palms for a day.
The thumb pad is richly endowed with sensory receptors and is associated with more brain receptors for receiving information than most other body parts. This makes the thumb a particularly useful palpation tool. While articles abound excluding the use of the thumb in massage, this article offers insights as to how to protect the thumb in order to use it for a lifetime.
Anatomy of the Thumb
The osteo-articular column of the thumb is comprised of five bones – scaphoid, trapezium, first metacarpal and two phalanges. The four joints within the column allow for flexion–extension, abduction–adduction, rotation and circumduction of the thumb. Only a ball and socket joint offers more range than the saddle joint of the thumb, which permits angular motion in almost any plane. Because the thumb is attached more proximally than the fingers, it also offers the hand an inherent architectural advantage, particularly in grasping, opposition and apposition.
In contrast to its profound mobility, the thumb can also be used as a solid structure for compression of myofascial tissues. As a solo instrument, the columnar thumb can statically compress muscle fibers into underlying tissues. In conjunction with the other digits (particularly the index and ring fingers), it can be used to grasp the tissues and to apply pincer compression (like a C-clamp), flat compression (like a clothes pin) and manipulation (the international hand signal for money). Each of these techniques offers ample opportunity to assess the tissues and also a standing opportunity for injury, repetitive strain and subsequent dysfunction of the thumb joints.
While the thumb is undoubtedly a useful tool in massage therapy, it can be misused and abused by poor mechanical habits. Gliding strokes applied with thumbs placed side-by-side (ulnar surfaces touching) project pressure through the osteo-articular column and onto the joint surfaces in a manner that is protective of the ligaments. However, gliding strokes applied with the thumbs touching tip-to-tip produce valgus forces on the thumb joints and can lead to a slow, insidious stretching of the thumb's ulnar ligaments.
Skier's thumb (also known as gamekeeper's thumb) develops due to a sprain or strain of the (usually strong) ulnar collateral ligament of the metacarpophalangeal joint. This may result in instability and weakness of the thumb, painful joints and, ultimately, arthritis and joint deterioration. This type of injury can happen abruptly, such as when falling onto the outstretched hand (particularly if gripping something, like a ski pole), or it can occur over time due to chronic repetitive stretching of the ligament, as occurs with poor biomechanics when performing massage.
Following an abrupt injury, the thumb may swell and be bruised, however, sometimes pain may not occur until a day or two later, or even over a period of weeks. When ligaments are torn, surgical repair may be necessary or treatment might consist of splinting or casting and rest. Exercises might be required to regain range of motion, although it may take weeks or even months for complete range and strength to be restored. This type of injury is usually more tangible than the similar results that occur with a repetitive overstretching of the ligaments through poor habits of use. Nevertheless, their outcomes may be similar, with painful loss of function being the ultimate consequence.
Besides sprains associated with falls and poor thumb mechanics, thumb dysfunction can also stem from hitting with clenched fist, bowling (which can also produce neural damage to the digital nerve from the edge of the hole of the ball) and chronic strains associated with excessive use when texting and playing video games. The following tips may be useful in preventing injury.
Judith DeLany serves as director of NMT Center, writes textbooks for Elsevier Health Sciences, and lectures internationally in the field of neuromuscular therapy. For more information regarding her work, visit www.nmtcenter.com or call toll-free at (866) 571-7942.
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