resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
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.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
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 History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
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.
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.
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!
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.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
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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