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News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
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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