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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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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."
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."
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.
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.
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.
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.
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.
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.
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.
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.
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 One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
February, 2012, Vol. 12, Issue 02
Freeing the Heart, Part 2: Equalizing the Pressure
By Dale G. Alexander, LMT, MA, PhD
Cardiovascular disease does not happen overnight. It is a progression that evolves over decades and genetic pre-disposition can accelerate this progression dramatically. That is why we read of so many people in the obituary column dying between the ages of 45 and 65 which is the prime demographic age range of so many of our clients.What is rarely considered is how these progressions toward cardiovascular disease figure into chronic somatic profiles that clients present to us every day and can dramatically affect their quality of life.
Two core principles of the Inside-Out Paradigm assert that the body's two imperatives are to allocate resources (oxygen and nutrition) as equitably as possible to all body tissues and to distribute the strains of physical and emotional stresses across as broad an area as possible. The allocation function is carried out by the blood vessels while the body's intricate reflex arc system governs the distribution of strain thesis. It is my premise that all forms of therapeutic massage and bodywork can positively influence these dynamic relationships.
The names that are given to cardiovascular problems are many and varied. The basic categories concern the heart itself and blood vessels. These terms include: heart attack, stroke, angina pectoris, atherosclerosis, arteriosclerosis and high blood pressure; all pathological progressions are labeled as diseases. I will explore other heart progressions that relate to disruptions in its electric rhythmic activity, infections and congenital pre-dispositions in a separate article.1
In order to de-mystify some of these terms, let's review the contrasting definitions of arteriosclerosis and atherosclerosis since even pronouncing them tangles my tongue. According to the Mayo Clinic, healthy arteries are flexible, strong and elastic. Over time, however, too much pressure in your arteries can make the walls thick and stiff and sometimes restricting blood flow to your organs and tissues. This process is called arteriosclerosis, or hardening of the arteries. Atherosclerosis is a specific type of arteriosclerosis. Atherosclerosis refers to the buildup of fats in and on your artery walls (plaques), which can restrict blood flow. These plaques can also burst, causing a blood clot which can either affect your heart causing a heart attack or, if it reaches the brain, may provoke a stroke.1
Functionally then, the term that I propose which makes the most sense to our orientation as massage therapists is "endothelial health."2 This relates to understanding what happens along the internal walls of arteries as a result of increased pressure and the accumulation of calcium and fatty deposits along their inner vascular tubes. Constant high blood pressure hardens and stiffens the arterial walls and makes them more likely to sluff off plaques. Again, it's a progression of deterioration. Pressure is like the Goldilocks fable... too hard, then, too soft, and finally, ah, just right! Instead of seeing pressure as the enemy, let's resolve to learn how we might assist the body to equalize its internal pressure(s) "between" the body's three great cavities and "within its 60,000 miles of blood vessels."3
In 1987, Dr. Jean Pierre Barral DO, inspired my understanding that the pressure within the thoracic cage needs to be "less" than the pressure of the cranial cavity and within the abdominal-pelvic cavity in order for circulation to maintain a normal homeostatic flow of fluids back to the heart.4 With this perspective, our goal as massage therapists is to increase the pliability of the chest wall, especially around the space of the heart, and to also ease the tensions throughout the thoracic cavity. Let's add two steps to the proposed screening protocol from my last article. First, lift the client's head, memorize its weight. Next, palpate the tension of the abdominal wall.
At the end of any bodywork session, not only do we want the chest to become more distensible, we would also like the head to weigh less and the tension of the abdominal wall to ease. All three markers are reliable indicators in my clinical experience that the pressure between the cavities has equalized to some degree.
Let's review one "inside-out" technique that can jump-start the easing of thoracic pressure. Its effectiveness relies on the loosely organized areolar connective tissue along the posterior margin of the diaphragm muscle. Standing on the right side of your supine client, posteriorly contact the opposite side of the spinous processes, beginning at C7, with your upper hand and placing the palm of your lower hand just below the anterior costal arch. Softly anchor C7 with finger tips in contact with the opposite side of the vertebra then stretch the abdominal tissue inferior and medial toward the belly button. Feel for the connectedness between your hands. Your intention is to stretch the internal tissues within the chest so that at the interface of the diaphragm, the downward and medial stretch gaps the loose connective tissues allowing the thoracic pressure to flow from an area of greater concentration to one with a lower concentration. A diffusion gradient is being manually produced. This same procedure can be repeated along each vertebra from C7 - T12. Yes, do both sides.
This approach is not the whole enchilada, but it consistently primes the pump between the thorax and the abdominal-pelvic cavities. And, this technique allows for a two for one potential effect. This same long lever stretching while anchoring each vertebra creates a potential rocker effect to the vertebral/rib complex which is theorized to hydrate and contribute to mobilizing the posterior thoracic spine. Therefore, is my premise that the progression toward all forms of cardiovascular disease is a backstory lurking behind many chronic somatic problems. It is also my assertion that as massage therapists we can make a real difference in the quality of life for our clients as we aspire to comprehend how the human body really works.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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