resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Joint Supplements for Athletes (Part 1)
Maintaining joint health should be a daily focus for athletes. Joint health is a complex issue for everyone, but for athletes it poses a greater concern.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
Connections Worth Making
"If most doctors are like me, [they are] isolated physically and professionally. I do not make the time to connect with other doctors and also a lot of doctors do not want to be connected for a lot of reasons. Dynamic Chiropractic keeps me grounded and connected.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
Leg Length and Pelvic Fixations
A common component of low back pain is sacroiliac joint dysfunction. Signs of SIJ dysfunction can include fixation with reduced range of motion, and localized pain or joint laxity and inflammation.
Online Efforts That Convert Traffic Into Patients
Most chiropractors are using "dinner with the doc," "refer a friend," customer appreciation days, grand openings, health fairs, chamber of commerce meetings, and other networking events to get new patients.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
We Get Letters & E-Mail
We Have Come a Long Way – But There's a Long Way to Go; Grounded and Connected.
The Easy Way to Learn How to Document ICD-10
The 2015 Work Plan for the Office of the Inspector General (OIG) includes a focus on chiropractic services. This means chiropractors can expect to see more audits and reviews in the coming year because private payers pay attention to the OIG's focus as well.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
A New Era of Injury Awareness Means a New Focus on Prevention
Despite a dramatic Super Bowl last month, the National Football League has taken quite a few hits lately concerning player injuries, particularly concussions.
What's Triggering That Point?
An orthopedic friend recently saw a patient of mine. He felt an injection of a trigger point (TP) at the upper trapezius and surrounding areas was necessary, since that was the patient's area of chief complaint and there was a tender, radiating nodule.
February, 2012, Vol. 12, Issue 02
Hip and Thigh Pain: The Tensor Fascia Latae Connection
By David Kent, LMT, NCTMB
Have you ever had a patient with hip and lateral thigh pain that did not respond to your traditional treatment? Would it be helpful to know which muscles to double check that refer pain into the hip and lateral thigh? Are you looking for cost-effective ways to educate patients and set your practice apart from the competition? Keep reading to get some answers to your questions.
Patients will describe referral patterns from myofascial trigger points in the tensor fascia latae muscle, as pain in the hip and down the front side of their thigh (Images 1A and 2).
Other symptoms include tenderness and pain, from the pressure of the patient's own body weight, which prevents them from laying on the effected side. Patients can lay on their opposite side by placing a pillow between their knees. The pillow prevents the tensor fascia latae, and the other hip abductors on the painful side from being lengthened, which can activate trigger points. If both sides are too painful, the patient will sleep on their back with a pillow under their legs or in a reclining chair.
Patients will also report experiencing pain when standing up straight after being in a hip flexed position from activities such as driving, sitting, sleeping in a fetal position or on their back with support under their legs. Movements of the hip, including walking, will also produce pain in the hip and or lateral thigh. They may have received a diagnosis of trochanteric bursitis or iliotibial band friction syndrome.
While you may know the location of trigger points and their specific pain referral patterns, your patients do not. They are in pain and looking to you for answers and relief. It only takes a minute to educate your patients about trigger points and it's a great way to build your practice. Explain to patients that if you press on a trigger point, it will produce a referred phenomena that is typically described as pain, burning, tingling or pressure in a region away from the location of the trigger point.
Charts are great visual educational tools (Images 1 and 3). Show patients how your charts work and what they may expect if you palpate a trigger point. For example, in image 4, "X" indicates the common location of trigger points within the muscle. Solid red areas indicate an essential pain zone or area of pain experienced by every patient that had that trigger point activated during research studies. The red dots indicate spillover pain zones. These are areas of pain experienced by some, but not all, patients outside of the essential pain zones.
Besides the tensor fascia latae, there are numerous other muscles that commonly have trigger points that also refer pain into the hip and lateral thigh. Laminated charts allow you to use a wet-erase marker to circle trigger points that may be involved. This process lets you educate the patient while creating a visual checklist of the muscles you will isolate during the treatment. After the therapy session, you can wipe the chart clean with a little water on a towel (Image 3).
Deep to the tensor fascia latae, the anterior fibers of gluteus minimus can have trigger points (Image 4a). (See "Pseudo-Sciatica and Gluteus Minimus Trigger Points," MT, May 2011). Trigger point 2 (TrP2) in the gluteus medius is positioned just belong the iliac crest, mid way along the crest (Image 5b). (See "Back Pain: Often a Pain in the Gluteus Medius," MT, March 2009). All five of the trigger points in the vastis lateralis can refer pain into the hip, the lateral thigh and lateral knee (Images 6 and 7). Trigger points in the more lateral fibers of quadratus lumborum also refer pain into the hip (Image 8)
The shape of the tensor fascia latae is wide in the middle and tapered on each end (fusiform). It is approximately 15cm (5.9 inches) long. The tensor fascia latae attaches proximally to the anterior superior iliac spine (ASIS) and the anterior part of the external lip of iliac crest. Distally it attaches into the iliotibial tract which continues to attach into the lateral condyle of the tibia (Image 1). These attachment points allow the muscle to abduct, medially rotate and flex the thigh. It also helps to keep the knee extended and to stabilize the trunk on the thigh.
Trigger points and the pain they refer are symptoms, our goal is to treat the causes. Trigger points form for many reasons, from direct trauma during an accident, to poor posture habits and more. Information from the patient history forms, subjective complaints, postural analysis, orthopedic assessments and tests (Ober's), joints range of motion (ROM), length and strength of muscles and palpation exam will guide us to design the most effective treatment plan.
A picture is worth a thousand words and a great way to document posture while educating the patients. Posture photos are simple, cost-effective tools that set your practice apart from your competition and should be included as part the initial treatment or package of treatments.
Just like doctors use x-rays and MRIs to give a report of findings, you can use pictures to show and tell patients how their posture is causing the pain. Simply take postural analysis photos using the camera in your iPhone, smart phone, tablet or iPad and show the obvious distortions to your patients on the screen. Visual aids help patients see how their posture is perpetuating the formation of trigger points and how your treatments can help. No special software is needed, you just take the pictures and look at them. A postural analysis grid chart make it easier for the patient's untrained eyes to see the distortions in the photos (Image 3). (See "Practice Building with Postural Analysis," MT, January 2012 and "Practice Building: Getting Inside Your Patient's Head," MT, January 2011).
Click here for more information about David Kent, LMT, NCTMB.
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