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Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
April, 2012, Vol. 12, Issue 04
Healing Touch: Using Massage to Break the Cycle of Abuse
By Tina Allen, LMT, CPMMT, CPMT, CIMT
"You're an idiot! Why did you do that?" Smack, whack, slam . . . does this sounds like any way you would treat a child? Well, unfortunately, this is the reality for many children throughout the United States.Abuse is found in many homes, kept a secret behind closed doors. Whether they are first hand recipients of physical touch, being yelled at or witnessing the abuse of another, the effects are deep and long felt.
Rate of Child Abuse
In the U.S., there has been an increase in child abuse. The nation's economic concerns during the recent recession have not only brought hardship to many families, but the accompanying stress may also lead to an increase in physical child abuse. Scientific research and anecdotal reports have long shown that economic hardship leads to an increase in the incidence of abuse. According to information presented at the annual meeting of the American Academy of Pediatrics, there has been an increase in shaken baby syndrome for children under the age of five.
To better understand the link between economic hardship and abuse, a team of medical researchers from Children's Hospital Pittsburgh reviewed medical records of children under age 5 with abusive head trauma. The research consisted of 422 children who lived in 74 counties across four states (Washington, Pennsylvania, Ohio and Kentucky) spanning the years from 2004 to 2009. The first four years of the study preceded the recession and the last 19 months coincided with it. The study found that about 65 abusive head trauma cases occurred each year before the recession, compared to about 108 annually during the recession. The average age of children with the injury was 8.9 months; most suffered brain damage and 69 children died, though the death rate didn't appear to rise during the recession. This documentation showed that cases rose 65% with about nine per 100,000 children in pre-recession years, to almost 15 per 100,000 kids during the recession.
In January, the Centers for Disease Control and Prevention released its annual vital statistics report, and upon its release, news headlines ran celebrating that, for the first time in more than 45 years, homicide was not a leading cause of death in the U.S. Unfortunately, this wasn't the case for young children. According to the preliminary data report, assault was the third leading cause of death for children 1 to 4 years old in 2010. That means that nearly 370 of the approximately 4,300 children that died in the U.S. during 2010, died at the hands of another person. These results are heartbreaking, and present an opportunity for us to analyze how we can play a part in breaking the cycle.
Understanding Abuse Factors
In order to have a better understanding of how massage and nurturing touch can play a part in making a difference, we must first look at factors that contribute to this growing issue. There are specific risk factors associated with being a victim. According to the Centers for Disease Control and Prevention, factors include being a child under the age of four years old and having specific special health care needs that might cause an increased burden on caregivers. Children with special health care needs, including those with physical and mental differences, may even be abused in higher numbers due to the stress the caregivers feel in having to provide extra care.
Just as there are specific factors associated with being victimized, there are also marked characteristics of perpetrators. Often, parents who lack an understanding of a child's needs, child development or lack significant parenting skills might find themselves stressed and unprepared to care for a child. Many parents also possess their own history of abuse and maltreatment. Often times, parents and caregivers repeat what they have learned during their childhood. Substance abuse and/or mental health issues including depression in the family might play a role in abusive behavior. Parental characteristics such as young age, low education, single parenthood, large number of dependent children and low income are also key factors contributing to this issue.
Scientific evidence supports that providing a supportive family environment and social networks contributes to breaking the cycle of child abuse. There are several additional protective factors, however, research is currently ongoing to determine whether the following factors do indeed protect children from abuse and maltreatment. Such factors include providing nurturing parent education and skills, stable family relationships, and caring adults outside of the family who can serve as role models or mentors. Communities can also contribute to childhood abuse prevention when they support parents and take responsibility for preventing abuse.
So, the question is, what do we need to think about as massage practitioners who wish to do our part to ease childhood trauma associated with abuse and provide an opportunity for breaking the cycle. If you are currently working or thinking about working hands-on in pediatric massage therapy, you need to remember to empower the child by using a structured permission process, safe positioning and giving choices. A structured permission process includes explaining the massage in terms the child will understand. Give the child phrases or code words for yes, no and stop. The reason for using a code word is not to reinforce that a child may not say "no," but rather to give them permission to say no without having to say the word "no." Many abused children will have a history of knowing they cannot say no to anything.
Safe positioning is needed to empower the child. It is recommended that you always begin with the child in a sitting up position. This is important, as laying supine feels very vulnerable, while lying prone feels vulnerable and does not provide for the pediatric client to see what is happening to them. Additionally, stay within a safe distance. Do not cross the personal bubble until the child has given you permission to do so. Give the child many choices. Not an overwhelming amount of choices. However, you want to let the child know they are in charge. Remember, they have likely never felt in charge of anything. Feeling out of control and confused does not create the best nurturing environment. It is advisable that you do not give a choice of removing clothing at the first session. This is important, as you want the child to feel safe and secure. Allowing them to keep their clothing on, even shoes and socks, provides for the safest beginning.
Not only should we provide the best environment for the child, whenever possible, we should try to include a parent who is likely also a victim of abuse. Many times, I have provided education on massage for infants and children in shelters for domestically abused women and their children. Education is important. If the parent has also been a victim of abuse, how do they know how to give and receive gentle touch appropriately?
Breaking the Cycle
During one visit at a shelter, I sat on the floor with the mothers and their children. We had a mixed group of mothers with infants, toddlers and children. One little boy, Sam, was six-years-old and sat next to his mother during the class. The director of the shelter had shared with me that Sam was quite an aggressive little boy and would lash out often. Throughout our lesson, Sam refused to have his mother massage him. As we began massage on each body area, we took time and asked permission. Every time mom asked Sam's permission, he said no. He instead asked a teddy bear's permission and would massage the bear. As it came time to massage the face, I had an idea. I suggested Sam ask mom if she would like a massage on her face. He liked this idea and scooted in front of his mom, warmed his hands and asked permission. Sam watched diligently as I demonstrated each massage stroke on my face. He lovingly placed his hands on mom's cheeks and provided gentle strokes. Sam asked her if the massage was too hard. Mom said no, it felt good, as the tears streamed down her cheeks. Together, they shared a special moment I felt privileged to witness.
Throughout the months following our class, I have kept in touch with the shelter director and am very happy to report that Sam has successfully integrated into his new school. He is no longer as aggressive and has made friends very easily. Mom is adapting well to their new life. Both mom and the shelter director have credited our massage time as the intervention that broke the cycle of abuse. The traumatizing effects of abuse might be felt for a very long time. However, using nurturing touch might be one effective tool to help break the cycle and help children to feel loved and valued. Many times it is not only our hands which provide the best care, but rather our hearts and minds sharing the information to empower others to be successful.
Click here for more information about Tina Allen, LMT, CPMMT, CPMT, CIMT.
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