resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
May, 2012, Vol. 12, Issue 05
Exploring the SI Joint
By Whitney Lowe, LMT
Lumbopelvic pain is a common complaint that affects close to three quarters of this country's population. As massage therapists, we have a tendency to look for muscular causes of these pain complaints.However, a narrowed focus of attention on muscular tissues might cause one to miss key components of the client's complaint. The sacroiliac joint can be a frequent source of lumbopelvic pain. This joint is unlike many others in the body and requires a comprehensive understanding of anatomy, biomechanics and related tissues in order to best help people with the numerous disorders that may stem from dysfunctional joint mechanics.
The first place to begin in a detailed exploration of the sacroiliac joint is its anatomical structure. Most joints in the body consist of two smooth articular surfaces that are designed to glide against each other throughout a full range of motion. This is not the case at the sacroiliac joint. The articulating surfaces between the sacrum and the Ilium are more of a rough, irregular surface (Figure 1). They are designed to fit together like puzzle pieces with the irregular surface of each side matching up so it can provide greater stability. Unfortunately, when these irregular surfaces don't align correctly, which is the case with sacroiliac joint dysfunction, it can be very painful and produce serious dysfunctional mechanics.
The next prominent aspect of sacroiliac joint anatomy is the extensive webbing of ligamentous structures that surrounds the joint (Figures 2 and 3). This extensive ligamentous complex clues us in to key biomechanical aspects of the joint. Because this joint is so tightly bound by ligaments, very little motion can occur at the joint. The ligamentous mesh is primarily designed to help transfer weight from the upper torso to the pelvis, and yet allow a slight degree of mobility at that juncture. The key stabilizing ligaments in this region include: the anterior sacroiliac ligament complex, the posterior sacroiliac ligaments, and the sacrotuberous, sacrospinous and iliolumbar ligaments.
One of the more interesting facets of anatomical structure at the sacroiliac joint relates to the muscles which span the joint. In most regions of the body, motion at a joint is governed by muscles which attach to each of the bones of that joint. That is not the case in the sacroiliac joint. There are no muscles that span directly from the sacrum to the ilium. There are numerous muscles which cross the sacroiliac joint, but they cross other joints as well. Consequently, addressing sacroiliac dysfunction by treating muscles in this region requires a much greater understanding of the role muscles play immediately around this joint, as well as in distant areas. The role of related tissues and fascial connections will become increasingly apparent after looking at some aspects of this joint's biomechanics.
At first glance it would appear as if the sacrum is tightly wedged between the left and right innominate bones. The innominate is the combined ilium, ischium and pubis on each side. However, if the sacrum were tightly wedged between these two bones it would be difficult, as well as painful, for motion to occur due to the very high levels of friction. Instead, the extensive webbing of ligament structures around the joint acts more like a sling to hold the sacrum suspended in this joint and allows a very slight degree of motion while maintaining extensive stability.
The slight degree of motion capable at the sacroiliac joint is a forward and backward tipping of the sacrum in relation to the innominate bones. Forward tipping of the sacrum is called nutation, where backward tipping of the sacrum is called counternutation. Nutation and counternutation are necessary for minor movement between each innominate and the sacrum. During a walking or running stride one hip is in flexion while the other is in extension. The opposing motions of each side of the pelvis require some degree of slight movement with the sacroiliac joint articulation on each side. If these small degrees of movement are not available, significant alterations in joint mechanics occur and can produce serious pain.
Various postural distortions can cause alignment problems at the sacroiliac joint on each side. Lateral pelvic tilts, as well as anterior and posterior pelvic rotations can each produce numerous detrimental biomechanical problems at the sacroiliac joint. These composite movement problems can produce low back pain, as well as radiating pain down the lower extremity. It might be tempting to suspect that low back pain that also extends down the lower extremity is resulting from a neurological disorder at the nerve root level, when in fact it could be a sacroiliac joint disorder instead. Treatment aimed at lumbar nerve roots or intervertebral discs would likely be ineffective in this scenario.
Role of Massage in Treating SI Joint Dysfunction
Sacroiliac joint disorders routinely cause pain and disability. Massage practitioners don't always think about joint dysfunction as a primary need for massage because the emphasis in most massage treatments is so closely aligned to working on muscles. However, practitioners should remember that numerous soft tissues spanning the sacroiliac joint, both close by and in remote regions, can have significant effects on joint mechanics, giving a valuable rationale for massage therapy treatment.
A great example for understanding the crucial role of massage is simply to look at the many fascial connections that exist in this region. There are fascial connections between the hamstring muscles and the sacrotuberous ligament. Consequently, excess tension in the hamstrings could be transmitted through the sacrotuberous ligament and give adverse pulling force on the sacrum, causing joint dysfunction. There are similar fascial connections between the erector spinae muscles and the posterior sacroiliac ligament complex. Chronic tightness in the lumbar extensor muscles can then be transmitted directly to the sacrum, altering sacroiliac joint mechanics and contributing to pain. Massage treatment of these spinal extensor muscles could be a key factor in normalizing dysfunctional joint mechanics.
There are also fascial connections between the gluteus maximus and the sacrotuberous ligament. The gluteus maximus also has fascial continuity with the lower lumbodorsal fascia which blends into the latissimus dorsi. All of these fascial connections could have beneficial or detrimental effects on sacroiliac joint mechanics. With the numerous fascial connections in this region, it is clear that massage therapy treatment of these soft tissues can play a key role in maintaining optimal joint mechanics of the sacroiliac joint. Yet, without a solid grounding in the complex anatomy and biomechanics in this region it may be difficult to achieve proper interventions.
Movement specialists are still developing working models that accurately convey the complex anatomical and biomechanical relationships in this region. Yet we now understand much more about sacroiliac joint mechanics than we did just a short time ago. The massage therapist who has a better understanding of the joint structure and function along with numerous fascial connections in this region will be so much more effective in helping clients who suffer from these common complaints.
Click here for more information about Whitney Lowe, LMT.
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