Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
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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