Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Fish Oil: A Key Component of 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?
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
June, 2012, Vol. 12, Issue 06
Achilles Tendon and Foot Pain Caused by Tibialis Posterior
By David Kent, LMT, NCTMB
When patients report subjective complaints of posterior leg (calf) and sole (bottom) of foot pain when walking or running, especially on uneven surfaces, the symptoms are typically not isolated to one muscle.The tibialis posterior muscle is often involved and is the deepest muscle in the posterior compartment of the leg. Let's review the anatomy, myofascial trigger point location, pain referral patterns and a treatment technique for the tibialis posterior muscle.
The region between the knee and ankle is called the leg, it is divided into three compartments: anterior (front), lateral (side) and posterior (back). The posterior (flexor) compartment is the largest and contains seven muscles, which can be divided into a superficial and deep group. (Photo 1)
The superficial group includes gastrocnemius, soleus and plantaris. The deep group includes tibialis posterior, flexor digitorum longus, flexor hallucis longus, and popliteus. (Photo 1)
The tibialis posterior muscle is positioned between the tibia and fibula. (Photo 2) Medially, it is covered by the flexor digitorum longus muscle and laterally by the flexor hallucis longus muscle. (Photo 3) These muscles influence the ankle and foot joints. The popliteus is also in the deep compartment, however, it affects the knee joint.
The tibialis posterior muscle attaches proximally to the tibia, fibula, adjoining interosseous membrane and the intermuscular septum. (Photo 2)
Distally, the tendon runs behind the medial malleolus to attach on the navicular, the calcaneus, the cuboid, three cuniform and the second through fourth metatarsals. (Photo 2)
When the tibialis posterior contracts, it produces inversion of the foot, with plantar flexion of the ankle joint. If the muscle is weak it contributes to pronation of the foot and a loss of support of the longitudinal arch. (Read Practice Building with Postural Analysis MT, January 2012.)
The fibularis (peronial) longus and bervis are main antagonists to the inversion action of the tibialis posterior.
Patients with myofascial trigger points in the tibialis posterior muscle report calf and foot pain when walking or running. The pain is more intense when walking of running on uneven brick or cobblestone surfaces, as the muscle contracts while producing inversion of the foot and plantar flexion of the ankle joint.
Active myofascial trigger points can typically be located in the proximal third of the tibialis posterior muscle. The referred pain is most intense in the achilles tendon and the sole of the foot. A spillover pain, felt to a lesser degree, is experience in the calf. (Photo 4)
Visual aids such as anatomical models and charts are great patient education tools to demonstrate the muscle layers, trigger point location and pain referral patterns prior to treatment. Show patients how your charts work and what they may expect if you palpate a trigger point. For example, in Photo 5, "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. (Read Getting In Our Patients Head MT, January 2011)
The patient's subjective complaints and your objective findings will determine the appropriate treatment techniques to integrate. Care for yourself while providing quality care for your patients by using proper body mechanics and adjusting the treatment table height accordingly. One goal during treatment is to reduce pain, not create it. Patient comfort should always be considered. Pillows and bolstering systems allow for a wide range of positioning options, with sections that adjust to various angles. Continually confirm with the patient during treatment that treatment pressure is comfortable. (Read Learning to Engage All The Senses MT, March 2012)
Whenever deep muscles require therapy the superficial tissues must first be properly released prior to treating deep structures. There are numerous techniques for treating the tibialis posterior muscle, this article will touch on only one.
Outline of the treatment technique:
Step 1 – First, shorten the superficial gastrocnemius and soleus muscles by positioning the patient prone with support like a bolster under the ankle to create knee flexion and plantar flexion of the foot. Apply oil or cream to posterior leg. (Photo 6)
Step 2 – Superficial Gliding. Start on the medial side of the calf. Using distal to proximal movements, from the ankle to the knee, treat in thumb width strips starting on the medial side and moving to the lateral side gliding over the gastrocnemius and soleus muscles. (Photo 6)
Step 3 – Pincer Compression. Isolate and examine the bellies of the gastrocnemius and soleus utilizing pincer compression. Note, if your hands are slipping on the skin during this step, due to oil of cream on the skin, treat through a tissue or linen. (Photo 7)
Step 4 – Tibia and Fibula attachments. Glide distal to proximal on the posterior aspect of the fibula, then repeat the same on the posterior aspect of the fibula. Caution to avoid the common fibular nerve located between the skin and the fibular head. (Photo 8)
Step 6 – Release distal attachments in the foot. (Photo 10)
Symptoms of pain when walking or running in the calf and foot are typically not isolated to one muscle. The tibialis posterior is the deepest leg muscle and often involved. I hope this article provides you with empowering knowledge that can be applied immediately to your patients.
Click here for more information about David Kent, LMT, NCTMB.
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