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PCOM Symposium Celebrates 25 Years
Acupuncture and Oriental medicine practitioners and students, as well as providers representing various other health care disciplines, flocked to San Diego's Catamaran Resort Hotel to attend the PCOM Annual Symposium on Oct. 24-27.
Educating the Growing Hispanic Population About the Value of Chiropractic Care
Chiropractic was given the spotlight on the largest and highest-rated Hispanic television network in the U.S., Univision.
German Auricular Acupuncture: Effective For Your Patients
Auricular medicine as developed by Western medical doctors in Europe is a complete modality of diagnosis and treatment. Unlike body acupuncture, auricular acupuncture is treating the central nervous system rather than meridians.
The Lateral Subsystem and Lower Extremity Pain
Human locomotion is an incredible demonstration of muscle activation, timing, sequencing and patterning. The very idea that we can stand upright and put one foot in front of the other to get from point A to point B without falling down is miraculous.
Sports Media Legend Joins the TIPS Team
The Foundation for Chiropractic Progress developed "Athletic TIPS" (Towards Injury Prevention in Sports) in an effort to address the growing concern of sports injuries.
Acupuncture: The Key and Future of High Sports Performance
Acupuncture is commonly utilized in the intervention of pain and has also been gaining popularity in sports medicine. Athletes are treated with acupuncture for the relief of soft tissue injuries such as sprains, muscle strains, and tendonitis.
The Newest Public-Health Epidemic: Sitting Too Much, Moving Too Little
In my last column, I wrote about sitting versus standing at work. ("Sit or Stand? Strategies to Improve Workplace Health and Reduce Disease," Oct. 1 DC) I wrote the article from the perspective of an ergonomist.
Patellofemoral Pain: Fascial and Exercise Treatment
I recently had a male high-school senior come in who was having some patellofemoral pain, as well as some distal iliotibial band (ITB) pain. He had just started end-of-summer training to play high-school football.
Breathing Techniques To Resolve Patient Issues
When a patient of mine who has practiced yoga for nearly 30 years, told me that she was experiencing panic attacks, I was surprised. "After so many years of training, can't you turn them off?" I asked. "I do turn them off, but only temporarily," she replied.
Electric Qigong: An Ancient Therapy Evolves
Recently in a small, dimly lit treatment room in downtown Taipei, Wesley Chen instructed his patient to lie down. A frayed wire, which he wrapped around a small piece of metal, is now plugged in.
Acupuncture In Haiti: Aid that Works
I recently returned from Haiti. So many people ask whether Haiti has recovered since the earthquake of January, 2010. Once you've been to Haiti, you would never ask that question. It doesn't make any sense.
Managing a High Protein Diet
One of the most common clinical presentations in today's clinic is patients following a high protein diet. It seems that every year a new version of a high protein diet appears promising weight loss and physical transformation.
Advancing the Primary Spine Practitioner
A large New York Blue Cross / Blue Shield plan hosted the formal inaugural training program for primary spine practitioners (PSP) on Sept. 28-29, 2013.
Acupuncture Today Continues To See Unprecedented Growth
For the past decade, the profession has seen steady growth in stature with legislators and the general public. The growing presence of the profession has been directly reflected in the growth of our publication.
A Tribute to Richard D. Yennie, DC (1928-2013)
It was with sadness that I read the obituary of Dr. Richard Yennie in the Oct. 20, 2013 Kansas City Star. However, reading it also brought reflection and warm memories, as he was a close family friend of my grandparents, Cleveland College founders Drs. Ruth and C.S. Cleveland Sr.; and my parents, Drs. Mildred and Carl Cleveland Jr.
Unlocking Secrets of the Pelvis (Pt. 3)
In part 1 of this series [Aug. 15 issue], we began to identify the many asymmetries human beings are all born with and detail how these asymmetries, when they become excessive or unchecked, can create a cascade of imbalance in every system of our body, resulting in dysfunction, pain, degeneration and eventually disease.
Continuing Education Showdown: Online Learning vs. In-Person Seminars
Many state TCM and acupuncture regulatory bodies and associations are interfering with the success of their members by limiting the number of continuing education credit hours they can earn online.
21st Century Marketing: Five Ways to Use Social Networks as a Customer-Service Tool
As the popularity of social networks grows among businesses and professionals, customers' expectations about how they will be served through these networks continue to evolve.
Facial Rejuvenation: The Key to Exceptional Results
Acupuncturists make the best detectives. I know this first hand because I'm an acupuncturist and a private investigator and in both professions, there is a need to dig deep to solve the mystery.
We Get Letters & E-Mail
Change: Healthy and Inevitable; Our Scope of Practice Needs to Change; Chiropractic Physicians Deserve to Be Accurately Informed.
50 Million Opportunities
Toca! Tira! Golasso! While you may not recognize these words ("Touch! Shoot! Goal!"), I hear them often.
Does Copper in Your Multivitamin Cause Dementia?
For the past year or more, I have been asked about whether it is safe to take multivitamins with copper because of a fear that is apparently spreading. The fear is that 1-2 mg of copper in multivitamins supposedly causes dementia and/or Alzheimer's disease.
Leaving a Vision of the Future Behind
Jeff Nelson, president / chief executive officer of Northwestern Health Sciences University since April, died suddenly on Oct. 22 as the result of a gunshot wound.
Partnerships Leverage Power for Our Profession
While there are many recognized benefits and advantages to developing partnerships between organizations, the main reason why partnerships are established is relatively simple: There is added value in working together for a common cause or purpose.
Promoting Acupuncture with Acupressure Demonstrations
Dan and his wife Marla were admiring the beautiful bouquet of flowers at our booth at the Business Expo when our receptionist asked him if he knew anyone who had tried acupuncture.
Peer Points: In The Business of Herbs
When it comes to herbs, acupuncturist Cathy Margolin wants her patients and customers to know she is the expert they need. In order to do this, Margolin has studied the marketplace and incorporated key business lessons to build an herbal company that sells and markets herbs to the masses who may be skeptics.
Acupuncture & Substance Abuse Rehabilitation
One of the most rapidly changing areas of healthcare is that of addiction medicine. Advances in brain imaging technology have allowed doctors and scientists to understand addiction, and recovery from addictive disorders, at the level of the individual neuron in the brain.
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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