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How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
July, 2012, Vol. 12, Issue 07
Do You Ever Wonder: What Technique Should I Use?
By Whitney Lowe, LMT
Open up any trade publication or listing of continuing education courses and you will see a vast array of different techniques you can learn. Many of these technique approaches claim to be new "inventions" and completely revolutionary.While there are clearly novel approaches to bodywork treatment, many of these techniques are simply variations on traditional massage techniques that have been around for a long time. With so many different techniques, it can be really difficult for the practitioner to know which techniques would be best in each unique client treatment. While the lure of advertising claims like "instant results" and "permanent pain relief" may seem attractive, can we really make those kinds of claims and be taken seriously as a health care field at the same time?
Like the carpenter or artist that uses tools to ply their trade, various techniques are at the root of our success in treating our clients. But what's the best technique to get the job done? The answer is clearly that it depends. Many years ago I grappled with this issue and recognized that other massage therapists do as well. To help understand and address this issue, I developed a four-part orthopedic massage system that could act as a framework for the clinical decision-making process of what techniques would be appropriate for different clients in each unique clinical situation. Two of these four component parts are directly related to helping the practitioner make an appropriate treatment decision about which techniques will be best for each unique client presentation.
As the saying goes, "If all you have is a hammer, then everything looks like a nail." This is quite applicable to what we do in massage as well. If you have narrowed your focus to one or two particular treatment techniques, then you may end up taking an ineffective approach and using them on a wide variety of conditions with only limited success. That saying could easily be changed to something like, "If all you have is neuromuscular therapy, everything looks like a trigger point." Very few people practice with that level of exclusivity on just one technique, but you can end up really narrowing your focus if it is not varied enough. Clients present with many types of soft-tissue disorders. In addition, one person's carpal tunnel syndrome can be very different from the next and the treatment approach for one person could be quite wrong for what is needed by someone else.
Another challenge for us if we focus too narrowly on just one or two techniques, is an over-emphasis on our lens of bias; and we all have one. The lens of bias is the way we look at client issues and the most effective way to address them. One of the best illustrations of the lens of bias concept came from an article written by Dan Cherkin and his colleagues in 1994. The article was titled, "Physician Variation in Diagnostic Testing for Low Back Pain. Who You See is What You Get."1 They found variation in the diagnosis of low back disorders depending on the practice and theoretical focus of the physicians; the lens of bias. We look at various pain complaints and treatment strategies differently depending on this lens of bias that is structured by what we have studied and practiced.
Match the Physiology
The second key component of this system is matching the physiology of the tissue injury with the physiological effects of the treatment technique. In order to choose the most appropriate treatment technique, we must understand the specific physiology of the pain or injury complaint. We must understand WHY we do the things we do. That means we also have to understand the physiological effects of our massage techniques. Over the years, I have heard some very interesting (and inaccurate) descriptions and explanations of what certain massage techniques were supposed to be doing (physiologically) to the client. If we base our treatment choices on inaccurate physiology, we may be far less effective. But we could also end up doing something that is detrimental and contraindicated, or even end up hurting the client as a result.
Take a look at how this might play out in a clinical situation. Suppose you have a client that comes in with lateral forearm pain and weakness. After going through an interview with the client, you decide to treat the client with deep friction massage to the proximal wrist extensor tendon attachments at the lateral epicondyle. After several weeks of treatment, the client reports that the condition appears to be getting worse.
You might wonder why the deep friction massage was not working in what seemed to be a classic case of lateral epicondylitis (tennis elbow). Further consideration of the physiology of the injury condition and the physiological effects of the treatment technique suggest what might be wrong. Suppose in your initial evaluation you didn't identify weakness in the wrist extensor muscles and note that the pain at the elbow was mild compared to the way it usually presents with lateral epicondylitis.
The client might actually be experiencing radial nerve entrapment in this region, which is a condition also known as "resistant tennis elbow" because of the way its symptoms mimic tennis elbow. You might be applying deep friction to a nerve entrapment disorder and making it worse. Instead, it would have been more appropriate to have identified the source of the client's disorder as a nerve entrapment problem and consequently your treatment choices would have changed and emphasized methods that would help reduce compression on the radial nerve.
Effective clinical massage is a comprehensive practice and having a systematic method for addressing assessment and treatment is at the root of clinical success. If you begin to pay much more attention to WHY you do the things you do and make sure there is a good physiological rationale for each treatment strategy, you are likely to see much greater success in your client treatments.
Click here for more information about Whitney Lowe, LMT.
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