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Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
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!
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.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
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.
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.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
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.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
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.
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.
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.
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.
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.
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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