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Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
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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