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The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
July, 2012, Vol. 12, Issue 07
Pelvic Pain from The Adductor Magnus
By David Kent, LMT, NCTMB
Living with pelvic pain is a daily occurrence for many people. It is very unsettling for a patient to have undergone countless medical tests and procedures with no clear source of the pain identified.Myofascial trigger points (TrPs) are one possible cause of pelvic pain. Trigger points 1 and 2 in the adductor magnus refer pain into the pelvic region (Image 2b and c). Let's talk about= the anatomy, trigger point locations, referral patterns and provide a link to an online video clip showing a treatment routine for the adductor magnus with the patient in a side lying position.
The adductor magnus is the largest muscle of the adductor group. It is tripartite, composed of three parts, an adductor minimus part, a middle part and an ischiocondylar or "hamstring" part (Image 1).The fibers of the adductor minimus part run almost horizontal. The fibers of the middle part run at an angle and the fibers of the isciocondylar or third part, run vertical (Image 1). Besides having three parts, the adductor magnus contains an opening.
The word hiatus originates from the latin term, hiare, to stand open. A hiatus is a normal opening in a membrane or other body structure. The adductor hiatus is an opening in the distal attachment of the adductor magnus muscle and is located just superior to the adductor tubercle of the femur (Image 1). As the femoral artery and vein pass through the adductor hiatus, their names change to become the popliteal artery and vein.
Two nerves innervate the adductor magnus muscle. The tibial part of the sciatic nerve supplies the ischiocondylar or "hamstring" part of the adductor magnus. This same nerve also innervates the hamstring muscles. The obturator nerve supplies the adductor minimus and middle parts of the adductor magnus.
Proximally, the adductor magnus attaches on the inferior ramus of the pubis, as well as, the ramus of the ischium and the ischial tuberosity. Distally, it attaches on the back of the femur, from the gluteal tuberousity to the adductor tubercle.
Since the adductor magnus has three parts, each with fibers pulling in differ directions and is innervated by two different nerves, the effects on posture and biomechanics are significant. For example, the middle part can rotate and tilt the pelvis, adduct and flex the thigh. While the ischiocondylar or "hamstring" part extends the pelvis. We will visit these dynamics in a future article. For now we will look at trigger points.
Trigger points can form in the adductor magnus for numerous reasons from physical trauma, activities like hiking, slipping on a wet or icy surface that causes the persons legs to extremely abduct, or from many hours of sitting in a hip flexed position on a plane, in a car or while working at a desk, to name a few.
Trigger point 1 (TrP 1) in the adductor magnus muscle is located at the level of the mid thigh. It refers an essential pain zone into the medial thigh, starting below the inguinal ligament, into the pelvic region, running distally to the medial knee (Image 2a - b), "X" indicating the common location of trigger points within the adductor magnus muscle. Solid red areas indicate an essential pain zone. Red dots indicate spillover pain zones. (Image 2 A-C) Trigger point 2 (TrP2) in the adductor magnus muscle is located proximally. It refers internal pelvic pain. Patients may describe the pain as referring into organs such as the vagina, rectum or bladder.
In addition to adductor magnus, other muscles with documented trigger points that refer into the pelvic region include the obturator internus, piriformis and obliquus internus abdominis, coccygeus and levator ani. Be sure you are properly trained, licensed and operating within your scope of practice prior to performing therapy.
I wish you the best helping patients with pelvic pain. If the cause includes trigger points in the adductor magnus, you now have information to provide a soft tissue solution. Here is a link to an online video clip showing a treatment routine for the adductor magnus with the patient in a side lying position: www.youtube.com/KentHealth.
Click here for more information about David Kent, LMT, NCTMB.
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