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Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
August, 2012, Vol. 12, Issue 08
Lymphatic Self Care: Boosting Your Body's Ability to Heal Itself
By Eileen Laird, LMBT, LTC
As massage therapists, we spend our days caring for others and often arrive home too tired to take care of ourselves. What if there was a simple self-care protocol that you could do in 15 minutes, while you lay in bed at night, one that was relaxing as well as healing? Lymph drainage is just such a therapy.The majority of lymph nodes are located on the front of the body, making them easy to reach. It's gentle work, so it doesn't strain over-tired hands and you can cleanse the main lymph nodes in just 15 minutes, which is plausible at the end of a long workday. The results are relaxation, detoxification and healing on many levels. I use this self-care sequence myself and have taught it to both clients and colleagues.
The Effects of Lymph Drainage
By manually stimulating the lymphatic system, you:
So how do these broad changes specifically affect the body? The most famous application for lymph drainage is its effectiveness in treating edema and lymphedema. However, this therapy is profoundly effective for supporting our health overall. The Chikly Health Institute lists more than 100 indications for lymph drainage, from relieving pain to regulating digestion to treating skin conditions. "The curriculum has evolved, since we started," says Dr. Bruno Chikly. "We have seen over 10,000 students and have developed both a lymphedema and non-lymphedema certification." Their training includes applications for organs, joints, trigger points and fascial restrictions.
Isabelle Mender, a massage therapist in Eugene, Ore., gives herself a lymphatic boost seasonally. "During hay fever season, I usually treat myself twice a day. The treatments help to alleviate my sinus congestion, runny, itchy eyes and overall inflammation in my head." David Doubblestein, a Lymph Drainage Therapy Instructor, uses lymphatic self-care to prevent illness and treat injury. "At the first sign of a cold, I do lymph drainage on myself and typically avoid the illness," said Doubblestein. "I've also smashed my fingers more than once. (I admit I'm not the most graceful with tools.) Draining the area gets rid of the pain and throbbing sensation, and quickly too." However, Doubblestein stresses that you don't need to be sick or injured to practice lymphatic self-care. "I personally love the neck sequence anytime. In particular, it's an excellent finish to yoga practice. You can do the neck sequence when you're relaxing in corpse pose, and it puts your body in a parasympathetic state." Mender agrees, "it's a great way to simply chill out!"
Self Care Protocol
The lymph nodes are the powerhouses of the lymphatic system, and you have more than 500, located at pivotal points along your lymphatic vessels. The majority of your lymph nodes are located in the neck, armpits, abdomen and groin. These are the areas we'll be addressing in this simplified self-care protocol. Stimulating the main lymph nodes of the body has a global effect on the lymphatic system, increasing lymph flow body-wide.
Lymph drainage is very different from traditional massage therapy. Here are some things to know:
Step 1: Clavicle (Collarbone)
Hand Placement: Place your fingertips at the base of your neck, on the superior edge of your clavicle. Direction of Stroke: Using the lightest touch possible, stretch your skin medially, toward the sternal notch. This is a slow, three-second stretch. Release your touch completely for three seconds. Repeat four more times.
Step 2: Back Chain (Trapezius)
Hand Placement: Place the pads of your fingers on top of the trapezius muscle at the back of your shoulders. Direction of Stroke: Using the lightest touch possible, stretch your skin in a curving motion, laterally toward your outer shoulders and then slightly forward. Picture a candy cane. The long part of the candy cane is the stretch laterally across your trapezius muscle, then finish the stretch forward, like the hook on a candy cane. The total stretching movement lasts three seconds. Release your touch completely for three seconds, and then repeat four more times.
Step 3: Neck Hug
Hand Placement: Although this photo looks a bit like a choking hold, this hand position is very light, more like a butterfly's wings. Place the pads of your fingers on your sternocleido-mastoid muscles. The rest of your hands shouldn't touch your neck at all. In fact, there should be a gap between your hands and the front of your throat. Direction of Stroke: Using the lightest touch possible, stretch the skin over your SCM muscle directly down (inferior), toward your clavicle. This is a slow, three-second stretch. Release your touch completely for three seconds. Repeat four more times.
Step 4: Spinal Chain
Hand Placement: Place the pads of your fingers along the sides of your neck. Direction of Stroke: Using the lightest touch possible, stretch your skin slightly forward (anterior) and then down (inferior) toward the clavicle. The total stretching movement lasts three seconds. Release your touch completely for three seconds, and then repeat four more times.
Step 5: Waterwheel
Hand Placement: This is a small but very important lymph node area. The entire head and face drain through these nodes. Place the pads of two fingers behind your earlobe. You'll feel a soft spot. That's the waterwheel. Direction of Stroke:
Stretch the skin over the waterwheel directly down (inferior). It's a small area, so the stretching movement will be short – approximately one inch. Stretch for three seconds, release for three seconds, and then repeat four more times.
Rinse the Neck
Now that you've opened up all the lymph nodes of the neck, it's important to encourage free flow back to the clavicle. To do this, repeat the steps in reverse order (4, 3, 2 and 1). Then continue on to step 6 below.
Step 6: Axilla (Armpits)
Hand Placement: Lift your left arm slightly, and place the fingertips of your right hand in the peak of your left axilla (armpit). This is a very important region. The lymph of your arm, breast and part of your torso drain through here.
Direction of Stroke: Gently push inward, toward the center of your body. You are encouraging lymph flow back to your heart. Gently push in for three seconds, release for three seconds, and repeat four more times. Be sure and repeat this process for your opposite arm.
Relax the Abdomen
The next steps treat the lymphatic vessels of the deep abdomen. They are located beneath the abdominal muscles, so it is helpful to relax those muscles first. This can be done through deep belly breathing, or a few minutes of massage, your choice. After you have relaxed your abdomen, continue to step 7.
Step 7: Cisterna Chyli
Hand Placement: Place the pads of your fingertips on the center of your abdomen, between your rib cage and navel. The rest of your hand is lifted off your skin, so that your fingertips are the only part of your hand touching your abdomen.
Direction of Stroke: Gently push inward and upward. The pressure here is a little bit deeper. The rhythm, however, is the same: a three-second stretching movement; release for three seconds; repeat four more times.
Step 8: Abdominal "V"
Hand Placement: Place your hands flat on both sides of your lower abdomen. They'll form the letter, "V." Direction of Stroke: Gently push inward, and then upward on a diagonal, toward the sternum. (The movement is supero-medial.) The movement is a three-second deep stretch; release for three seconds; repeat four more times.
Step 9: Inguinals (Crease of Leg)
Hand Placement: Bend your knee and feel the angle that forms between your leg and pelvis. Place your fingertips on this crease.
Direction of Stroke: The pressure here is very gentle again, because these lymph nodes are just under the skin. Stretch the skin upward (superior). The length of the stretch is short – approximately one inch. Stretch for three seconds; release for three seconds; repeat four more times. Be sure and repeat this process for your opposite leg.
Rinse Back to the Heart
Now that you've opened up all the lymph nodes of the abdomen, it's important to encourage free flow back to the heart. Repeat steps 8, 7 and then finish with step 1.
The same contraindications that apply for massage therapy also apply for lymph drainage. Professional course curriculum goes into these in more detail.
Eileen Laird, LMBT, LTC has been a massage therapist for 10 years and has a private practice specializing in Lymph Drainage Therapy. She is certified through the Chikly Institute in Lymphatic Techniques, which is the holistic branch of their curriculum. She is also the author of two books.
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