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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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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 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.
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.
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.
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.
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%.
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.
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.
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).
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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).
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.
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.
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.
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.
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.
November, 2012, Vol. 12, Issue 11
Practice Building with Self-Care Tips
By David Kent, LMT, NCTMB
Our patient's lives are affected, on many levels, by their pain. They spend a lot of time and money receiving treatment and are looking for the best return on their investment. Building a successful practice that stands out from your competition includes providing self-care tips.Patients need to know how to care for themselves between treatments. They appreciate, respect and recommend your practice when you deliver useful information that is easy to understand and implement into their daily lives. Here are some suggestions for delivering self-care tips. I have also included links to video clips that discuss these concepts in more detail.
After a cleaning procedure at a dental clinic, the hygienist provides a new toothbrush with samples of toothpaste and floss with patient self-care tips. They explain and demonstrate proper techniques for brushing and flossing (See image 1). The hygienist also stresses that implementing these simple recommendations will prevent costly oral disease, pain and medical procedures. They finish by giving you the samples, collecting payment and scheduling the next appointment. This is a time proven practice-building model in the healthcare profession. (Read "Practice Building: Getting Inside Your Patient's Head," MT, January 2011).
Patients often ask their massage therapist for advice or guidance pertaining to self-care. Just like a dentist or other healthcare provider, you can easily provide cost effective self-care tips. However, you can only make recommendations within your legal scope of practice, so stay current with the laws.
Treatment can be more specific when patients are assessed and educated about their postural patterns, restricted joint range of motion, myofascial trigger points and how they cause pain (see image 2.) Poor posture and improper biomechanics while walking, running or performing any repetitive movement can perpetuate or reestablish a patient's pain. These patterns develop over hours, days, and years from holding in positions that caused some myofascial tissues to habitually stay shortened and others lengthened. Other activities that contributes to poor posture in today's modern world include a lack of physical exercise, being overweight, sleeping on one side or supine with a pillow under the head and knees, sitting the majority of the day while eating, driving, at a desk or computer, watching TV, etc.
With the digital camera built into an iPhone, smart phone, tablet or iPad, you can instantly take postural analysis photos and gait videos. No special software is needed, just the camera built into the device. Zoom-in on photos and show patients their forward head and high shoulder posture (see image 3). Play the gait video, assessing the positions and movements of the lower and upper extremities. This level of education leaves a lasting impression of your ability to quickly identify the musculoskeletal cause of a patient's pain while instantly providing visual evidence of your objective findings and how it supports their subjective complaints. A picture is worth a thousand words so show each patient the myofascial causes of their pain, then explain how your treatments and self-care tips can help. (Read "Practice Building with Postural Analysis," MT, January 2012).
Patients are more likely to implement self-care tips that are simple and easy to make a part of their daily lives at home, work or when traveling. Every patient has unique challenges and they must individualize their own self-care routine. Explain what muscles and joints are being stretched, where they are located and why restoring proper movement helps their symptoms improve. To establish and maintain proper posture, gait and other movements the muscles throughout the body must be able to completely contract, relax and lengthen. The cervical, thoracic and lumbar spine must flex, extend and rotate. The ribs should move with breath and each scapula fully retract, protract, elevate, depress and rotate on the rib cage. All of the joints in the body need to properly move as they are designed.
As a visual aid, I use videos, anatomical models and even a slinky, to help patients understand the movements that take place throughout their vertebral column and rib cage. Next, I show them the movements I perform daily to maintain good postural and normal range of motion in the joints throughout my body. I am able to communicate to my patients with first hand knowledge and experience. I show my patients how I stretch, depending on the environment, sitting on a chair or standing holding onto a desk, table or counter top.
I demonstrate how I use an exercise ball throughout the day to stretch and maintain good range of motion (see images 4a and 4b). I also mention how to select the correct size, safety tips and major differences between the various types on the market.
My schedule is busy and changes frequently. I downloaded a yoga application onto my iPhone and now I have a variety of 20-minute routines with me anytime, anyplace, at home, between treatments or when traveling. I integrate yoga into my self-care routine and share how it helps both physically and mentally.
Patients often do not know how or when to use ice. This is a perfect opportunity to provide self-care tips that are simple, cost effective and set your practice apart from the competition. Review the importance of a towel between the ice pack and skin, indications and contraindications. Create a fact sheet about the use of ice to give to your patients.
For patients with acute soft tissue injures, I show them helpful tips for applying ice. I freeze water in 9-ounce cups to create large ice cubes. I keep them handy in the freezer at the clinic or in a cooler when on out calls. This size allows for application on large or multiple areas.
So the patient can conveniently start ice applications, I send them home with a few 9-ounce ice cubes by placing the ice in a freezer strength (Zip Lock) plastic bag.
Ice is extremely beneficial, but not always a practical option. Many people find topical analgesics helpful for providing relief of their symptoms.
Medical doctors give patients samples of drugs. You can provide samples of topical analgesics. One company will supply you, free of charge, patient education brochures with your name and phone number printed on them with a sample packet of the topical analgesic attached. This is a free way to promote your business. Topical analgesics sell for a fifty percent profit and are great way to increase your income. Place a counter top display case of the product in your treatment room and checkout counter. Also take a counter top display when preforming chair massage or at public events like health fairs.
The economy today does not allow people to miss work or lose income. They need treatment that is cost effective and provides long-term solutions. I hope this article showed you how to take the best from the dental model and redesign it for your practice. Give every patient the gift of knowledge and standout from your competition. Teach them how to care and maintain their bodies to avoid pain and unnecessary emergency treatments. Educate them on posture, gait and self-care tips. Give them a gift bag, just like the dentist, with sample packs of the topical analgesic, ice cups, recommendation sheets and your business card with the date and time of their next treatment. Good luck and I wish you success.
Editor's Note: Check out this exclusive practice building video from David Kent: www.youtube.com/playlist?list=PLVpoWkt4aQvK9mUJNL_OMZ9zEIZqutwC9
Click here for more information about David Kent, LMT, NCTMB.
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