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The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
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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