resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
January, 2013, Vol. 13, Issue 01
Freeing the Heart: The Role of the Autonomic Nervous System
By Dale G. Alexander, LMT, MA, PhD
This series of "Freeing the Heart" has evolved to offer our profession and other touch and movement therapies a conceptual framework for how we may collectively contribute to slowing the progression of cardiovascular disease.These ideas are extrapolations of my clinical experience that have assisted clients with cardiovascular problems and those that present with persistent chronic somatic problems. A descriptive summary of the concepts "Enhancing Central Circulation" is detailed at the end of this article.
From my point of view, the basic problem the human body faces in the aging process is that many variables combine to slow the "return of raw blood products to the heart" in the process of freshly oxygenated blood being reconstituted and delivered to all tissues and cells. Both the "quantity and the timely delivery" on both ends of the vascular system are key functional components of the heart's capacity to contract 100,000x's a day and to send blood efficiently over the estimated 60,000 miles of vessels.1 Obviously, the build up of fats inside the walls of these vessels is a primary component of the resistance to the efficient flow of blood, which I propose happens for most of us, not just some.2
Here is an anatomical interpretation of the progression of cardiovascular disease and I propose that the autonomic nervous system (ANS) has evolved three cards to play in its efforts to offset the inefficient flow of blood back to the heart.
I also propose that most progressions toward pathology will be accompanied by a decrease in the volume of freshly oxygenated blood. Whether it be a chronic somatic dysfunction, chronic illness, cancer or cardiovascular decline, such progressions reflect a compromised capacity for the body to manufacture in a timely manner and to deliver the nutrients, hormones and oxygen so desperately needed to maintain our health, contribute to our vitality and support our capacity to move, dance and sing.
In this theory, the autonomic nervous system has basically three cards to play at its reflexive disposal to keep up with the demands of producing and delivering freshly oxygenated blood. I am further proposing that these typically occur in sequence over the course of one's life. First, The heart works harder, and in some people, the left ventricular muscular wall may become thicker and stiffer and is most often identified as left ventricular hypertrophy. Second, the blood vessels narrow to push the blood through faster which, in many people, is identified as hypertension or high blood pressure. And third, the delivery of freshly oxygenated blood to "all body tissues" is decreased. My premise is that this latter progression is related to many chronic somatic conditions associated with the aging process, including most joint degradations, and might play a role in setting the stage for other illnesses including cancer.
Let's examine the concept of the heart working harder first. This happens when we exercise. It's normal, up to a point. However, if the resistance to the heart's expansion increases and, especially when this happens over a period of years, then the muscular wall of the heart's left ventricle thickens in its attempt to pump more blood. Many factors may contribute to the creation of this condition: internal tensions within the thoracic cage, atheromatous plaques made up of fat and cholesterol, scar tissue, extrinsic myofascial tension, reflexive righting reflexes and emotionally related identity and stress factors combine in my experience to provoke the dual innervation of the heart to strain in its efforts to provide enough push to send the blood throughout the vascular system and back to itself. Again, the time required to complete the loop and in sufficient quantity are the crucial variables that maintain circulatory efficiency.
At a certain point in the thickening of left ventricular wall, the additional effort of the heart actually decreases the amount of the blood being ejected. This is why left ventricular hypertrophy (LVH) is considered a very real risk factor in the progression of cardiovascular disease.3 In my view, increasing the force of the heart's contraction is the first card that the ANS plays as it spans both normal function and the possible progressive stages of dysfunction into pathology.
Considering hypertension and high blood pressure, what I sense has been overlooked is that the 60,000 miles of our human vasculature is principally innervated by the sympathetic division of the ANS as contrasted to the heart's innervation by both the vagus nerves from the brain and the sympathetic nerves from the spinal cord.4 This suggests to me that the narrowing of the vasculature system is the second card that the ANS plays in its reflexive efforts to push and rush blood back to the heart/lung complex in order to keep up with the process of producing freshly oxygenated blood. There appears to be no question that high blood pressure is a significant risk factor in potentially provoking plaque to break free and thereby triggering a heart attack or stroke.5
The third card that the ANS has to play is to prioritize moving the blood back to the heart as it's end goal and, by necessity, sacrificing the delivery of freshly oxygenated blood to some tissues along the way. Might this be reflected in the frequency of chronic somatic dysfunction that increases as we age? Further, this might contribute to the predominance of joint problems including the need for spinal surgeries, hip, knee and shoulder replacements as we age. I speculate that this is an under-recognized variable in the progression of many persistent chronic somatic dysfunctions. The consistent delivery of fresh blood containing its full constituents (oxygen, nutrients and hormones) is necessary to maintain vital human function and the health of all our various tissues.
Defining the problem more clearly often leads to targeting possible solutions. The following is an updated distillation from the previous article, "Enhancing Central Circulation" from the August 2012 issue of Massage Today.
The take away here is for us to turn our attention toward enhancing the central circulation of the human body. In the many and varied ways that touch and movement therapies have evolved and continue to improve their effectiveness, each may contribute their measure. Let us all commit to this direction and seek to assist as many clients as we can.
Author's Note: Many thanks to Annie Dundon, Glenn Gaffney, Katie Truax-Alexander and Dr. Ed Charlton for their editorial support and guidance.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.