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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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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.
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.
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.
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.
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.
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.
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.
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.
February, 2013, Vol. 13, Issue 02
Following a Road Less Traveled
Finding the cause of chronic shoulder pain where you least expect it.
By Debbie Roberts, LMT
What do you think a shoulder injury, breast augmentation, lymphatic system, mammograms and orthopedic assessments have in common? A road less traveled would be the answer.I never dreamed when I added another tool to my tool box of Manual Lymphatic Drainage that it would lead me down a path to help thousands of women and, specifically, my very best friend. The information I am about to relay to you will not only help you be aware in your every day practice, but will hopefully bring about a global warming effect to the importance we can play in a women's life.
The Shoulder Injury
My dear friend is a personal trainer, yoga instructor, egoscue practioner, and a gyrotonics trainer. She is also one of the healthiest people I know, but she was suffering from a should injury that just would not heal. The injury was caused by slipping off of a stability ball while performing a tricep dip. Being a trainer, she immediately iced, took arnica and rested. She went to see her chiropractor and naturopath for additional help and examination. After doing three to four months of exercises for shoulder rehabilitation, she still lacked complete range of motion and there was an ongoing dull, nagging pain.
She began thinking there must be a myofascial component to the injury, so she made an appointment to come see me. I performed ROM and manual muscle testing to the shoulder joint. I found loss of flexion by 10 degrees, loss of external ROM by 20 degrees, a positive impingement sign and some weakness to supraspinatus and infraspinatus (indication of a possible partial tear). Based on these assessments, I suggested making an appointment with an orthopedist, to hopefully get a MRI done so the rehabilitation process has a complete picture and nobody is guessing. This wasn't the route she wanted to take. She wanted to try some soft tissue work first and continue the shoulder rehabilitation exercises. I explained that in four visits or less we would know if massage therapy, combined with her doing her own physical therapy, would help. In two weeks, there was improvement happening with the range of motion, but there was still this dull pain.
Anytime I see a patient, in the back of my mind is always Hilton's Law. Hilton's Law as espoused by John Hilton in a series of medical lectures given in 1860-1862, is the observation that the study of anatomy often finds that a nerve that innervates a joint also tends to innervate the muscles that move the joint and the skin that covers the distal attachments of those muscles. Not ready for the traditional medical route, she sought more chiropractors care. He adjusted the shoulder and rib cage which made her pain increase, reduced her range of motion, and now she had a burning in the sternum. Be sure to read on because it wasn't his technique that was the problem. She was in so much pain from the adjustment that she came back to see me to try to calm down the symptoms and now there was a palpable place along her sternum that was mobile and felt like a piece of calcium. I performed again the orthopedic assessments to determine where we were from the last time I saw her, and this time in addition to loss of external range of motion, there was an audible clicking sound (possible labrum tear). I begged her to go seek out an orthopedist's opinion and possible MRI. She ignored me yet again and another couple of months went by with her still in the same place.
Here is where the breast augmentation comes in. Another symptom appeared in her opposite breast from the shoulder problem. The right breast had begun to sag and take on an odd appearance. This finally forced her into seeking out medical care in the form of a plastic surgeon. He did an ultrasound and found that both breast implants had ruptured and had been leaking for what appeared to be a very a long time. This contributed to the underlying cause of why she could not heal. The surgeon found tremendous calcification in the chest wall underneath her breast, which had to be scrapped in order to add a new implant. If a woman's silicone gel implant ruptures, it might feel less full or flatter, and may bulge where the rupture is. This can be accompanied with pain or tenderness, swelling, numbness, burning or tingling. Her implants had been in for more than 23 years.
He put new implants back in and sent her home to rest. The right breast did fine, but the left breast stayed swollen. After one MLD session, the breast immediately became softer. Her surgeon was impressed and told her to continue the MLD. In the meantime, she went back to work and when I saw her on the next visit, her breast was back to square one swollen and uncomfortable. Red Flag! She also didn't feel well and was experiencing flu-like symptoms and her axillary lymph nodes were swollen and tender to touch. Another Red Flag! Lymphatic overload. Another trip back to the doctor and he had to remove the implant because the underlying tissue was just not healing. She will get the implant eventually, but not until the chest wall has time to heal. I can report finally that without the implant, she is back to her usual good state of health.
What a lymph node does is filter the lymph and fight infection and in which lymphocytes, monocytes and plasma cells are formed. Most lymphatic nodes are clustered in areas such as the mouth, the neck, the lower arm, the axilla and the groin. The lymphatic network and nodes of the breast are especially crucial in the diagnosis and treatment of breast cancer.
The suspected mechanisms of breast-implant rupture are:
What to watch out for and how you can contribute to patient education:
And finally, remember Benjamin Franklin's great quote: "By failing to prepare, you are preparing to fail."
Click here for more information about Debbie Roberts, LMT.
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