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Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
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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