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Going Shoeless: The Pros & Cons of Barefoot Running
With the subculture of barefoot runners and the products catering to them growing daily, just about every chiropractor has been asked at one point or another about their opinion regarding barefoot running.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Remembering Joe Weider (1920-2013)
With the death of Joe Weider, the world's most famous body-building visionary, crusader, fitness magazine publisher and icon, on March 23, 2013, chiropractic has lost one of its greatest friends and supporters.
A Building Block of Healthy Aging
Coenzyme Q10 has gained enormous attention in recent years, and with good reason —it's the Energizer Bunny of the cellular world.
Are They Finally Fixing Medicare Reimbursement?
Even with federal sequestration cuts taking effect in March, including a 2 percent reduction in Medicare reimbursement to health care providers, hope may be on the horizon in the form of a much-anticipated, perpetually suggested overhaul of Medicare's Sustainable Growth Rate formula, which serves as the basis for determining physician reimbursement.
Correcting Kid Logic in Health Care and Research Design
A recent broadcast on public radio described a fascinating phenomenon known as kid logic.
Research Abstracts From the Journal of Manipulative & Physiological Therapeutics
Effect of Pain Relief on Lumbar Muscle Function and Activation; Effects of Thrust Amplitude and Duration of HVLA Spinal Manipulation; Immediate Effects of Upper Thoracic Manipulation on Cardiovascular Response.
SOAP Notes: It's Time for a Cleaning
I have been planning for some time to write an article about how traditional SOAP notes do not fit chiropractic practice, and the unfairness of holding DCs to a model clearly created for and primarily applicable to medical physicians.
Have a Heart: Say No to Soda
It's not enough that soft drinks and other sugar-sweetened beverages have been linked to cavities and weight gain, among other negative health consequences.
Medicine Presents: A Great Opportunity
The changing nature of health care presents both opportunities and challenges. While we tend to focus on our profession, we can sometimes forget the impact other health care professions can have on us.
Let's face it – patient evaluation takes time. Unless you are really into the diagnostic evaluation game, you probably have found the formal exam protocol tedious if not downright annoying.
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
Why You Should Get to Know the National Vaccine Information Center
Barbara Loe Fisher has been a diligent advocate for providing parents with the information necessary to make informed decisions regarding the usage of vaccinations for their children.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
The Potter's Wheel: Reflections on Practicing in a Technology-Driven World
In my very early years of practice, an older patient named Cora would call me at home, usually late Sunday night after she had consumed an unknown quantity of beer.
Some Thoughts on the TMJ
The temporomandibular joint is an interesting and dynamic articulation that can cause a lot of problems.
Happenings in Our Evolving Profession
Good things seem to be happening for our profession and recent developments show we are all on board. Talking about being on board, this September The Veterans Express-Purple Heart Tour is expected to make its way out of the station.
What the Science Says About Magnesium Stearate
It's often been said that scientific studies can be used to support just about anything. But discoveries are never made one study at a time.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
What They Don't Say Could Hurt You
I have written previously regarding the difficulties of drawing information from patients who are poor historians, forgetful or just plain uncooperative. The thought to revisit the topic occurred recently during preparation for an upcoming seminar.
Chiropractic: The Right Choice for Relieving LBP
"Low back pain (LBP) is a common threat to medicine and a reasonable threat to all national health care systems. ... Reducing ineffective treatments is necessary to decrease the LBP associated costs."
We Get Letters & E-Mail
Patient Perception and the Farce of "Fast Relief"; A Fly in the Ointment; Persecuted for Choosing to Practice Chiropractic.
News in Brief
Controversial Florida PIP Law Under Review; D'Youville Chiro. Students Learning Art of Co-Managing; And the Award Goes To...; F4CP Recognizes Major Contribution by ChiroTouch.
Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
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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