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Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
February, 2013, Vol. 13, Issue 02
CranioSacral Therapy and the Multiple Therapist Approach
By John Matthew Upledger
One of the qualities of CranioSacral Therapy that has always fascinated me is how well the modality lends itself to multiple therapist work. I have watched, as well as experienced, the coming together of two or more therapists as virtually one set of hands, assessing and responding to areas of restriction within a client's body. Through the process I have seen exponential improvements in a person's health.
The approach always reminds me of a concept I learned while working as a waiter in college. The restaurant brought in a wine expert to teach us about the "synergistic" effect of pairing certain foods with different wines. He explained that, while the food and wine were very good individually, when the right ones were combined they were even better.
I like how Sue Cotta, MSPT, CST, describes it in terms of the practice of CST, "In multi-hands work, one plus one equals more than two. More gets accomplished when two therapists treat for one hour than when one therapist treats for two hours." A longtime proponent of the multiple therapist approach, Cotta regularly joins with fellow CST practitioner Susan Steiner OTR/L, CST-D, to work on each others' clients. While they maintain their own practices in separate locations, Steiner in Providence, R.I., and Cotta in Swansea, Mass., they have developed a partnership of sorts, born of more than 20 years each of practicing and teaching CST.
Two of their most challenging cases on which they collaborate are a boy, now 4, with cerebral palsy (Steiner's client) and a girl, now 10, with microcephaly (Cotta's client). For both of these children, life has been a succession of medical and therapeutic interventions; it will be that way throughout their lives. Yet, in the years that each child has received CST, there have been profound breakthroughs — the kind that can't be attributed to anything but CST Cotta says.
Steiner remembers the first time she saw Robbie (name changed). Six months old at the time, he presented with cerebral palsy and severe brain damage due to anoxia resulting from birth trauma. His behavior was characterized largely by screaming and posturing, particularly when placed in a seated position. Just getting him into a car seat to get to the appointment was almost impossible for his frazzled mother.
Assessment showed that Robbie held a restriction, like a whiplash, in his neck. His dural tube was so tight that his hips curled forward and his back arched, causing him to go into spasms. Through the course of the session, Steiner felt Robbie's neck restrictions begin to release and his dural tube to elongate. By the end of the first session, he was able to sit in the car seat without crying. "That was a huge change in quality of life not just for Robbie, but for his mother, too," Steiner said. "Imagine being able for the first time to drive your child around without him screaming."
In the case of Carla (name changed), the challenges to treatment were just as great. Legally blind and fitted with tracheostomy and gastrostomy tubes, the then 2-year-old reacted to her initial sessions in an unexpected way. "She would go upside down almost every session and wanted to stay that way the whole time," Cotta said. Asking the mother about her daughter's birth, Cotta was told that Carla had gotten stuck in the birthing canal. When the delivery actually occurred, she came out so quickly that her clavicle was broken. By going into the upside down posture during sessions, "It was like she wanted to relive her birth except slow it down this time," Cotta said.
CST treatments with both children over the years have been a combination of individual and dual therapist sessions focused largely on their dural tubes and cranial membranes. "To paraphrase Dr. John E. Upledger," Cotta says, "The cranium is like the foundation of a house. If we can get that foundation corrected, it will help the house to be balanced." In other words, "We'll improve the ability of the brain to function (more efficiently)." Over the course of time, both Robbie and Carla have experienced improvements and reached milestones that no one expected.
With Robbie, there is a visible decrease in his tone and pain, and an increase in his ability to sleep and eat. His facial structure has become symmetric and the quality of his skin is much better. His mother described the effect of CST on her son as being "intensely calming" and helping him to "transition from a traumatized, defensive, clenched being into a more relaxed baby, better able to absorb some of the world around him."
Carla, who started with vision of 20/1200 is now at 20/132 and no longer considered legally blind. Doctors are working to reverse the tracheostomy because the tracheomalasia (softening of the trachea) is no longer an issue. She also has seen improvement in the areas of digestion and communication. Just as significant as these physical and functional improvements are the issues that haven't manifested. For example, Carla hasn't developed scoliosis, which doctors expected to happen because of the severity of her diagnosis. Steiner says, "We may never know all the issues that have been prevented because of the cranial work."
Working In Tandem
When working as a part of a multiple therapist team, Steiner and Cotta emphasize that a key to success lies in letting go of ego. Just as in an individual session, the multiple therapist CST experience is about blending and meeting the client where they are. "If both therapists think of themselves as one therapist with four hands, you treat what you find," Cotta says. "Susan and I don't treat independently. Our hands are an extension of the other person's hands."
By working this way, Steiner says, "There is an increased energy and awareness, and more areas of the body can be addressed in one session. Oftentimes, Sue will have the neck and I'll have the sacrum. Sometimes there's a tension involved, and one will have to stabilize while the other mobilizes. We end up being able to treat the entire structure."
Robbie's mom describes the experience from her vantage: "As an observer, the sessions feel like a dance to me. There is an indescribable energy in the room, something that brings about an emotional fluidity, the same way music can strike your soul. The difference between the individual session and the multi-hands session seems to me like the difference between a dancer dancing alone to swinging with a partner. There is a mutual support between the therapists that both broadens the treatment and heightens the awareness of the client."
"Parents who bring their children to CST feel like their children are being touched and seen in a way that is important," Steiner says. "Sometimes we think of CST as helping those who have a pain or want a better quality of life or wellness. These cases show how CST is valuable for anybody with any challenge. When you meet the individual at the place where they are and treat from there, great things can happen."
So whether you are pairing the right wine with dinner or pairing the right therapists for a treatment, the concept that I learned back in my college days holds true. As these cases attest, CranioSacral Therapy and the multiple therapist approach has a synergistic effect.
John Matthew Upledger is the CEO of Upledger Institute International. For 25 years, he has been actively engaged in all aspects of the organization — from education to clinical services. For more information about CranioSacral Therapy and other modalities offered for study through Upledger Institute International go to www.iahe.com.
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