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Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
May, 2013, Vol. 13, Issue 05
Soft Tissue Tools Help Post-Natal Calf Pain: A Case Study
By Massage Therapy Foundation Contributor
Contributed By Derek R. Austin, BS, MS, CMT, Sandra K. Anderson, BA, LMT, ABT and April V. Neufeld, BS, LMP, NCTMB
Do you use massage tools in your practice? Do you work with post-natal women? If so, this month's Massage Therapy Foundation (MTF) research column features a case study that might interest you.According to the Massage Therapy Foundation's website (www.massagetherapyfoundation.org) a case study documents a massage therapist's experience with an individual client. Case studies help the practitioner and the massage therapy profession improve communication and critical thinking skills, and they can contribute to future research and clinical practice. If you are a massage therapy student, read on to see how you can enter the MTF Student Case Report Contest.
We all want to save our thumbs and have long, pain-free careers. This month, the MTF is reviewing what could be called massage tool research. It is not a commonly researched topic, so we are highlighting information from the Department of Physical Therapy at Indiana University. In this case study, Amy Bayliss, et al, reported on how instrument-assisted soft tissue mobilization (ISTM) was used to treat a post-natal patient with chronic calf pain.
Musculoskeletal pain is often reported by women at the end of pregnancy and following delivery. While lower back pain is most common in pre-natal women, non-specific lower leg pain is another common symptom reported during pregnancy. Such pain is thought to decline at some point after delivery. However, massage therapists know that this musculoskeletal pain can linger and is often successfully treated with massage. One method is cross-fiber friction (CFF), sometimes known as Cyriax technique. ISTM is based upon the concepts of CFF, applied with a uniquely-shaped instrument.
The patient in this case study was a 35-year-old female who had a two-year history of right mid-calf pain, beginning during the last trimester of her first pregnancy. The calf pain was preceded by severe lower leg edema. On a scale of 1 to 10, the pain was described as a dull ache, rating 2 on the day of examination, 0 at best and 5 on her worst day. Pain with deep palpation was an 8. There were no relieving activities and her symptoms were aggravated by direct pressure on the calf such as crossing her legs, and by activities that created tension in her calf, such as walking up stairs, jogging or strength training. The calf pain limited her activities of daily living, including standing and lifting her 35 pound son.
There were no significant issues with the arteries, veins or nerves, or with the endocrine and gastrointestinal systems. Additionally, the hip, sacroiliac joint and lumbar spine were cleared of dysfunction. An MRI was considered normal, although a dense soft tissue abnormality in the small superficial venous tissue network was noted that corresponded to the patient's pain in the right calf. Range of motion testing was normal. The instruments used by the physical therapist during treatment were those specifically for Graston Technique. The Graston Technique is a form of ISTM combined with a targeted stretching and strengthening program. (Currently, Graston tools are limited to chiropractors, physical therapists and athletic trainers and are restricted from massage therapists.)
The goals of treatment were for the patient to be able to stand for two hours, sit cross-legged and walk up stairs without right calf pain, as she was previously able to do. The patient also wanted to be able to lift 40 pounds from floor to waist without right calf pain so she could lift her child. The patient received nine treatment sessions over eight weeks, consisting of a 5 minute warm-up of brisk walking, 6 to 8 minutes of ISTM on the posterior right calf, standing stretches for gastrocnemius and soleus, eccentric exercise for the right calf and ice for 10 minutes to reduce inflammation.
On reassessment after eight weeks, soft tissue quality of the right calf was considered normal, meaning supple and easily moved. Additionally, her pain was reduced from 8 with deep palpation to 0. Her pain at rest had also improved to 0 and 0 to 1 with activity. Follow-up at one month and four months showed no return of pain. A follow-up MRI was not possible because the patient became pregnant three months after conclusion of treatment.
This study has several notable limitations for immediate application into massage practice including being a case report without experimental or comparison groups; featuring patented tools and techniques requiring specialized training and expense; and excluding any massage techniques such as gliding, kneading or compression, which are commonly used during a massage session.
Additionally, two points represent the gap between the work physical therapists and massage therapists do. First, the term "trigger point" never appears in this case study, even though it could be a possible cause of the tender mass in the patient's calf. Second, the authors write, "One of the consequences of targeted soft tissue mobilization and in particular ISTM is bruising over the site of the soft tissue dysfunction." They include an image of the patient's bruise, clearly visible after a treatment session and a few inches in diameter. Most massage therapists adjust their pressure to avoid bruising clients.
The authors conclude, "ISTM offers a mechanical advantage afforded to the clinician as well as the potential to minimize the clinician's joint stress. […] Allowing the tools to absorb mechanical stress rather than the therapist's hands has the potential to reduce over-use injury to the treating clinician." While the evidence is still preliminary, it points toward the continued use of massage tools. However, as massage therapists cannot practice Graston Technique, the application of this research to massage practice is unfortunately limited. Although alternative massage tools may be as effective, massage therapists should continue to rely on clinical judgment when deciding whether to use massage tools in practice.
To learn more about the effects of massage therapy, review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies. For more information on Graston Technique, see their website.
Are you a massage therapy student with an interesting case of your own? The MTF Student Case Report Contest submission deadline is June 1, 2013. The Massage Therapy Foundation has offered Case Report Contests since 2006 to provide massage and bodywork practitioners and students a way to develop research skills and enhance their ability to provide evidence informed massage to the public. Cash prizes are available to the winners of each contest, contingent on publication of the case report.
Click here for more information about Massage Therapy Foundation Contributor.
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