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Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
May, 2013, Vol. 13, Issue 05
Technique Synergy: Blending Unique Combinations for Success
By Whitney Lowe, LMT
Specific techniques and modalities are the key tools of our profession. But as any artisan or craftsmen will tell you, each tool is only as good as the person using it. Sometimes, we may look to one specific assessment or treatment technique to give us the key results we are looking for.Yet, in reality, the most effective approach might be a unique combination of different methods—technique synergy.
Synergy can be defined as the interaction of elements that, when combined, produce a total effect that is greater than the sum of the individual elements by themselves. So, how do you know which different techniques to combine together for the greatest effect? The key lies in understanding the physiological effects of your treatment or assessment techniques so you can choose the most effective approach. Let's look at an example of how several different assessment strategies were combined together to produce more effective evaluation methods for identifying carpal tunnel syndrome.
Variation on Common CTS Evaluation Procedures
Carpal tunnel syndrome (CTS) is the most common median nerve pathology. Yet, there are still challenges in recognizing it, especially in the early stages before symptoms are prominent. Nerve evaluation tests need to be more sensitive to identify the problem at different stages of severity. The sensitivity of the test refers to how accurate it is at identifying the problem when it is present. Below are several variations on standard carpal tunnel syndrome assessment tests that make them more sensitive, and consequently more able to identify a problem before it is severe. These descriptions are excerpted from an article originally published in the Journal of Bodywork & Movement Therapies.1
Massage therapists routinely treat clients with carpal tunnel syndrome. Yet, they do not have the high-tech diagnostic procedures like nerve conduction tests available for identifying possible median nerve involvement. Therefore, the reliance on physical examination to support (or replace) findings from nerve conduction studies is very important. When performing any of these procedures, the practitioner should remember that exaggerated neural sensations may be indicative not only of mechanical compression neuropathy, but of a host of disorders that cause increased neural sensitivity. Appropriate contraindications for proper treatment should be carefully weighed after gathering evaluation information.
Phalen's Test is the most common special orthopedic test for evaluating carpal tunnel syndrome. To perform this test, the client presses the back of the hands together so the wrists are flexed close to 900 (Figure 1). If the sensory symptoms of pain, paresthesia or numbness in the median nerve distribution are reproduced within about 60 seconds, the test is considered positive for median nerve compression in the carpal tunnel.
When this test is performed, the wrist is in flexion, which decreases tension on the median nerve. If there is increased tension on the median nerve, there is a greater degree of sensitivity in the evaluation procedure and it could therefore pick up less severe conditions.2 Greater sensitivity would therefore result if the wrist was held in flexion (Phalen's test position) while the upper extremity was held in a position that increases neural tension on the remainder of the median nerve. An upper extremity position that would increase tensile stress on the median nerve, while compressing it at the carpal tunnel region, would include lateral flexion of the neck to the opposite side, shoulder abduction, elbow extension, and wrist flexion (Figure 2). This test would be performed unilaterally, unlike the standard Phalen's test, which is performed on both sides at the same time. Make sure the cervical region is laterally flexed away from the side that is being tested.
Another relatively new evaluation procedure that has demonstrated greater accuracy than the Phalen's test is the hand elevation test. In this procedure the client holds the hand as high as comfortably possible overhead (Figure 3). If neurological symptoms in the median nerve distribution of the hand are reproduced within one minute, the test is considered positive.3 Neural tension in the median nerve could be added to the hand elevation test to make it more sensitive. With the arm held overhead, the neck is laterally flexed to the opposite side. Additional tension on the median nerve is added by putting the wrist in extension (Figure 4). Another variation would be keeping the wrist in flexion (as in the Phalen's test wrist position).
Increased neural tension is already a component of this test. The wrist is held in extension and supination. While in this position, the index finger is pulled into hyperextension as far as motion allows (Figure 5). The finger movement can be performed by the practitioner or by the client.4 If neurological symptoms are felt within about one minute, the test is considered positive. As with several CTS tests, this test is considered more accurate when combined with other procedures to produce a comprehensive clinical picture.5
The tethered median nerve stress test already involves tension on the median nerve at the wrist. Additional neural tension can be added to the proximal upper extremity to make this procedure more sensitive. Positions to add include lateral neck flexion to the opposite side, shoulder abduction, elbow extension and forearm supination. Note that not all of these motions need to be added. In some cases symptoms will be exacerbated with addition of just one position.
Accurate evaluation of soft tissue pathologies is an essential element of effective treatment. No diagnostic procedures have proven to be the gold standard for accurately identifying carpal tunnel syndrome. Electrodiagonstic testing, which is commonly used by medical professionals, has demonstrated limited effectiveness. It is also not available to most manual therapy practitioners. There is, therefore, a need for alternative accurate physical examination procedures for CTS. Common physical examination procedures are not always sensitive enough to identify the pathology when it exists. Some of the variations described in this article could prove to be useful adjunctive evaluation procedures that help the manual therapist gather more precise information about their client's soft-tissue pathology so that appropriate treatment or referral may result. These variations on standard CTS evaluation tests show that applying biomechanical principles to various assessment procedures allows us to combine the different strategies together for more accurate results. And that is the key benefit of technique synergy.
Click here for more information about Whitney Lowe, LMT.
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