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Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
June, 2013, Vol. 13, Issue 06
Key Nutrients for Maintaining Musculoskeletal Health
By Christopher Oswald, DC, CNS
As a chiropractor, I fully appreciate the amazing potential of manual therapy. Whether that therapy is a chiropractic adjustment, therapeutic massage, or some of the many other effective body work options; people generally have a wonderful response.From time to time though, we all run into an individual who doesn’t respond to our therapy as we would expect. This can be very frustrating as you are providing something to them that you know should be making a big difference, but for some odd reason they just don’t respond and they may think that massage or body work is just not the right option.
In my clinical experience, I have come to realize is that these "non-responders" are the people who need the most help, but the problem is that their body is so malnourished, there is no support for the underlying biochemistry to respond to the exact therapy they need. When their bodies are supported with appropriate nutritional supplementation, the newfound results are, at times, amazing. Think about this for your own health as well.
Nutritional support for musculoskeletal health may target many physiologic functions due to the multifactorial nature of pain, inflammation and tissue abnormality underlying musculoskeletal conditions. Sometimes, optimal support focuses on addressing a unique factor involved in someone’s disease, such as chronic inflammation underpinning rheumatoid arthritis or providing targeted nutrition for joints affected by arthritis. For this article, I will be focusing on a more general approach to musculoskeletal health support that can be beneficial to the majority of your massage clients.
One of the first concepts to consider is generalized support of the tissues. Within my practice, I have noticed that without base nutrition people cannot respond to the more specific therapies. Through the proper application of a high quality multi-vitamin mineral complex, it can be nearly assured that your client will be receiving the proper base nutrition to have an appropriate response to any manual therapies you perform.
Fish oil is another general recommendation that will benefit most of your clients. While research has shown a myriad of positive health benefits, there have also been some fairly specific benefits to overall musculoskeletal health. In regards to fish oils being beneficial for musculoskeletal health, many people understand that they promote an anti-inflammatory effect within the body, but do you really know why and how effective they can be? A study in the Journal of Nutritional Biochemistry from 2010, discusses the endocannabinoid signaling system and its role in musculoskeletal health and osteopenia. This system is activated and suppressed by the balance between omega-6 and omega-3 fatty acids. The standard American diet (SAD) today is extraordinarily high in harmful omega-6 fatty acids and is almost devoid of the healthy omega-3 fatty acids (which are primarily found in fish oil, but can also be found in cod liver oil, krill oil, flax and others). This system has been found to be more active under the presence of high levels of arachidonic acid (omega-6), which will ultimately result in muscle atrophy and osteopenia. The researchers found that when omega-3 and omega-6 fatty acids are balanced, this problem is corrected and healthy muscle development and bone modeling occurs.
Vitamin D supports many functions throughout our bodies, but has some significant effects on musculoskeletal health. People with adequate vitamin D status seem to benefit from a protective effect against muscle weakness and bone fractures. There are a variety of additional nutrients that support the health of the musculoskeletal system. Two which I have come to use quite regularly in practice are bromelain (from pineapple) and proteolytic enzymes, which both have a systemic effect. When used away from food (30 minutes prior to eating or 90 minutes after), the systemic effect is one that helps to break down the exudates that our cells release following any type of injury or insult. Some studies suggest that use can reduce swelling, pain and inflammation. The mechanisms that have been proposed to support this activity include a reduction in PG-E2 production and through the modulation of adhesion molecules and supporting appropriate cytokine balance.
Vitamin C is another nutrient that can be very beneficial in the support of soft tissues throughout the body. This is essential for the adequate formation of collagen and L-carnitine. Collagen is a major component of all of our connective tissues and therefore is an essential component to maintain to ensure the integrity of our musculoskeletal systems. Carnitine is also very essential as it plays a key role in the transport of fatty acids into our mitochondria. Without this nutrient our body would have a very difficult time utilizing our fat stores to produce energy to initiate muscle contraction. Research has found that vitamin C can help to decrease muscle soreness after exercise and speed up our muscles recovery to full strength.
When you successfully combine nutrition and manual therapies (such as massage therapy), the results for your clients can be absolutely amazing. Remember to stay within the limits of your scope of practice for your specific state. Suggest a client might need to see their medical provider or a chiropractor who can counsel them on proper nutrition. Nourishing the bodies of the people that you work with will provide them the extra advantage of having adequate levels of the proper nutrients to ensure an appropriate response to the therapy that you have been providing them.
Christopher Oswald, DC, CNS, is currently in clinical practice in both Wisconsin and Minnesota, as well as a 2007 graduate of Northwestern Health Sciences University. Upon graduating, he started a private practice with a focus on using a functional medicine to approach tissue health, adrenal health, GI health, weight loss, and optimizing sports performance. Along the way Dr. Oswald has learned how to effectively address many of the underlying concerns with chronic health problems with a combination of chiropractic care, lifestyle changes, and specific nutritional protocols. He can be reached at
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