resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
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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