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The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Suffering Makes Us Human
It is possible that suffering, instead of being something negative, can be one of the greatest gifts to bring out one's humanity — if we allow it to be.
Building Community: A New Way to Socialize Your Practice
Social Media can seem like a slippery slope when, in fact, it is fairly easy to understand. With social media platforms, you can connect with current and potential new clients, build strong customer loyalty and increase brand awareness.
Create Community and Grow Your Practice
Many healthcare providers are fortunate to enjoy the freedom and independence of owning their own businesses. However, the constant demands can lead to a lonely and isolating experience unless you make an effort to get out of your office.
The 2015 Nobel Prize Shines a Spotlight on TCM Research
Traditional Chinese Medicine continues to make it's presence felt on the world stage as the 2015 Nobel Prize in Physiology or Medicine was jointly awarded to William C. Campbell and Satoshi Omura for their work on combating parasites and YouYou Tu for her discoveries in combating Malaria.
Yo San University Receives $1 Million Gift
Long-time Yo San University supporter Thomas S. Blount recently gave a $1 million dollar gift to the University, it's largest charitable gift to date. Mr. Blount was a retired naval officer, aerospace consultant and philanthropist.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
How to Market to the Medical Profession
The world of health care is changing dramatically. When situations occur that cause expenses to increase, it is time for you to develop strategies that maintain and grow revenue.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Detoxification Demystified and the Crucifers that Help
"Let food be your medicine and medicine be your food," is a quote often attributed to Hippocrates, a philosopher of the 5th century BC.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
When I started to think about what I wanted to do, I toured different schools to choose where to pursue my original chiropractic education.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Are You a Stakeholder?
In today's world many new things are occurring, especially in the world of information technology. With these changes, comes an entire new set of vocabulary words and definitions.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Cold and Flu Season: Expanding the Repertoire
As we move into the winter months, it is important for clinicians to have a solid working knowledge of effective herbal protocols for treating and managing clinical cold and flu presentations.
July, 2013, Vol. 13, Issue 07
Using My Massage Therapy Skills to Help Save a Career
By Debbie Roberts, LMT
I always like to bring you a real case and a real story. I know you, too, will someday probably have that same type of client that needs your help with treatment. This time, I am helping an oral surgeon save his career by saving his hands.When this doctor presented in my office seeking help, he had been looking at surgery on his hands as his only option to save his career. It took him 10 years to complete his degree and 10 years of practicing to almost lose everything he had worked so hard for.
While working with him, it became clear to me that a massage therapist looking to specialize and gain a reputation as the one to seek out for hand dysfunction could have a forever busy practice. Just go to YouTube and look at what small instruments and awkward positions that this profession does on a daily basis. Now, think how many other professions use similar intricate tools. Those professionals need a therapist that can take a no nonsense approach to helping them save the career they have spent so much time and money on to achieve.
Working with hands or feet is very challenging for the massage therapist in terms of how it affects your hands. The work has to be very meticulous and that can be very wearing to your own hands. So I have tried to offer suggestions of how to do treatment in a manner to get the job done and have less wear on you.
He presented with aching hands all the time, he was beginning to lose grip strength, his fingers had become stiff feeling and it was affecting his ability to close his hand, he had bilateral thumb pain and bilateral numbness and tingling in the ring and little finger. He had more thumb pain on the right, but said this was due to the fact that three months ago he was playing with his son and his finger had been abruptly pulled backwards. He also complained of right shoulder pain.
The first thing we want to do is assess or take a screen of the patient. A screen helps you rule out, should they be in your office or do they need other higher medical care. Just a reminder to stay within your scope of practice, a screen is not to be used as diagnoses, it is to be used as a tool to understand movement quality. You are looking at how healthy or dysfunctional is the individual's joint movement. This helps you determine the complex of muscles and fascia to be treated. When taking a screen, you will want to look above and below the joint being questioned. From the screen, you can develop an organized logical approach to treatment and suggestions of home care.
Screen Number One
Rule out cervical involvement by looking at the quality of cervical motion and asking the question throughout the screen: is there pain or no pain? In this case, he has presented with ulnar nerve involvement. Also ask if they feel any referral pain when going through the range of motion. Cervical flexion: they should be able to touch their chin to chest 45 degrees. Cervical extension: 45 degrees with mouth closed. Cervical side bending 20-40 (watch to see if the shoulder rises indicating how tight the trapezius muscle can be). Cervical rotation 70-90 degrees without pain. See reference.
Specific to this case because he had shoulder pain, I also went through all of the shoulder range of motion tests and he had a positive impingement sign. He also had a very stiff neck. We are addressing all of his concerns from the screen, but for this article I have kept the focus on the hand and forearm.
Screen Number Two
Assess their wrist and elbow range of motion. Wrist flexion: 80 degrees. Wrist extension: 70 degrees. Ulnar Deviation: 45 degrees. Radial Deviation 20 degrees. Supination 90 degrees. Pronation 90 degrees. Elbow extension 0 degrees and Elbow flexion 145. See reference.
Screen Number Three
Muscle test wrist flexion, extension, pronation and supination. Muscle test elbow extension and flexion. Muscle test all the ranges of each digit including the thumb. Each finger may flex, extend, abduct and adduct and also circumduct. See reference.
The reason I listed all of the muscles indicates your need to be extremely specific. You want to look at an anatomy book and to the best of your ability treat each and every muscle you see. If you treat fractional inches at a time from the finger tips to the elbow joint, and then from the elbow to the shoulder, slowly along the bone, you won't miss anything. But if you always do an effleurage type of stroke you will miss something. Therapy should be about being specific, not generalized. The hand should not only feel better, but should also have better function. Recheck your range of motion and muscle tests to show the client how much improvement your treatment has made. I mentioned above all the tools I used besides my hands and every few minutes during the session I will trade out and use those tools so I save my own career.
Treatment Tip: I generally follow the thought of contrast first, myofascial second, specific work next, then PNF stretching and repeat. So far, 25 years and still going strong!
So, how is this client doing today? He is doing great and I continue to see him once a week. He has since been able to go back to more intricate work because his body isn't fighting him with pain anymore.
Fun Ring Finger Trivia
Before medical science discovered how the circulatory system functioned, people believed that a vein of blood ran directly from the third finger on the left hand to the heart. Because of the hand-heart connection, they chose the descriptive name vena amoris, Latin name meaning, literally vein of love. Based upon this name, their contemporaries, purported experts in the field of matrimonial etiquette, wrote that it would only be fitting that the wedding ring be worn on this finger.
Click here for more information about Debbie Roberts, LMT.
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