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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
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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