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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.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
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.
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.
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?'
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.
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.
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).
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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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