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Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
August, 2013, Vol. 13, Issue 08
The Theory of Orthopedic Massage, Part 1
By Ben Benjamin, PhD
Orthopedic massage is an extension of orthopedic medicine, a field that originated in the early 20th century with the work of Dr. James Cyriax. Dr. Cyriax developed a system of precise methods for assessing and treating soft-tissue injuries that do not require surgery.The term orthopedic massage was first coined by Whitney Lowe, a leading massage therapy educator (and Massage Today columnist). This modality has several distinguishing features that set it apart from other forms of massage. They fall into three major categories: theory, assessment and treatment. Here, we'll focus on the theory, and in part 2, I'll cover assessment and treatment.
To practice orthopedic massage effectively, therapists must possess a thorough background understanding of anatomy, physiology, kinesiology and body mechanics. They must also understand a variety of additional core concepts, including five I'll discuss here: adhesive scar tissue, myofascial restrictions, ligament laxity, direct vs. indirect causes of pain and referred pain.
Adhesive Scar Tissue
Many people don't realize that the cause of most chronic pain in muscles, tendons, ligaments, fascia and joints is the poor healing and repeated tearing of adhesive scar tissue. A little bit of scar tissue, located in the right places, is a normal part of healing. It acts as the glue holding torn fibers together. But when tissues heal by forming a random, jumbled matrix of adhesions, constant re-tearing and pain usually follow.
When we use an injured part of the body and experience pain, it is often a sign that we are re-tearing malformed scar tissue, which then stimulates the formation of additional scar tissue. The secret of effective therapeutic treatment is breaking this cycle of tearing and re-tearing. In addition to removing any adhesive scar tissue that has already formed, we must prevent the formation of future adhesions by ensuring that healing takes place in the presence of a full range of movement.
Every cell, every muscle spindle, every muscle, every tendon and every ligament is wrapped in fascia. Myofascial restrictions result from every injury, as well as from poor posture or movement habits, and they predispose a person to suffering from more pain and injury problems in the future. Therefore, the ability to identify and effectively treat fascial restrictions is important for any orthopedic massage practitioner.
Ligaments are supposed to be tight in order to hold our bones together in the proper alignment and limit movements in directions that would hurt us. There should be a little bit of flexibility in these structures, but not much. When ligaments are abnormally loose, we lose the integrity of our joints. The bones they hold together rock around and make us unstable, making us more vulnerable to injuries. Ligaments may be lax due to hereditary factors; they may become lax suddenly as the result of an accident; or they may distend slowly over time through poor posture and the stretching of old adhesive scar tissue from previous injuries.
When ligament laxity is due to hereditary factors, a skilled practitioner will advise the client to avoid hyperextending their joints, to work on developing and maintaining good skeletal alignment and posture, and to keep their body physically strong. When the laxity is due to adhesive scar tissue resulting from an accident or injury, the therapist will work to locate this tissue and suggest treatment to eliminate or diminish it so that further injury can be avoided. Such treatment might include friction therapy, myofascial work, stretching, fitness training, massage, injection therapy and so forth.
Direct vs. Indirect Causes of Pain
A comprehensive plan of treatment must address not only the direct cause of a client's pain, but also any indirect causes. Direct causes of pain are physical injuries, such as strained fibers of a tendon, an inflammation of the bursa, a disc compressing a nerve and so on. When you relieve that problem, the pain disappears. Indirect causes of pain are the contributing factors that predisposed the person to become injured. For example, an exaggerated kyphosis in the thoracic spine makes it difficult to raise the arm overhead without some strain; the last 15 degrees of this movement occurs in the thorax. In a person with a thoracic kyphosis, this condition might be an indirect cause of a shoulder tendon strain. Similarly, poor knee and foot alignment in a young athlete might be the indirect cause of a sprained ankle. Simply improving the person's alignment would not make the injury go away; however, following successful treatment of the ankle, it would help prevent future injuries from occurring.
Referred pain is pain felt at a distance from the source — for instance, pain from a neck injury that is felt in the shoulder or all the way from the shoulder to the hand, or pain from a low back injury that is experienced only in the thigh or low leg. We learn from orthopedic medicine that no matter where referred pain originates, it follows four basic guidelines:
Referred pain creates confusion for many healthcare practitioners. However, once you learn about the specific patterns in which particular injuries refer pain, the confusion quickly diminishes. For example, the sacrotuberous ligament in the pelvis refers pain down the back of the thigh and calf and into the heel, the gluteus medius muscle refers pain to the lateral calf, and the TP7 ligament (intertransverse ligament at C7) refers pain down one side of the lower neck to the medial border of the scapula.
Together, these five core principles guide both assessment and treatment in an orthopedic massage practice. Stay tuned for my next article, when I'll discuss these topics in detail.
Click here for more information about Ben Benjamin, PhD.
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