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From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
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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