Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
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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