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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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%.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
September, 2013, Vol. 13, Issue 09
Rehabilitation Associated with Low Back Pain
By Don McCann, MA, LMT, LMHC, CSETT
Decades of published research on low back pain almost always includes a short leg as part of the functional/structural cause of distortions in the spine and pelvis leading to low back pain.There is much debate over this and no one has provided a universally acceptable answer for this structural imbalance. Various studies evaluate the ilium/sacrum relationship from either a standing position (front, back or side) or lying supine or prone. Consequently, what was already a confusing issue becomes even more confusing, as there is no one standard for this evaluation.
P.J.R. Nichols, DM, specialist in physical medicine and a member of the Royal Air Force states, "the recorded incidence of leg length will depend on the method of assessment and the selection of the subjects. The smaller the unit of measurements, the greater will be the incidents and the larger the unit of measurement the greater will be the agreement between the observers." This raises some very significant questions as to assessment and interpretation as seen in the results of the work of Denslow and Chase in their measurement of leg length discrepancy which found a 66% incidence of short right leg, and in the work of John H. Juhl, DO. who found a 68% incidence of the right leg being short. The difference in the way they are assessed and interpreted makes even these figures questionable. The one constant with the majority of people with low back pain symptoms seems to be that a short leg syndrome is present.
From my 38 years of evaluation and practice, I have noticed that there is an observable anterior/posterior rotation of the iliums which tends to create a functional short leg on the side of the posterior rotation. With this ilium rotation, the sacrum is tipped, creating increased curvatures throughout the spine. We call this the core distortion since the structural core of the body from the pelvis through the spine is distorted in direct correlation to the degree of the rotation of the iliums and tippage of the sacrum.
In this core distortion, the left ilium is rotated anteriorly and the right ilium is rotated posteriorly. This is easily observed when viewed from behind. Also, when viewed from the left side, the ASIS of left ilium is rotated counterclockwise downward and forward and from the right side, the PSIS of the right ilium is rotated counterclockwise downward and back. If using functional kinesiology, the client is supine and asked to raise the right leg 10" off the table. When the right leg is pressed down toward the table, there is significant strength. The same test done with the left leg will show significant weakness, even in a weight lifter who can squat 400 lbs. The rectus femoris is a powerful extensor of the knee but is weak when the hip is flexed along with the other hip flexors. The anterior rotation of the left ilium (flexion) prevents the rectus femoris and the other hip flexors from being functionally strong. This is a consistent finding in clients with the core distortion and is just one of many functional tests that verify the structural imbalance in the pelvis that is a major part of the core distortion found in the body.
The rotation of the iliums creates a long leg/short leg, a tippage of the sacrum and a stretching of the connective tissue between the sacrum and ilium. When moving the iliums back into support using classic manipulation or deep soft tissue therapy there is some improvement, but this improvement will not be maintained when under a weight bearing load because of the stretched ligaments and fascia associated with the sacrum, ilium and the position of the legs. Even after a significant number of treatments, when a client is weight bearing, the iliums will again rotate and the weight bearing separation will reappear along with the tippage of the sacrum. This is extremely important because if the sacrum cannot be level enough to support the spine, the exaggerated curvatures of the spine which put pressure on the discs and cause spasms or contraction of soft tissue cannot be brought into long term balance and support for long term pain relief.
The relationship of the movement of the cranial bones to the rotation of the iliums provides a tool for bringing the structure at the pelvis into weight bearing support. The wings of the sphenoid have a direct relationship to the ASIS of the iliums and the ridge of the occiput relates to the PSIS. When the cranium is moving in its cranial motion of flexion/extension, 8 to 12 cycles per minute, the cranial motion moves off a fulcrum of the SBS where the sphenoid and occiput meet. The wings of the sphenoid and the ridge of the occiput display a distortion in this motion. The left wing of the sphenoid moves easily downward into flexion, but is restricted in going into extension. The right ridge of the occiput moves easily downward into flexion, but is restricted in moving upward into extension. This creates a distortion that is identical to what is happening with the iliums.
The application of the Cranial/Structural Core Distortion Releases (CSCDR) address this imbalance in the cranial motion using specialized soft tissue releases to bring the cranial motion into balance by releasing the soft tissue restrictions that govern the distorted cranial motion. There is an immediate observable improvement in the pelvis where the anterior rotation of the left ilium is lessened and the posterior rotation of the right ilium is lessened. The result is a leveling of the sacrum and an immediate weight bearing support for the spine.
After the CSCDR, I reapply the functional left leg test discussed previously and the left leg will now test strong showing no inherent weakness. This is just one of many tests that show improvement in strength and indicate a balancing of the iliums. The obvious improved balance of the iliums results in a lessening of the leg length difference. The myofascial planes that have been holding the compensation for this core distortion which includes the long leg/short leg start unwinding to the degree that the fascia and other connective tissue can release.
I have been working since 1985 with the CSCDR to bring the pelvis back into weight bearing support and balance and have found these results to not only be consistent with every client, but remarkable in achieving long term recovery. Clients with back pain now have a weight bearing functional structure that supports the pelvis and spine more evenly lessening the curvatures. This results in an immediate reduction in the cause of degenerative disc disease and nearly every spinal condition starts to show improvement.
Using this new paradigm, treatment for low back pain begins with a structural evaluation with the client standing, followed by applied and functional kinesiological evaluation with client supine. Over the years, every client with back pain has tested positive for the core distortion in this initial evaluation. The core distortion is then released with the application of the CSCDR which can take 15 to 45 minutes. After the CSCDR, kinesiology tests show significant strengthening throughout the body as the pelvis moves into balance. When clients stand after the CSCDR they generally report feeling their legs more directly underneath them with more support from the feet all the way up their structure. Measurements taken before and after using a level measuring tool indicates an average of a quarter to a half inch gain in height. Many clients also report a significant reduction in the amount of pain and discomfort.
Once the CSCDR is applied, the body structure begins moving back into balance with support for the sacrum and spine. The myofascial holding patterns start to unwind to the degree they can, but the extent of this unwinding is limited by the complications from injuries and degeneration of discs and joints from imbalances and weaknesses of the core distortion. At this point, specific soft tissue myofascial work is applied to assist the unwinding of the chronically tightened old holding patterns to move the body into maximum balance. This totally changes the way the soft tissue responds to the myofascial work. Instead of resisting and trying to maintain an old pattern it is now actively unwinding into balance and support from the very first session without resisting the myofascial work. Everyone with back pain has a different degree of distortion, degeneration, damage, spasm and pain. Consequently the number of sessions varies, but each individual is treated until the pain disappears and function is restored. Thus, applying the CSCDR before soft tissue therapy initiates the unwinding of the core distortion to provide weight bearing support at the pelvis making the full treatment10 times more effective.
Clients treated with the CSCDR 25 years ago are still maintaining their structural improvements pain free. The weight bearing support that was previously unattainable successfully rehabilitates severe disc herniation, bulging discs, stenosis, spondylolisthesis, spina bifida, scoliosis, sciatica and simple lumbosacral sprain/strain long term. The missing link was not treating the cranial core distortion to bring the sacrum/ilium relationship into weight bearing support. The Cranial/Structural Core Distortion Release technique integrated with specialized myofascial techniques can be used as a basis for bringing long term support to the pelvis. This has opened an exciting new frontier in the effectiveness of treating low back pain with long term results.
Click here for more information about Don McCann, MA, LMT, LMHC, CSETT.
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