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Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
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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