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Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
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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