Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
September, 2013, Vol. 13, Issue 09
Tissue Density Restoration Massage for Plantar Fascitis
By Linda LePelley, RN, NMT
Plantar Fasciitis (PF), is a painful condition of the connective tissue of the bottom of the foot. While its etiology is not well understood, its symptoms are easily recognizable; acute pain upon walking after a period of immobility, which then dissipates, only to return again after extended use.
I have had the opportunity to treat many cases of PF with very good results using Tissue Density Restoration (TDR) Massage, which is based on the theory that there is an elevation of tissue density associated with musculoskeletal pain; and the belief that by restoring the density to normal, pain is relieved and function restored. I approach foot pain by focusing on the painful areas of elevated tissue density (ETD).
All tissues have a normal density and in the incidence of it becoming denser than it should be, it is often accompanied by pain. The etiology of ETD is a matter that I myself, not being a research scientist, can only guess about and hope that one day it is determined, which may provide the path to prevention. Until then, I focus my work on identifying ETD and restoring it to normal density, eradicating the pain in the process.
You will need warm towels, a heating pad, a massage cream with excellent glide, a couple of dry washcloths and a large, pink eraser. Explain to your client that you need them to let you know if their pain level becomes greater than a three on the 1/10 pain scale. You don't want to elicit a pain response that may worsen the condition and there is just no benefit or need to inflict pain. TDR massage takes about 45 minutes per area of concentration to affect a change in density, so if you are working on bilateral PF, you will want to schedule at least an hour and a half.
Prepare the feet for treatment with a warm foot soak, if available, then wrap in warm towels and work over a moderately warm heating pad unless your client is a diabetic, in which case the heating pad should be avoided. The whole point being that you want the feet warm, relaxed and as naturally soft and pliable as they can be. While working on one foot, keep the other wrapped warmly.
Warm massage cream in your hands and apply it to the foot. Massage the entire foot for several minutes to increase circulation and warmth, and especially to soften the tissues, engaging the foot with the full palmar surface of both hands and fingers, pressing and squeezing, moving the tissues of the toes, ball, arch and heel as if you are trying to stroke the surfaces of the underlying bones. Press firmly with the base of your palm into the heel and bottom of the foot, hold that pressure a moment, then release and repeat several times, to encourage circulation into the deepest layers of tissues in the foot. Do the same for each toe, grasping and rolling them so that all sides are manipulated. Take the foot in both hands, grasp the sides and with the joint of the big toe in one hand and the lateral side in the other, gently roll the foot back and forth, encouraging movement between the metatarsals. Once the foot is sufficiently warm, and has become relaxed, begin to look for the areas of ETD. Your clients will be able to direct you, if needed, to the area that is hurting.
As you focus in on the specific spots that are affected (they hurt), you will be able to palpate ridges and areas that are more firm than their surroundings. Areas of ETD can often feel as if a layer of candle wax has been melted over the bones and under the skin. As you continue to massage the entire area, the more normal tissues will soften first, making the areas of ETD more palpable and apparent. They often have a rubbery, "gristly" feel. These are the most tenacious tissues and they take the most effort to restore. This is where the large, pink eraser comes in handy. Use it to press into the firm, rubbery tissue, massaging in small circles. Have your client direct you to the spots that are the most painful and work on them first. You will likely notice that as the areas clear up, the pain shifts to adjacent spots. Every five minutes or so go back to massaging the entire foot for several strokes, and use a dry washcloth to vigorously rub the whole surface of the top and bottom of the foot to stimulate and keep the tissues moving, and maintain overall warmth.
As the affected tissues soften and become more pliable, you will be able to increase the pressure and movement without causing additional pain. If there is a heel spur involved, gently use the eraser to move the tissue around over the spur. It can take quite a bit of time for it to reduce and fade away, but the relief that brings is well worth the effort.
My clients with PF usually need six to eight treatments to clear the problem up, sometimes a few more, and sometimes in just a couple of treatments. By creating diagrams depicting the areas you worked on and cleared, with before and after measurements of the size and locations of dense tissues with descriptions of texture, quality and clients input regarding pain levels, you will have helpful indicators of the progress you have made. They are also the documentation you need to share your results with other members of the health care team.
As you become familiar with the feel of ETD, you will notice additional areas that are affected. Your client will often say they hadn't realized it hurt and sometimes it doesn't hurt at all. If it doesn't hurt, leave it alone for the time being. Make a note of its location after the treatment and suggest to your client that you work on it once the painful areas have been restored as a part of maintenance and to prevent future pain and dysfunction.
Linda LePelley, RN, NMT is a registered nurse and licensed massage therapist with 19 years of clinical massage experience. She developed Tissue Density Restoration (TDR) Massage, an effective treatment for the pain found in hyper-dense tissues. For more information, visit www.MyHealingHands.com.
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