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Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
October, 2013, Vol. 13, Issue 10
The Theory of Orthopedic Massage, Part 2
By Ben Benjamin, PhD
In my previous article published in the August 2013 issue, I introduced the topic of orthopedic massage and explained five core theoretical principles of this modality.This article continues by discussing orthopedic massage assessment and treatment techniques.
The assessment process involves taking a detailed history and then performing a series of physical assessment tests. Each question in the history and each assessment test is designed to give you specific information about the client's condition — such as the possible causes of their injury, the severity of the injury, the specific structure(s) that are injured, any other relevant medical conditions and so forth. The duration of the assessment will vary depending on the area of the body you're testing. For example, for the back, there are 26 tests plus a set of palpations, while for the shoulder there are 12 tests. To yield accurate information, each test must be performed with precision and skill.
Orthopedic assessment tests fall into three major categories:
Following the assessment, the next challenge is determining the appropriate treatment for the client. The goal is to restore full functioning by eliminating any adhesive scar tissue or fascial restrictions, rebuilding strength and either restoring or increasing flexibility. In an orthopedic massage practice, you might use a combination of friction therapy, massage therapy, anatomy trains or some other form of myofascial work, muscle energy techniques, positional release, active release techniques, trigger point therapy, active isolated stretching and strengthening and various other modalities. The technique that I've found to be most effective at removing adhesive scar tissue in the majority of injuries is friction therapy, so I'll briefly describe that method here.
Cross-fiber friction therapy, also known as transverse friction massage, is a very precise form of medical massage developed by Dr. James Cyriax, commonly known as the “father of orthopedic medicine.” It is remarkably effective in treating most muscle, tendon and ligament injuries. Of course, if the injury site is inaccessible to the therapist's fingers, this treatment cannot be applied and another must be chosen.
As I explained in my previous article, when microscopic tears occur in muscles, tendons and ligaments, scar tissue develops to mend the damaged structures. It often forms in a jumbled matrix, so the resulting scar has much less integrity and uniformity of structure than the original tissue it replaces.
Cross-fiber friction massage works by breaking down scar tissue that is preventing proper healing. It also separates ligament-to-bone adhesions and promotes the formation of properly aligned and mobile tissue. In chronic tendon injuries where collagen tissues have degenerated, friction therapy promotes collagen formation. This type of treatment also increases the blood supply to areas that normally have very little circulation. It accomplishes this through a mild, controlled trauma to the injury site.
Of the three main components of orthopedic massage — theory, assessment and treatment — the cornerstone of this approach is the assessment. Unless you know exactly what is causing a client's pain, it's very difficult to relieve that pain. It's also difficult to know why what you do works or doesn't work. I find it very satisfying that after taking a detailed history and doing a physical assessment, I have a really good idea of whether or not what I do can help the person. In cases where my skills will not be helpful, I can provide an immediate referral to a more appropriate professional, without wasting the clients' time and money. In cases where I do offer treatment, I do so with the confidence that I can make a lasting difference.
Click here for more information about Ben Benjamin, PhD.
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