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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
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.
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.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
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.
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.
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
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.
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."
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.
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.
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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