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Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
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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