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Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
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!
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.
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.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
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.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
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.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
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.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
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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