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Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
November, 2013, Vol. 13, Issue 11
The Sternocleidomastoid Muscle and Cervicogenic Headaches
By David Kent, LMT, NCTMB
There are many types of headaches with a long list of triggers from hormones to food, drinks, sleep deficiency, dehydration, and emotional and physical stress. A cervicogenic headache (CeH) is characterized as unilateral head pain with a cervical source.Symptoms include a dull ache with restricted cervical range of motion. Contributing factors often include poor posture, sedentary lifestyle, prior neck injuries, and improper computer and workplace ergonomics.
While many muscles can be involved in a cervicogenic headache, I want to share information on the sternocleidomastoid muscle and ways to educate clients of its referred pain, as it can directly affect whether the client reschedules, upgrades to a package of treatments or refers friends, family and co-workers.
Physicians, depending on their specialty, can be a great referral source for clients suffering with cervicogenic headaches. Doctors are familiar with myofascial trigger points and referred pain. A cervicoengic headache can also be caused by the bones, discs and or joints in the neck.
Clients rarely report pain in the front of their neck when experiencing a cervicogenic headache unless recently involved in a motor vehicle accident or other physical trauma. Educate clients about the sternocleidomastoid muscle, integrating three learner styles; visual, auditory and kinesthetic.
Take postural analysis photos with your smartphone, iPhone or iPad to show the position of their head and how the sternocleidomastoid muscle is involved. Use skeletal, muscular and trigger-point charts to show the structural and myofascial patterns.
Provide auditory support for each visual by explaining the details in each photo and image. For example, in posture photos, discuss a high shoulder or forward head posture. On trigger-point charts, explain that the "X" indicates the common location of trigger points and the red color indicates the referral areas patients report pain, tension, burning, tingling, numbness and headache (Photos 1-2).
Now, when you palpate (kinesthetic) an active trigger point in the sternocleidomastoid muscle and it refers pain to the patient's head, they realize why and what is taking place. Without pretreatment education, the patient might think you are pressing on a nerve versus treating an active trigger point.
Use intake forms to screen clients and identify contraindications. Watch for procedures like coronary bypass, stints, angioplasty or a carotid endarterectomy, a surgical procedure for cleaning out the carotid artery to restore blood flow to the brain. Other red flags include blood thinners and carotid sinus hypersensitivity (CSH); even if a client states they have previously received massage, I will not proceed without a prescription for treatment from their physician.
Practice palpating and treating the sternocleidomastoid muscle on your own neck. The name of this muscle reveals its attachments to the sternum, clavicle and mastoid process. To palpate the right SCM, begin in a supine position, shorten the muscle by turning your head to the left, lateral flexion of the cervical spine and place support under your head. Practice muscle testing the right sternocleidomastoid by lifting your head from the support and palpating the outline of the muscle. Relax the muscle prior to treatment, by placing your head back on the support and then using pincher compression to treat each division, checking for active trigger points.
In Myofascial Pain and Dysfunction, The Trigger Point Manual, Drs. Travell and Simons documented numerous active trigger points in the sternocleidomastoid muscle. They found the sternal division refers pain into the forehead, behind the eye, the anterior cervical region and can produce throat pain, discomfort or tightness (Photo 1); while active trigger points in the clavicular division can refer pain to the forehead, behind and/or into the ears (Photo 2).
Recently, the Journal of Manipulative and Physiological Therapeutics published a pilot randomized clinical trial titled, "Manual Treatment for Cervicogenic Headache and Active Trigger Points in the Sternocleidomastoid Muscle." The preliminary findings show that manual therapy targeted to active TrPs in the sternocleidomastoid muscle may be effective for reducing headache and neck pain intensity, and increasing motor performance of the deep cervical flexors, pressure pain thresholds (PPT) and active cervical range of motion (CROM) in individuals with CeH showing active trigger points in this muscle. Studies including greater sample sizes and examining long-term effects are needed.
Active trigger points in the sternocleidomastoid muscle may be a contributing factor to a client's cervicogenic headaches. Providing education to the general public, local doctors, healthcare providers and clients is essential to building your practice.
Click here for more information about David Kent, LMT, NCTMB.
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