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Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
The Life & Legacy of James Sigafoose, DC (1933-2014)
Surrounded by his family and closest friends, Dr. James M. Sigafoose passed away quietly on Thursday, July 3, 2014. With his wife of 60 years, Patsy, along with his children, Tina, Daun, Kieth, Selina and Carey – all chiropractors – at his side.
Decompression-Traction: A Core Treatment Method in Chiropractic's Future
We're all competing for new patients. We're competing for new patients with physical therapists, massage therapists, medical specialists and hospital fitness centers. We're even competing with side-effect-ridden medications that quit working every four hours.
Ringing in a Fiscal New Year With a Recommitment to Cost-Effectiveness
Back when the Foundation for Chiropractic Education and Research was in its heyday, I used to send out New Year's greetings and virtual noisemakers to some close friends on July 1 – the beginning of our new fiscal year – wishing for prosperity in the year ahead.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Building the DC-MD Bridge
From MDs practicing integrative holistic medicine to the family internist, many DCs are enjoying unprecedented attention from their allopathic colleagues.
News in Brief
Oregon Gov. John Kitzhaber (a medical doctor, no less) proclaimed October 2014 "Oregon Chiropractic Health and Wellness Month" in an official proclamation signed Aug. 25, 2014.
Your Patients' Best Health Resource
There is nothing as powerful as information. The right information has won wars, saved lives and changed hearts; lack of information has led to hesitation, poor decisions and unintended consequences.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Detoxification for Athletes: The Key to Winning Performance
One of the most dangerous culprits that affects an athlete's ability to perform at an optimum level also happens to be one of the most elusive.
From the Other Side of the Table
People come to us to gain freedom from pain, to feel better, to live better. As D.D. Palmer stated, "We Chiropractors work with the subtle substance of the soul." Therein also lies the rub.
Take Care of Your Skin: Tips to Pass on to Your Patients
Many of our patients are not aware that the largest organ in the human body is actually the skin. Accounting for 16 percent of total body weight and covering up to 22 square feet of surface area, the skin is more than just a "covering," as originally thought.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Watch Out for Red Herrings
In clinical practice, when one condition mimics another, it makes it difficult to obtain an accurate and timely diagnosis.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Don't Forget About the Performers
Donald Petersen Jr.'s recent article, "Your Chance to Go Back to High School" [May 1, 2014 DC], focused on the injuries incurred by high-school athletes and the subsequent opportunities for the chiropractic profession.
How to Find Your Ideal Patient – and Help Your Ideal Patient Find You
Just imagine: You're at the front desk looking at the scheduler and a smile creeps across your face. Row after row, name after name, hour after hour; you're blessed with an entire day of ideal patients. Every day should be like this, you whisper. Exactly!
February, 2014, Vol. 14, Issue 02
What Does an MRI Tell the Therapist? A Closer Look at Cervical Pain
By Debbie Roberts, LMT
There are more than six million car accidents every year in the United States alone. Worldwide, an estimated 1.2 million people were killed and fifty million injured from a car accident. There is a very big chance you will treat a whiplash injury over the course of your career.It is important not to treat these potentially serious trauma cases blindly. Even if you work in a chiropractic office ask to see their MRI report. The MRI and his prognosis for the case will give you a more precise treatment strategy. This will also help you determine how severe the injury is. You can divide a whiplash prognosis into three categories. Minor whiplash injuries usually resolve within one to two weeks. Moderate whiplash injuries with muscle spasm or ligament strains may take up to four to eight weeks to resolve. Severe whiplash injuries, or those that involve nerve damage or ligament or disc injury to the spine, may result in chronic or permanent disability. These injuries may require more drastic measures to resolve.
How many times has a patient said to you, "I feel like I am crazy?" Massage therapy is sometimes so much more than the physical portion of manual therapy. Massage therapy can be the gap of empathy, education and evaluation between the patient and their physician. Where does the process start? It starts with how well you assess and evaluate the situation. Evaluation takes a level of judgment, necessary to make sense of the clinical findings in order to correlate a relationship between the symptoms and the signs of dysfunction. This kind of thinking takes you away from treating symptom-based massage therapy into cause and affect therapy. Having real tangible evidence helps the therapist decide which techniques are necessary to help the client regain their previous level of health or even a better state of health.
Where is the easiest place to start? Start with the facts and not speculation. If the client has had a MRI, ask them to bring it to their first appointment. If you have never read a MRI report it can look and sound daunting, but it will actually help you make a more sound therapy session. The information this report can lend to you as a therapist is insight into what is really going on with the client. There may be certain range of motion movements you will not want to do with this client knowing their history. Also, now you will have a better idea on what you can expect from your treatment plan.
There are well over 100 types of massage and massage modalities to choose from these days so it is even more important to have a system on which to base the appropriate technique or tool from the tool box. I bring this up to help our community of massage therapists understand that although some techniques such as stretching, elongating fascia and helping with mobilization are good at times, certain directions of movements may not be appropriate after reading the clients MRI report. Holding ourselves accountable for knowing standard orthopedic joint range of motion measurements are critical in making sound stratagem for massage therapy. Just because you learned that a stretch in lateral side bending will lengthen the trapezius muscle, will that technique or modality be appropriate for this cervical patient? And without looking at their MRI report, you are trapped at speculating instead of correlating the facts.
It is not hard to read a MRI report of findings. You simply go to the end of the report and find the word IMPRESSION. This is where the basic conclusion of what the testing results showed. Taking the time to ask for the report and reading the report demonstrates to the patient you have knowledge and understanding as well as empathy. It also demonstrates you really want to know what to do and what not to do during their treatment session. Massage therapists have an opportunity to educate the client by showing charts of the muscles, joints and nerves involved that were indicated in the report. The patient doesn't understand why their muscles are still going into spasms one month, two months, even a year later, but you do. Giving the needed educational and emotional support when someone is in pain can immediately reduce their anxiety which in turn reduces their pain levels and an opportunity for healing can begin. When you take the time yourself to understand what a MRI report is saying, your treatment plan can be much more precise.
Here is the exercise for this article. I am going to give you the subjective information and the results of one of my cervical patients MRI report. Read the report all the way through. Jot down what you understand and then what you don't understand. Google it! Based on the subjective, how would you treat? Now, based on the facts how would you treat? Which technique or modality would you be comfortable using. Is there range of motion movements you would avoid? What muscles would you do manual muscle testing on?
Case Study Subjective
In total tears, over lunch my girlfriend relays she has been in neck and headache pain now for the past six months and can't workout. She had chiropractic care which included adjustments, ultrasound, hot/cold and electric stimulation which offered some relief.
Past Medical History
She had an accident one year prior to this car accident. She fell off of a ladder that tore her ACL, MCL, the medial meniscus and fractured her tibial plateau. She was found on the ground in a pool of blood.
Here is a beginning list of the muscles innervated at the different spinal roots. C5/6 innervate the Deltoid, Teres minor, Biceps, Brachioradialis, Subclavius, C4,5,6 Infraspinatus, Supraspinatus, C6/7 innervate Coracobrachialis, Pronator teres, Flexor Carpi Ulnaris, Triceps, C7 innervate the Latissimus dorsi. Let's look at a few terms that were in the report.
Spinal stenosis is an abnormal narrowing of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. There can be either sensory or muscular weakness. Cervical spinal stenosis is dangerous because it involves compression of the spinal cord.
A bulging disk extends outside the space it should normally occupy. The bulge typically affects a large portion of the disk, so it may look a little like a hamburger that's too big for its bun. The part of the disk that's bulging is typically the tough outer layer of cartilage. Usually bulging is considered part of the normal aging process of the disk and is common to see on MRIs of people in almost every age group.
A herniated disk, on the other hand, results when a crack in the tough outer layer of cartilage allows some of the softer inner cartilage to protrude out of the disk. The protrusion of inner cartilage in a herniated disk usually happens in one distinct area of the disk and not along a large component of the disk, which is more typical of a bulging disk. Herniated disks are also called ruptured disks or slipped disks. A herniated disc is more likely to cause pain.
Relief In The Findings
Because she didn't understand the report of findings, she was not making the necessary adjustments to her lifestyle to help with relief of long term pain and dysfunction. Her neck seems like a train wreck and is the third type of whiplash discussed previously. We treated her with ice and heat, performed soft tissue work to tolerance. No deep tissue was used. She was treated in supine, prone and side lying. Other treatments included some craniosacral therapy, light traction, and no range of motion movements instead the use of isometrics in all directions and again to tolerance. I managed to take her pain level from a 10 down to a 3 with soft tissue work, home contrast therapy, lying down as often as possible during the day while she was working. Also, she made modifications to her workout routine. The focus was not to let the pain cycle get started.
Understanding the MRI helped her make the necessary lifestyle corrections to allow the chiropractic and massage therapy to be successful. Although both kinds of care lowered her pain levels, it still remained a constant nagging dull ache with limitations to her standard of living. On the advisement of her lawyer she sought care from an orthopedist. The orthopedist recommended a series of facet injections to help break her pain cycle and he felt strongly that it would eliminate her pain. The injections were successful and this allowed her to resume closer to her previous way of living and working out. To make sure she doesn't get into that pain cycle again she presently maintains herself on as needed bases of both massage therapy and Chiropractic care.
Because the disc does not always protrude in the same direction in relation to the nerve root there is no way to know for sure which motions or positions will aggravate a nerve root compression. A safe rule of thumb is that if any motion or position or technique further aggravates the client's symptoms, it should be immediately stopped.
Click here for more information about Debbie Roberts, LMT.
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