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Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
May, 2014, Vol. 14, Issue 05
Buying the Right Table for Your Practice: Know the Basics
By Terry Russell
Aren't you amazed at how brand marketing plays a role in almost every daily decision you make? From the car you drive to the clothes you wear to the grocery store you stop at on the way home.You will be hard pressed to find your daily life not influenced by brand marketing. Wouldn't it be nice if you had the same influences when buying equipment and supplies for your practice? While table manufacturers, distributors and even trade shows have worked hard to influence decisions, you still fall a little short in answers and knowledge at the end of the day.
I have only had to buy two portable massage tables in my entire career. My first massage table purchase was one of the hardest buying decisions I have ever made. It seems the more one reads and researches tables, the more one becomes confused. I was still learning the difference between effleurage and friction and now was expected to become an overnight expert on portable tables. Being a student, there wasn't a lot of money in my budget so the pressure to get it right the first time was on me.
Whether you are a student buying that first table or a seasoned therapist replacing or buying a second table, we have all been faced with that daunting task – which table? What do I need, what do I want and what is of no importance to me. All questions are easily answered once table basics are understood.
When looking for a table, the first thing to look at is the frame. The table frame should be made of a hard wood or strong aluminum. Common wood choices by manufacturers may include maple, oak, birch and bamboo. The platform is usually plywood so look for at least medium density plywood.
If you have the benefit of being at a trade show or even in your class, don't be afraid to turn the table on its side so you can get a good view of what is underneath. We talked briefly about the platform, now to table support. Some tables offer dual supports that run the length of the table along the platform, some offer a single joint while some may not have any additional support. If you don't see any additional support, ask! Newer technologies allow some models to have a jointless beam so just because there is not a support doesn't mean the table is weak. If the table does not have a visible support or the newer technology, this could be a problem as this is where your client could bottom out on the table.
Hinges play a role as well. Some tables offer a full length piano hinge for added support while others offer two to three smaller hinges. Look to see if smaller hinges are used, how well they are attached to the table. Keep in mind, this is in the middle of the table and needs the most support.
After turning the table over and back on the legs, time to examine the rest of the construction. Starting with the legs, the table height adjustment is made by either a wheel knob, double wheel knob or push pin (more commonly found with aluminum tables). While all three styles accomplish the same task, my personal preference is the double wheel knob. The knobs will become loose after repeated folding of the table and while easy to get in the habit of checking the tightness before every client, the second knob just gives you a little extra insurance in case you forget to check, the adjustment becomes loose and the knob falls off during treatment. With the second knob, the table is still secure as with a single knob the table leg will be at risk of falling off and sending your client to the floor.
On the ends of the table you will find the lock that secures the table when folded. A good lock will be free of movement when engaged and allow you to fold down when the table is set up. By folding down the lock, you can prevent yourself from brushing against the metal edge and cutting yourself. On the sides of the table, you will find the carry straps. These should be secured tightly to the table with no raised or rough screw heads visible.
Padding comes in all styles and depends on a combination of the therapist's preference and modality most often performed. One of the most common forms of padding is known as triple density foam. This means there are three layers of foam, each layer one inch thick, layering from firm next to the base followed by a medium density in the middle to a softer density that will be closest to the client. This style allows a softer table that will not pit or indent after repeated use. Tables that use single density foam will be firmer and at risk for showing indentions sooner than multi-density foam.
The most common thickness of foam range from 2" to 3" depending on the therapist's preference and modalities anything in this range should work. Thinner foam tends to make the table a little lighter and a lot firmer, perfect if the majority of the work done is sports or deep tissue. A simple addition of a fleece pad can add an inch of softness when doing Swedish and softer modalities. There are different upgrades to foam ranging from 4" to 6" and some offer a more memory type feeling. Density and types depend on the area of practice that they will be used in. Also, leading manufacturers offer CFC free foam for a safe choice.
Vinyl choices have come a long way in that there are choices now from a standard vinyl to an ultra-soft feel. Anything above the standard is usually considered an upgrade by most manufacturers. The leading manufacturers now offer a biodegradable vinyl making this an earth friendly choice. Beware of bargain tables found online, at big box stores and membership warehouses as they are more often directly imported with little to no quality control or added benefits.
Face rests are included in a lot of table packages. If you find you are in need of a face rest you have many options. First the base. There is an inexpensive classic that does not allow for adjusting. This is the least favorable in the lineup as the therapist has no control to make the angle comfortable for the client. The typical adjusting face rest is usually a double articulating face rest meaning that not only will the base move perpendicular to the table, but the entire platform will adjust up for clients a little thicker in shoulder/decolletage. In addition, there are bases that have different platforms allowing for sinus relief if a lot of your time is spent with the client prone.
The pad comes with a few choices as well. A basic pad comes with standard padding and vinyl. A fleece cover can give you an inch of softness if desired. In addition, there are memory foam types, water spheres, curved pads and pads with sound for your MP3 players.
Several other options include rounded corners, shiatsu release cables and Reiki end plates. The therapist can save themselves many bruises when adding the rounded corners to their tables. Shiatsu release cables come with wing nuts on one end so that the cable system can easily be undone allowing for the table to fold flat on the floor with the legs tucked inside. Reiki endplates refer to the wood between the legs on the ends of the table. Reiki plates are small and close to the table base allowing a therapist to sit with their legs under the head and feet as they work on a client. Standard endplates are wide and will not allow this. All of these options are clearly a therapist‘s preference.
Your table is meant to last you many years. When purchasing a table, take a minute to look the table over for the options we've talked about. Will that table fit into your practice nicely? Taking care of your table is critical to making it last. NEVER clean with alcohol-based products. Alcohol will dry out the vinyl and cause premature cracking. If you are a mobile therapist, make sure the table never leaves your house without a case. And lastly, don't leave the table in the trunk of your car for extended periods due to extreme temperatures of nature.
Keep in mind the client's comfort is a direct reflection on you. If you have the luxury of seeing the table before you purchase (trade shows are great for this), don't be afraid to climb on top of the table to feel firsthand the comfort or lack of in some cases. Long after you purchase the table, make a habit to lie on your table often to see what experience you are providing. Your client may not be so honest to let you know how uncomfortable that old table has become. There are many areas you can cut cost in your practice, but your table is not one of these. Next to your hands, your table is one of your key assets.
Lastly, Internet shopping is great but can easily become confusing when reading description after description of equipment. Don't be afraid to call the company with questions. Some companies offer chat sessions so a live person can instantly answer your questions or put you in contact with someone in their company that can answer them for you. Equipment purchases are important to you; make sure the company you are dealing with takes that equally important. You want to know the company that you purchase from will be there for you long after the sale.
Terry Russell has been involved in the massage community since 1999. His previous career includes being a full time therapist at Spa Palazzo in the Boca Raton Resort & Club, as well as owning a successful private practice. As the Director of Sales – Schools, Distributors & Franchises Division at Universal Companies, his efforts are now focused on bringing schools, distributors and franchises the best of equipment and supplies with outstanding customer service. For more information, visit www.universalcompanies.com.
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