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New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
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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