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Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
May, 2014, Vol. 14, Issue 05
Using Transactional Analysis to Speak "Client"
By Gerry Pyves
One of the most valuable things I learned when I trained as a Transactional Analysis Psychotherapist was to learn the difference between my "self" and the "other." This is particularly important in a therapy like massage which offers so many opportunities to "merge" with our clients.
By "merge" what I mean is to confuse what I am experiencing and thinking with what the client actually experiences. This sounds a bit obvious, doesn't it? However, one of the most common mistakes I witness in my training of massage therapists is precisely this problem. Many therapists pride themselves on their "sensitivity" and their "psychic" abilities, even. They simply love to prove their abilities by telling clients exactly what they notice about them and what their "energy" is doing.
Most of this is simply projection. We feel uplifted so we say to the client, "I notice how uplifted you are." In the power relationship of massage, the client is bound to agree. Occasionally, a client with a strong ego will simply walk out and not return as a result of such insulting and manipulative behaviour.
We must ensure it is the client's own experience they are describing in their own words. To do this, I invite the client to spend a few minutes lying on the table at the end of the treatment. This is so they have time to integrate the effect of the massage. Sometimes this is the most powerful therapeutic time of the treatment. Clients often report that they "let go" even more than during the bodywork itself. I leave the room so they really are in their own space for this phase.
The second part of this "integration phase" is when the client is dressed. Here, I still avoid chit chat and deflect the inevitable, "what did you notice?" game by simply asking the client to: "Walk around the table and notice how your body wants to walk after this treatment. Tell me anything you notice that feels different from this before you got on the table - if anything."
What is remarkable is that clients never say "Wow, I feel so myofascia-ed!" or "I feel like my iliopsoas is now so much longer!" Only massage therapists and professional bodyworkers talk such language. If clients really do speak this way, then they have been educated. What clients actually come out with, without such professional brain washing is, well, absolutely anything!
Learning From Our Clients
That is what makes it so exciting to actually listen to clients - I never know what will actually come out of their mouths. One client may walk like a zombie carrying lead weights on his feet and say, "I feel so light and free." They could not look less free or light if they tried. But who am I to say what my client actually feels or experiences internally? What is certain is this: everything I learned about the power of touch and massage came from the mouths of my clients. None of it can be found in the massage text books which, of necessity, only speak "bodywork." Yet, to really understand the immense power of massage, we really need to turn each client we massage into our teacher, by truly listening to their words.
Many therapists I know actually give a non-stop verbal commentary on what muscle is being released as they work. Now this is beyond the scope of practice, because it is hypnotherapy. Telling another human being what is happening in their body while they are in a semi-relaxed state and giving them suggestions is hypnotherapy. It is not ethical, in my opinion.
Only one person truly knows what the client is feeling in the treatment room, and it isn't the massage therapist. If you want to be a psychic, go get a velvet tent and a crystal ball. Otherwise let your clients have the space to find their own words for what they are feeling. When my clients "walk" after the treatment and are integrating their new body structure through the walk, I must bite my tongue and let them explore this new state of being.
What if they say, "nope, don't feel any different?" If there is not a convenient 8th floor window to throw yourself out of, you might just stay around and learn something. These "failures" are sometimes the most powerful teachings of them all.
You will not learn about massage from training courses. You will only learn about it from actual clients. if you bother to really listen to them and really want to know about them. All about them, not just their "physical" state. Know about them as human beings. You are not a bodyworker. The only place to find bodies without energy, emotion, mind and spirit is in the morgue or in bodywork text books. What you are, is a "human being worker."
The Best Marketing Tool
One of the great advantages of giving the client the chance to define their own reality in their own words, is how your clients walk out of your treatment room extremely clear about the value of coming for treatments with you. When they meet their friend for coffee after the treatment and they ask, "what have you been doing?" Your client replies, "I have just had a massage treatment and I feel six inches taller, so much lighter and ready to take on the world."
What just happened here? You just got yourself a new referral is what happened. Just from learning how to speak "client."
Gerry Pyves lives in West Yorkshire, in the United Kingdom. He holds an MA from Oxford University and qualified as a massage therapist in 1984. He became a UKCP registered Transactional Analysis psychotherapist in 1999. He is the founder and creator of NO HANDS® Massage. He is currently looking for instructors to teach NO HANDS® in the U.S. For more information, visit www.nohandsmassage.com.
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