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News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
July, 2014, Vol. 14, Issue 07
Prone Position Syndrome
By David Lauterstein, RMT
How many times have you been receiving a massage and noticed after 40 minutes that you are still lying face down? Your sinuses have filled up. Your face and jaw are being deformed by the face cradle, leading to a related symptom, "cradle face." Your pelvis has been stuck in one awkward position for the much of the session.If you're a knowledgeable receiver, you may already be wondering what will be left out of the massage, because, after 40 minutes prone, receiving mostly back and shoulder work, there is no way the lower body, front torso, arms, hands, head and neck can be adequately addressed. How many times has a therapist apologized for leaving something out because they "didn't have enough time" or they simply ignored it? How many times have you gotten off the massage table and found some symptoms worse from being prone too long or sore from certain areas overworked or underworked?
Much of this can be traced to what I have named, "Prone Position Syndrome" or PPS for short. I'm being both funny and serious in bringing this up. This syndrome is obvious, but I've not often heard it identified as one of the major problems with massages these days. Why do therapists cause PPS so often? What are the causes and problems of PPS and what is the cure?
The first poblem is the lack of education regarding the importance of timing in a massage. What's the cure? Take a better history and determine a game plan for what body segments you will emphasize and approximately how much time you will spend on them. Get client agreement regarding your plan. Then monitor your timing as you go.
The belief that more is better – especially when it comes to working tense areas. The assumption that more force or that more repetitions will improve the session especially affects therapists' work with the back and posterior shoulder girdle. What's the cure? Realize less is often more! The thing that relaxes muscles' tensing is the nervous system. So honestly in massage we are not so much doing soft tissue manipulation (in spite of what most state laws say), instead we use manual suggestions to talk the nervous system into initiating the relaxation response. More repetitions do not do a better job of convincing the nervous system to relax – anymore than verbally telling the person to relax again and again and again.
Therapists are sometimes taught or get into the habit of always working at the same tempo, often doing all their strokes somewhat slowly. Frankly, if the massage is all slow, the client is often just put to sleep. When the client sleeps, there is no body-mind learning. The cure? Work that truly honors the nervous system, the mind and the body's needs – will vary in tempo. It is important to slow down in places of tension. It is equally important to speed up where things are relatively fine. I often think of Muhammed Ali's famous exhortation to "Float like a butterfly. Sting like a bee."
To repeat a stroke more than three or four times generally dishonors the client's nervous system. The nervous system GETS the message pretty quick! It doesn't need to be forced to relinquish its tension through brute force or excess repetitions. We need to remember that the client's awareness accompanies our touch and that a really good massage often will nonverbally impart important information to the client about their body and mind and emotions. I recently received a student session and I pointed out that the nervous system gets the message pretty quick and, if it's all slow, it's like assuming talking slow will improve communication.
Excess preoocupation with addressing the back, shoulders and neck and especially in the prone position. This often is a habit reinforced by frequent client requests to "just work on my back and shoulders." Clients do not realize that where their pain ends up is not necessarily where it's coming from. The most common example of this is back pain due to chronic forward flexion of the torso. As long as the front isn't lengthened, the back cannot let go. The cure?
Ida Rolf had an important saying, "Go where they're not." Explain to your clients, if they are willing listen, that you are happy to emphasize their backs and shoulders, but that often their back tension is related to posture and to stress elsewhere in the body. Therefore, in order to give them even more thorough and longer-lasting relief, in addition to giving the back, shoulders and neck lots of attention, your work will help them even more by addressing tension in the legs and feet which give critical support to the back; and addressing tension in abdomen and upper chest to help with the hunched over posture so many of us adopt at our desks and driving.
Boredom - the therapist just won't be bothered to individually plan the timing in the session. The cure? If you are bored in your work, you need to re-examine your attitudes and the environment you work in. Often in school, students say the subject they find most boring is business. But in graduate surveys, they often say if there was one subject they needed to pay more attention to it was business. If you are bored in your work, it is time re-examine your business plan; or, if you don't have one, it is high time create it. This can be fun and it certainly is necessary – look at Business Mastery by Cherie Sohnen-Moe or some other good business text written for massage therapists/health professionals.
Even more serious - lack of care. Sometimes one may be the sixth or seventh client of the day or the twenty-fifth of the week! The therapist, sadly enough, may just not care a whole lot at that point. The cure? Similar to boredom, lack of care may result from your attitudes or from being in an environment that is discouraging. Re-visit your business plan! Every business owner and/or employee needs to make sure that they keep on finding ways to activate their care for themselves and others in their work.
Not having the anatomical knowledge or technical skills to address the client's problems. The cure? Re-visit your anatomy and the most effective techniques you learned in school. Take continuing education that gives you efficient ways to address tension. Learn particularly how to pleasurably and effectively address the myofasical structures which keep the torso in chronic flexion – among them, especially rectus abdominis and pectoralis major.
Together we can overcome this pervasive problem. Let us free ourselves and our clients from the dreaded effects of Prone Position Syndrome!
David Lauterstein is Co-Director of Lauterstein-Conway Massage School in Austin, Texas. He is author of "The Deep Massage Book" and "Putting the Soul Back in the Body." David has been inducted into the Massage Therapy Hall of Fame, received AMTA's Jerome Perlinski Teacher of the Year Award, and in 2013, was recognized as "Educator of the Year" by the Alliance for Massage Therapy Education. For more info, visit www.TLCschool.com.
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