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Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
August, 2014, Vol. 14, Issue 08
How To Effectively Work with Wheelchair-Bound Clients
By Sharon Puszko, PhD, LMT
There are more than 1.7 million people in the U.S. who depend on wheelchairs and scooters to get around. Most of these people are currently over the age of 65, which means massaging them requires specific knowledge about how to work with geriatric clients, as well as clients with mobility issues.With the growing number of elderly in our country, as well as veterans of war, practitioners would benefit from learning how to properly work with wheelchair-bound clients.
Injuries to the elbow, wrist and hand are common among wheelchair users, but shoulder injuries are the most prevalent. Torn rotator cuffs and tendinitis are often the causes of shoulder pain. Muscle imbalance caused by overuse can lead to abnormal biomechanics and thus, injury. The most common disparity in strength associated with rotator cuff tear or tendinitis is an imbalance between the internal and the external rotators of the shoulder. Also, the prevalence of carpal tunnel syndrome among manual wheelchair users is between 49% and 73%.
Proper positioning in the wheelchair is probably most important for the prevention of repetitive strain for manual wheelchair users. A combination of manual mobility and powered mobility may be a workable compromise for some wheelchair users. Modern manual wheelchairs are easier to transport and easier to carry than powered wheelchairs. However they may not offer the same degree of independence for users with chronic arm or shoulder pain.
Many people who use wheelchairs suffer from foot pain as well. Walking and standing allows people to stretch the achilles tendon that runs up the back of the leg. Constantly sitting can cause the achilles tendon to shorten, placing the foot in a constant state of extension. Many people using wheelchairs develop plantar flexion, a condition in which the achilles tendon shortens as a result of sitting for most of the time. When the foot is being pulled into an extended position by the ever shortening Achilles tendon, it becomes very painful as it progresses. Plantar flexion also makes relearning to walk after a stroke even more difficult because it disrupts the normal heel to toe gait. An extended foot massage can help relieve some of this pain. Passively flexing the foot and stretching the calf muscles can also help with pain management of this condition.
"Massage therapy is seen as a positive method of pain management, but just treating the pain is not an end in itself," said James Laskin, MS, PT, adjunct professor for the division of rehabilitation services at the University of Oklahoma and the Health Services Center of Oklahoma City. He emphasizes the importance of treating the problem, not just the symptom.
Many people who spend their time in a wheelchair will develop pressure sores. These lesions are caused by unrelieved pressure over a period of time sufficient to cause the destruction of soft tissue cells. The pressure between bone and searing surface compresses the soft tissues of the buttocks and forces the blood out of the tissues. The longer one sits without movement to change the pressure areas, the greater the cellular damage. The same process occurs for those of us who can walk when we sit on a hard surface for too long. However, our subconscious nervous system causes us to move periodically, shifting the pressure points and allowing blood to re-enter the compressed tissues. Spinal cord injury causes a loss of the sensation that is vital to this process.
Most paraplegics and quadriplegics have no feeling in their soft tissues. They feel no distress, fail to move periodically and consequently develop pressure sores. Chair-bound individuals are advised by their physicians and therapists to change their position every 10 minutes or so by doing "pressure lifts" or other pressure point changing routines designed to stimulate the flow of blood to soft tissue. This allows the blood to re-nourish the tissues that have been under high pressure. The sad fact is that people forget to move, or may be unable to move themselves. The use of massage therapy on the coccyx, ischium (pelvic bone) and lower back can help prevent pressure sores on wheelchair users.
Even with the best passive cushion technology available, pressure sores are one of the greatest health risks a chair-bound person can have. They can cause a drastic decline in quality of life. Curing a sore may require weeks or months lying face down on the stomach or even skin grafts. Deep sores may very well develop into life-threatening bone infections, and can change a productive, self-sustaining individual into a bed-ridden patient dependent upon others for a long period of time.
Ultimately, the benefits of massage therapy for wheelchair-bound clients include improved range of motion, circulation and alleviated decubitus ulcers. This specific modality is also important for the massage therapists who are led to the rewarding practice of working in nursing homes and with assisted-living residents.
Click here for more information about Sharon Puszko, PhD, LMT.
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