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Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
August, 2014, Vol. 14, Issue 08
A Look at Compression, Congestion and Dis-Coordination
By Dale G. Alexander, LMT, MA, PhD
I want to propose that compression, congestion and dis-coordination are the cornerstones of the physiological processes which perpetuate chronic somatic dysfunction. Understanding this triad of dysfunction will allow you to describe the sources of the problems that many of your clients who are struggling to regain their function and quality of life are facing on a daily basis.
I have previously noted the importance of having clear and simple ways to describe the intentions of clinical massage therapy and bodywork to prospective clients, and to the public in general. Learning to describe this triad will greatly assist you in this pursuit. What prospective clients really want is an indication of the depth of your competence and your comprehensive understanding of how the human body really works.
Compression within our human structure, congestion of our bodily fluids and dis-coordination of our nervous system are inevitable outcomes of long-term, repetitious and intense periods of stress. These same variables are at play in response to trauma, extended illness, pathology and the aging process. Accompanying these variables, there may also be elements of scar tissue formation, derangement of joint structures and soft tissue compensations from impacts, falling or surgical interventions. Any of these may trigger the influence of the righting reflexes.1
In my January article, "The Sacs & Tubes Theory of Stress," I proposed that the sacs around organs, the menninges, pleurae, pericardium, peritoneum "cringe" in response to stress while the tubes within and between organs "shorten, narrow and twist." That old colloquial phrase of "feeling twisted up inside," has more reality to it than those who have used it realize.2
The very organization of the major internal viscera being slung "down and forward" from both the cranium and the anterior neck are suggestive to how and why so many clients present with posterior chronic symptoms related to their neck, upper, middle and lower back.2 As well as, how and why clients are challenged with postural dilemmas when faced with the progression of osteoporosis as they age.
Cringing, shortening, narrowing, and twisting of the structural elements related to the heart/lung complex, the diaphragm muscle, the liver, the uterus, the esophagus and the small and large intestines all activate "a war between the flexor and the extensor reflexes" to my sensibilities. The intrinsic visceral connections that activate this war between reflexes exist between the occiput and the anterior neck all the way to the sacrum.2
Consider that this resulting tension between the reflex systems is communicated down the length of the axial spine. Also, let us remember that these reflexes are governed by subcortical structures within the spinal cord and brain stem.1 As human beings, whether client or practitioner, we do not conceive of these reflexes, let alone are aware of their effects upon our moment to moment complex movement patterns. Most have never heard of them. We may notice the slump in our posture. And, we really notice when an involved joint goes "tweak" and the soft tissues dedicated to protect it reflexively spasm. That is the one positive function of pain, to get our attention. Understanding how this process happens so frequently is what this article is describing.
Congestion of the body's fluids is an inevitable result of compression within the human structure. The transverse diaphragm's at C0-C1(occipital /cranial base), C7-T1,T2 (thoracic inlet), T12-L1 (respiratory diaphragm), L5-S4-coccyx (pelvic diaphragm) are actually designed to distribute these strains yet, these same areas are where the flow of fluids and nerve transitions between body cavities and structures are most vulnerable.3
Using the C0-C1 junction as an example, consider the impact of compression upon the delivery of arterial blood to the brain, as well as its influence to slow the venting of venous blood and lymphatic fluids from the cranial vault. One theory of migraine headaches suggests just this juxtaposition of reduced arterial flow and inhibited venous return from the brain.3
Dis-coordination within the human nervous system may occur in many ways and places yet, the superior sympathetic ganglion located lateral to the uppermost cervical spine is easiest to reference as any downward and forward pull to the cranium and neck will add distortion to the occiput, atlas and axis resulting in many forms of autonomic confusion which usually results in disruption of blood supply.4 Dis-coordination within the sensory-motor systems usually relates to spinal cord compression, also known as stenosis.5
Stimulating blood toward a particular portion of anatomy is easily accomplished by all forms of touch therapies whereas stimulating the system as a whole to re-distribute blood and nerve flow within the entire body typically requires additional skill sets.
One such orientation to systemic re-distribution that has shown promise in my clinical experience was described in the last article of this column in which the body's central linkage was described from occiput to sacrum and the crucial role of the ankle/foot complex was emphasized in propelling blood and lymph back to the heart/lung complex.6 Many additional therapeutic perspectives are possible.
The crucial factor is that the body needs freshly oxygenated and nutritious blood containing the necessary hormones and effective nerve supply to all tissue structures to heal and to balance its healthy function. As the nerves hitch a ride on the arteries and arterioles, this therapeutic goal is one and the same though techniques differ in their orientation to stimulate circulation or neural expression.7
Compression relates to any structure which has a superior to inferior attachments. Compression eventually interferes with both blood and nerve supply to all body tissues.
Congestion infers that the body's fluids are impeded from flowing to their natural outlets, primarily back the the heart/lung complex. Congestion adds pressure to delicate peripheral nerves exiting the the spinal cord from the occiput to the sacrum.
Dis-coordination occurs both within the neuro-circulatory matrix of autonomic reflexes which direct blood supply and between the sensory-motor divisions of the central nervous system which coordinates gross and fine motor movements through its peripheral nerves to the extremities.
In summary for now, allow these ideas to distill through your own clinical experiences with clients. Consider the triad of compression, congestion and dis-coordination. Create your own synthesis for how the body heals. Create your own description of how it progresses into physiological difficulty and pathology. The ability to verbally articulate these processes is more important than any marketing tool. Re-emphasizing what was stated earlier in this article, "What prospective clients really want is an indication of the depth of your competence and your comprehensive understanding of how the human body really works."
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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