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Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
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Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
January, 2016, Vol. 16, Issue 01
Positional Release Techniques: What are the Mechanisms?
By Leon Chaitow, ND, DO
At its simplest, positional release techniques as used in manual therapy settings, involve the unloading of tissues, placing them into less-stressed, "ease" positions. In such a comfort state, a number of beneficial changes may emerge including reduced pain perception and reduced inflammation,15 greater local muscular strength, reduced fascial stiffness,1,2 reduced pain-medication use and number of days of hospitalization, as well as enhanced peripheral circulation, post-surgically.11
There are four main forms of PRT methods:3
The benefits of reduced stimulation, applied to the whole body may help us to understand the effects of PRT. For example, time spent in a flotation tank, immersed in neutral temperature water, of high salt concentration to increase buoyancy - described as Restricted Environmental Stimulation Technique (REST) – reduces anxiety, depression and pain in individuals suffering chronic pain.
In 2001, Kjellgren et al, described 37 patients suffering from chronic pain who were randomly assigned to either a control group (17) or an experimental group (20) who received nine REST treatments over a 3-week period. The most severe pain intensity was significantly reduced, but low perceived pain intensity was not influenced. REST treatment elevated optimism, reduced the degree of anxiety or depression, and improved sleep.
In another study, Edebol et al (2008) reported the benefits of the REST method in the management of the chronic effects of whiplash injuries. And of course, relaxation, mindfulness, meditation approaches – are all known to be useful as means of reducing general over-sensitive states, whether mental, or physical. Here are some suggested mechanisms for manually induced stimulus reduction.
Neurolophysiological changes might involve muscle, fascial and joint mechanoreceptors (e.g. Ruffini corpuscles, Golgi tendon organs, muscle spindles),10 as well as pain receptors. To explore the role of muscle spindles, and the hypothesis that sensitivity of the deep tendon stretch reflex contributes to range-of-motion restrictions, Howell et al. (2006) measured stretch and H-reflex latency and amplitude before and after strain counterstrain treatment. The results suggest that SCS affected the sensitivity of the muscle spindle, thought to be heightened by the existence of tendonitis.
Proprioceptive theory is probably the most commonly discussed explanation for the efficacy of SCS. It is suggested that when a disturbed relationship exists between muscles and their antagonists, following strain, the positioning of these tissues into an unloaded, ease, position, may allow spindle resetting and partial or total resolution of inappropriate motor impairment.9
Mechanotransduction: Altered fibroblast responses resulting from changes in the shape and architecture of cells through mechanotransduction can be anti-inflammatory. Meltzer et al.14, observed that traumatized fascia disrupts the normal functions of the body, causing myofascial pain and reducing ranges of motion. Resulting inflammatory responses - involving fibroblasts - can be reversed in as little as 60 seconds by changes in load on the tissues, delivered either by counterstrain or myofascial release. In 2007, Standley & Meltzer observed that "fibroblast proliferation and expression/secretion of pro-inflammatory and anti-inflammatory interleukins may contribute to the clinical efficacy of indirect osteopathic manipulative techniques..." such as SCS. Standley and Meltzer (2008) also reported that "it is clear that strain direction, frequency and duration, impact important fibroblast physiological functions known to mediate pain, inflammation and range of motion."
Ligamentous reflexes: Solomonow13 identified the sensory potential and major ligamento-muscular reflexes that have inhibitory effects on associated muscles. He states, "If you apply only 60 to 90 seconds of relaxing compression on a joint... an hour+ of relaxation of muscles may result. This may come not only from ligaments, but also from capsules and tendon" (personal communication 2009). A possible clinical application of this ligamentous feature may be seen when joint "crowding" is induced as part of Facilitated Positional Release and/or SCS protocols. Such effects would be temporary – 20 to 30 minutes – but this would be sufficient time to allow an enhanced ability to mobilize or exercise previously restricted structures.
Wong16 summarizes current thinking regarding ligamento-muscular reflexes and SCS: Ligamentous strain inhibits muscle contractions that increase strain, or stimulates muscles that reduce strain, to protect the ligament.7 For instance, anterior cruciate ligament strain inhibits quadriceps and stimulates hamstring contractions to reduce anterior tibial distraction.7
Hydration: Crowding (compression) of soft tissues – as used in SCS and Facilitated Positional Release (FPR), has an effect on the water content of fascia, leading to temporary (20 to 30 minutes) of reduced stiffness of fascial structures – with the potential for enhanced mobility during that period. This window of opportunity can be usefully employed to enhance function and for the individual to experience less painful movement.
Hysteresis: In a study at the Philadelphia College of Osteopathic Medicine (Barnes 2012), 240 subjects were palpated for cervical articular somatic dysfunction. This was followed by use of a durometer to objectively measure soft-tissues overlying each cervical segment pre- and post-intervention, using a single consistent piezoelectric impulse, quantifying hysteresis (tissue stiffness/densification). Various soft-tissue techniques, including SCS, myofascial release, muscle energy technique and high velocity manipulation were tested. The results showed that all methods - but not the sham intervention - improved symptoms and stiffness of tissues but that SCS resulted in the most significant beneficil changes.
To what degree all, or any, of these mechanisms are operating during application of PRT in general, and StrainCounterstrain (SCS) in particular, remains to be more definitively established. Meanwhile positional release methods are among the safest and most effective ways of easing painful symptoms and inducing a healing response.3
Click here for more information about Leon Chaitow, ND, DO.
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