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Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Newly Identified Self-Repair Methods
Implications for manual therapists.
In June of 2009, Massage Today published my article titled "Research in Water and Fascia: Micro-tornadoes, hydrogenated diamonds & nanocrystals." In this issue, I will describe important new evidence of fascia's ability to self-regulate, maintain and repair itself, as it performs its' multiple vital tasks – with the stabilizing contribution of water, forming part of the process. For readers who are unfamiliar with fascia's many roles, I have summarized some of the more important of these in Box 1 - with notes on one aspect – mechanotransduction in Box 2.
Fascial/connective tissue – which is made up of the triple-helix of fibrillary collagen (Figure 1), the primary building block of connective tissue/fascia - organizes itself into a supporting scaffolding that supports, separates and shapes the extracellular matrix, tendons, bones, and other load-bearing structures.
New research by Dittmore, et al., (2016) has been able to describe experimental evidence as to how collagen operates a self-healing process. These researchers have identified what they call "cleavage-vulnerable binding regions" on collagen fibrils, at tiny intervals of 1 micron (a millionth of a meter) apart.
It seems that when collagen fibrils are lined up, with their molecules in a more-or-less straight conformation (demanding high energy to resist the tendency to uncoil) the fibrils periodically accumulate so much internal strain, that "buckling" occurs at the cleavage sites. This exposes collagen, so allowing enzymes (specialized matrix metallo-proteinases or MMPs) to bind to and degrade the collagen, before an almost immediate process (taking seconds) starts, of repair and remodeling.
This research suggests that fibrillar collagen self-regulates its own maintenance in this way, by constantly repairing collagen on a cellular level. They – and other researchers - have observed the importance of tissue tension in this process, suggesting that the self-repair, remodeling sequence is tension-dependent, meaning that repair may be delayed (i.e. made less necessary) if stabilization tension in the tissues is adequate.
Other researchers, such as Susilo, et al. (2016), have also reported that, "mechanical loading induces stabilizing changes internal to the fibrils themselves, or in the fibril-fibril interactions."
Collagen fibrils contain billions of minute sites that are vulnerable to buckling, if internally or externally derived forces fail to maintain optimal tension. A triple helix collagen fibril that is not under adequate external tension spontaneously forms buckling (cleavage) sites at approximately 1 micron intervals. However, if the fibril is under appropriate tension, the number of buckling sites decreases, and if tension is sufficiently high, there are no buckling (cleavage) sites.
Buckling exposes collagen to specific enzymes (MMPs) at these cleavage site, initiating the enzyme-related degradation and subsequent repair process that strengthens and maintains the fibrils. These findings raise the possibility that externally applied load via exercise, or the application of compression/shear force/stretching, might be capable of influencing this apparently constant operation.
Rather than speculating – it may be safer to ask a few questions – to which answers will eventually be found (if not already obvious):
Specific and detailed answers need to wait for further research, but what is clear is that massage/movement and manual therapies can and do influence the vital self-regulation and maintenance of these foundational tissues.
The challenge will be to identify optimal types, degrees, directions, durations and frequency of applied load, in particular clinical situations, involving different body-types, age groups etc - whether this involves manual or movement methods.