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A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
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.