resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Understanding Low Back Pain
If you are a massage therapist who stands clients up for postural or structural evaluation to determine a treatment protocol, then I'm sure you have noticed certain structural imbalances that are evident with every client. These will be greater or lesser in different clients and usually correlate directly to the severity of symptoms. For example, a greater degree of rotation of the hip causes a greater curvature in the lumbar spine and increased pressure on the discs causing bulging, herniation and pain.
Unfortunately, the medical profession would just examine and treat the bulging or herniated discs. However, when concentrating only on the discs, they are not looking at the rotation of the iliums and the tipping of the sacrum which are responsible for the exaggerated curvature of the spine and the reason for the pressure on and damage to the discs. In doing this, they tend to ignore that these imbalances repeat themselves throughout the structure of the entire body.
Consequently they miss both seeing and understanding the overall structural distortion and weakness. Perhaps one reason they don't pay attention to the ilium/sacrum relationship is that an expert in radiology, Dr. Terry Yokum, who has taken tens of thousands of x-rays of children, has determined that a one-year-old has iliac angles of 55 degrees and acetabula angles of 20 degrees, which he refers to as being "normal." Since this rotation of the iliums represented in this data is considered "normal," is it any wonder that it is overlooked as part of the problem in structural imbalances related to musculoskeletal issues. A standing weight bearing one-year-old already has this structural imbalance so the additional stresses and injuries of life experience will contribute to more imbalance and distortion.
I call this structural imbalance the core distortion with the rotations of the iliums and tippage of the sacrum that is identified in normal one-year-olds. Understanding this "normal" child's structure with its strengths and weaknesses helps to explain how herniated discs can develop in adults. Using functional kinesiology, which is testing the actual strength and function of muscles, we find significant muscle weaknesses throughout the structure. Some of the most easily tested muscle groups show greater than a 50% loss of strength and function.
In basic kinesiology, an imbalance or rotation in the structure of more than 15 degrees will produce substantial diminishing lever strength of muscles. According to Dr. Yokum, these substantial rotations of the iliums already exist in the one-year-old. The imbalances of the core distortion easily explain the muscle weaknesses in the legs and pelvis of our one-year-old. In this core distortion, the left ilium rotates anteriorly which means the left leg will test weak when the child is supine holding the leg out straight at a 45 degree angle. Using the same test, the right leg will test strong because the right ilium is rotated posteriorly. If the child is then turned over and tested the same way while prone, the left leg which has the anteriorly rotated ilium will test strong. The right leg with the posteriorly rotated ilium will test weak. This substantial weakness in the legs and pelvis will dramatically affect the spine and its curvatures. Just normal weight bearing walking and standing in gravity with these weaknesses can cause a further distortion of the structure with increased tippage of the sacrum and even greater stresses on the spine and discs.
Examining these muscle weaknesses further, as they affect the developing child's life, the normal falls, strains and twists of childhood can add additional distortion to the structure due to lack of strength in the muscles to stabilize the pelvis and low back. Add to this the growth spurts, and we again see the development of more distortions from the lack of muscle support and stabilization. Now include structural imbalances from shoes, desk chairs and beds, car and airplane seats, and the adverse effects of muscle weaknesses continue to accumulate.
Looking at a five-year-old, we see a structure where half the muscles of the legs, pelvis and spine will test at 50% or less strength and efficiency. This has been noted through my 40 years of practice. Adding more rigorous physical activity and opportunities for injuries as the child develops toward adulthood, we see more reasons for an increase of spinal distortion leading to disc issues. Injuries tend to occur in the weakened areas where if the muscles were stronger the injuries probably would not have happened. The lack of muscle strength to stabilize the joints of the legs, pelvis and low back can result in strains, sprains and sometimes worse injuries that would have been minor had the muscle strength been there. Major accidents like falls down the stairs or auto accidents can result in even more damage and distortion to the spine due to the inability to stabilize the structure because of muscle weaknesses from the core distortion. Any one of these major accidents by itself could cause a disc issue, but with the core distortion, the muscle weakness and the exaggerated curvatures of the spine are much more likely to result in disc injuries.
Having seen the development of this child that started in the core distortion, which was significant at the age of one, we now see that life experiences can lead to further distortions in the core distortion which also lead to further muscle weakness, a continuing cycle of increasing structural imbalance, weakness, and degeneration. Add to all this the constant force of gravity and, in time, the pressure on the discs can increase until degeneration or herniation or worse takes place. The unrecognized cause of this degeneration is the core distortion which is so common it is viewed as normal. Thus, it has been overlooked as the cause and focus for rehabilitation.
A degenerated or herniated disc is a symptom where pressure has increased to the point of damage. What causes this pressure is the exaggerated curvatures of the spine from the lack of support of the core distortion. Keeping in mind that the body wants to heal itself and, if given a chance it will, massage therapists need to focus on taking the pressure off the discs by reducing the curvatures in the spine which come from the core distortion. When this happens, significant number of disc issues including herniations resolve without surgery or other invasive treatments.
Successfully addressing the core distortion with massage and soft tissue manipulation requires an understanding of the core distortion and a high level of soft tissue myofascial therapeutic skills. For long-term rehabilitation, it is necessary to first, reduce the rotation of the iliums to the point where they can support a leveling of the sacrum and be able to maintain the support while the client is weight bearing. Second, restore muscle strength and function to the weakened muscles both for structural support and functional life activities. Third, release the soft tissue myofascial holding patterns, adhesions and scar tissue back into balance to support pain free structure and function. Obviously, these improvements need to be long term to provide time for the long term rehabilitation of the spine.
The good news is there is a connection between the movement of the cranial bones and the rotations of the iliums. By releasing the soft tissue restrictions that created the imbalances affecting the movement of the cranial bones, it is possible to achieve a substantial reduction of the rotation of the iliums and bring weight bearing support to the sacrum. Thus, leveling out the base of the spine and allowing an unwinding of the exaggerated spinal curvatures of the core distortion. Fortunately, this is a long-term correction. An additional benefit is that the balancing of the iliums reduces the rotation to less than 15 degrees, bringing about an immediate increase in strength and function of the weakened muscles. This stabilizes the improvements and returns strength to the structure that had been missing. This will initiate an unwinding of the old myofascial holding patterns along with the structural distortions of the core distortion.
The second therapeutic component of the rehabilitation of the back is specialized myofascial soft tissue release protocols designed to further unwind the core distortion imbalances of the legs, pelvis and low back. The myofascial protocols will further release and unwind the body into the direction it wants to go. Additionally, specialized myofascial techniques are used to release scar tissue and soft tissue impingement of nerves, which are often present with the exaggerated curvatures of the low back. This is further aided by muscles that were weak due to the major rotations of the core distortion that have been strengthened because of the reduction of the rotation of the iliums. This increased muscle strength helps maintain the increased structural balance. Specialized energetic healing techniques are also used to release energetic and emotional blockages which are a result of the distortion, dysfunction and pain. Having an understanding of the core distortion and how it leads to degeneration and exaggerated curvatures of the spine, and then being able to apply effective treatment protocols that will lead to long term rehabilitation, massage therapists can help many clients avoid surgery and costly invasive medical treatments for severe low back and disc issues.