resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Long Thoracic Nerve Injuries in Sports (Part 2)
Editor's Note: Part one of this article, in last month's issue, ended with the "In- Gravity Functional Movement" screening test. Here, Debbie resumes with the "Table Functional Movement" screen and gets resolution in the case findings.
Table Functional Movement Screen
Latissimus test was positive for both the lat and the glenohumeral joint being dysfunctional. The serratus test produced weakness and pain. There was a very slow hesitation and uneasiness moving her glenohumeral joint into external rotation.
This did not produce pain in the shoulder, however once again it produced pain along the lower medial border of the scapula. I asked if she had fallen and she said she was clumsy, which can be an indicator to look for leg length discrepancies.
Her mother concurred that she constantly tripped over her own feet. She appeared to have a gross difference at the medial malleolus with a long left leg as compared to the right. Her femur on the left appeared longer but nothing could be concluded without a standing radiography.
The really important message here is what a screening and an assessment test can tell us with regards to helping the client achieve optimal movement again. After identifying problems within certain movement patterns, and, after identifying the problems, we can focus on the weakest link.
Finding the Weak Link
Here are four things to consider when finding the weakest link.
One: Long Thoracic Nerve
You will want to rule out the long thoracic nerve. The MM test revealed weakness of the serratus anterior; paired with her practice of an overhead sport and her cervical spine rotated to the left, I suggested she be seen by a higher medical professional. The objective here is to rule out damage or entrapment of the long thoracic nerve, which supplies the serratus anterior muscle.
The nerve typically arises from the anterior rami of three spinal nerve roots: the fifth, sixth, and seventh cervical nerves and sometimes C8. The roots from C5 and C6 go through the scalenus medius, while the C7 root passes in front of the muscle. As the nerve descends through the cervicoaxillary canal behind (posterior to) the brachial plexus and the axillary artery and vein, resting on the outer surface of the serratus anterior, I advised she would need both chiropractic care and myofascial work.
Two: Leg Length Discrepancy
Rule out leg length discrepancy. It's essential to deermine if this is anatomical or functional. If she continues to play on a true leg length difference then she has a very high chance of incurring multiple lower body injuries because of the misalignment. In this case a higher medical professional could decide if she needs a standing radiography test. If this is anatomical she may need a shoe lift. If this is functional both chiropractic adjustments and the myofascial work would be beneficial.
Rule out scoliosis. The same reason as above with regard to future unpredicted upper and lower extremity injuries. Also, it's important to know if this is functional or anatomical. A higher medical professional would be able to look for a left over injury that is causing the spine to become stiff, that now has a rotational pattern. If it is functional then the myofascial work will be beneficial.
Four: Labrial Tear
Rule out labrial tear. She didn't stop playing after the MRI; she played through tendonitis and bursitis; all the muscles around the shoulder tested weak; and there was major hesitation of motion and end feel while performing external rotation of the shoulder. Due to this, surgical repair may be needed.
The bodywork did resolve some of the pain symptoms, but not much was resolved in the loss of forward flexion. I referred her out to a local chiropractor with a report of my findings. He called me and concurred on the results of the screening and let me know of his plans to see her for next four weeks. He also asked me to continue myofascial massage. Remember the ultimate goal is to help a client not have any future problems, as well as resolving the current situation. Especially in this case since the client was only 11 years old.