resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Following the Body's Clues
How 29 minutes of massage therapy changed a life.
There was a higher power at work when I helped Marianne. You know as a therapist when you jump right in and try to help someone and all your efforts work, but you are not entirely sure why. Then your mind is reeling in the possibilities of what just happened, followed by you can't wait to get your nose into a text book to further investigate how exactly you made those dramatic changes. A twenty-nine minute demonstration at a massage therapy conference using a gross cervical movement screen, a piece of equipment that allows firm pressure and my hands led the way to an incredible, life changing event for my volunteer, Marianne.
On January 5, 2012, Marianne and five of her children were in their minivan stopped about 10 cars away from a red light. She was one and a half car lengths away from the car in front of her. Her two-year-old had just woken up and they all had turned around to give the child attention, when they were hit from behind and then shoved forward to hit the car in front of them. The driver was texting while driving and the approximate speed was 55 miles per hour on impact. She was knocked unconscious from the whiplash as her head did not hit anything during the accident. She became conscious as they were prying her foot from underneath the gas pedal. She was taken to the emergency room and a CT scan of the neck was performed. She was told nothing was broken, given a muscle relaxer, pain medication and then sent home. The total ER visit was only about four hours. She woke up the next morning with varied symptoms. When she followed up the next day with the doctor, he referred her to a neurologist because he felt she had a severe concussion and a possible stroke because she had lost function in the right side of her face and neck.
In the two and half years of seeing the neurologist, he had prescribed every kind of medicine for migraines which never worked. She felt she wasn't being heard, that the headaches were not vascular headaches. He prescribed narcotics, muscle relaxers, ultra sound, tens machine and physical therapy. He also prescribed Botox for the migraines.
She started seeing a chiropractor who performed adjustments, Dural unwinding, myofascial release and cranio-sacral therapy. The treatments never seemed to last. "I got more relief in the 30 minute demonstration than in the 29 months of medical care, physical therapy, chiropractic care and not to mention the $100,000 I have spent elsewhere," said Marianne.
By now I am sure you are wondering what on earth did I do so different than the other well intentioned skilled therapist and doctors? How did I know I had helped her? As a group, we looked at her range of motion of flexion, extension, side bending and rotation. Well, she had none. Yep, you heard me none. In order to drive, she turned her whole body. After two years, she literally had no motion to her cervical spine to look in any direction and she was forced to move through her thoracic spine. I was very nervous to work on her after she revealed her history and by observation her neck appeared to have permanent damage. The other thing that was odd, nothing showed up on the MRI to indicate such severe damage that would be contributing to this kind of loss of motion.
Addressing the group, I talked about changing muscle inhibition left over from an accident and how to approach the injury using isometrics for neuromuscular re-education of the mechano-receptors. The importance and value of taking the movement screen, also that I didn't have any preconceived notion that in 30 minutes what changes I could make. In other words, I was willing to fail.
I began doing the demonstration placing the cranial device under her T-spine, doing soft tissue work to the scalene muscles and trapezius. I then tried some very light isometrics with no post-isometric stretch to see if I could help re-set the mechano-receptors and encourage length to the scalene, SCM and trapezius muscle. I didn't stretch the neck because she grimaced every time I moved her neck in the slightest. The direction of lateral flexion with the isometric set off her pain pattern over the right eye. Since this elicited the pain pattern of the stroke, I didn't do any further cervical isometrics.
I continued the demonstration and used the cranial device to support the neck and let her doing some gentle rocking to her tolerance. The place I always go looking when someone has severe headaches is the first rib. Hers was very prominent and had no motion on springing. Leaving the cranial device at approximately T2-3, I explained that first rib dysfunction can give a lot of headaches and hers felt really elevated and fixed. I used the technique of positional release which uses the elbow and forearm to guide the humerus lateral to medial towards the spine to influence the first rib, asking the typical question of any pain or discomfort, and there was none. I then asked her to put her head in a slight rotation to the side of dysfunction and placed my left thumb over the rib head and asked her to make an isometric contraction of the forearm adducting to her side. I pulled the scapula out further with her head in the same position and asked her to contract again. I repeated the above about four to five times. I also rolled her onto her side just far enough to place the cranial device at the level of T3-4 along the rhomboids and middle trapezius using my fingers began a posterior to anterior push. I repeated the lateral to medial positional release into the spine and finished again with her on her back the cradle resting under her neck this time and repeated the downward adduction of the humerus into her side.
By now, they were flashing the lights at us to end the demonstration. She sat up carefully and I stopped the crowd that was trying to leave and said, wait we need to see what it is we accomplished. You assess in the beginning and at the end of every session don't you? I don't know who you could have picked up off the floor first, her or me. She flung her head back into extension; easily tossed her chin to chest into flexion without difficulty looked over her shoulder, and with some reservation accomplished about 20 degrees of side bending. She continued to take her head from flexion to extension because it was so exciting. It happened so fast, I grabbed her and said don't do that. I was so taken back by the amount of motion I was afraid she would hurt herself somehow or undo what I had done.
What had I done? I went to one of my resource reference books, An Osteopathic Approach to Diagnosis and Treatment, third edition. There, in chapter 78 Practical Applications and Case Histories of the Thoracic Cage, I found just what I was looking for. An explanation and a case history of something very similar to what I had experienced. I also called one of the author's to get her input into the somatic dysfunction of the first rib.
She explained that the first rib is probably the rib most commonly involved in somatic dysfunction of all the ribs. It is affected by trauma, stress and posture, as well as by the dysfunction of the C7-T1 complex. The patient may complain of "shoulder" pain, stiff neck, upper back or neck pain, and here it is an inability to turn the head while driving. The first rib can impinge the neurovascular bundle as it passes between it and the clavicle through the costoclavicular space. Since the anterior and middle scalene muscles assist in raising the first rib, they can also compress the brachial plexus when they are in spasm and result in thoracic outlet syndrome symptoms.
What I had accomplished was helping a first rib dysfunction that was hung up on the C7-T1 vertebra. The whiplash injury with the head turned to look in the back seat created an eccentric load to the scalene and trapezius. The force was so great that it displaced the first rib. I used the cranial tool at approximately the C7-T1 vertebra in a posterior to anterior position and I was able to use isometrics and positional release lateral to medial resulting in a release of the first rib.
I encouraged Marianne to continue to get body work done to the scalene's, trapezius, rhomboids and SCM to decrease the hyper tonicity. This will help to encourage the first rib to have better motion. Massage therapy is not an exact science that is why we have so many modalities to choose from. I wasn't sure I would be able to help, but I was willing to be vulnerable and fail. Marianne is eternally grateful I tried.