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Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Learning How to Treat PopeyeI want you to know as massage therapists, some things are just simple, very straight forward and can be helped within one to two visits. I sometimes see massage therapists looking for the more complicated reasons for pain. I have tried to convey in every article that you can save your hands and help more clients by understanding form and function along with simple assessment tools. Treating Popeye is no exception.
After two MRI's (one of the bicep and one of the shoulder), acupuncture, and a failed attempt of physical therapy, this young man found his way into my office to seek help for an unrelenting pain in the bicep. Lucky for me, his Orthopedist had ruled out that there was not a complete tear or a partial tear of the bicep tendon by doing the MRI's. But he wasn't so lucky in the fact he had been suffering with this pain and loss of function for more than six months and no one had any answers. His doctor said, "I don't know why you still have the pain, none of the lab work or the MRI's have a definitive answer. Let's try physical therapy."
I want to explore together controlled micro-tears of fascia, the difference of macro and micro-tears of fascia, how to assess bicep pain and the treatment options of micro-tears. A look into why physicians might miss this critical piece of the pie altogether. Plus, take a walk back in time with me to the beginning of the medical era of fascia reality. Try to guess the year!
I would like to clarify that a Popeye reference to a bicep usually means the client has suffered from a full bicipital tear and is left with a bulging in the center of the upper extremity showing a Popeye like effect from the tear. The look is actually the long head of the bicep hanging there not attached. You won't need many assessment tools for this one just your eyes to see that it is torn and your treatment options are relief of pain symptoms being caused from the tear. The long head of the biceps tendon is more likely to be injured because it is vulnerable as it travels through the shoulder joint to its attachment point in the socket. Fortunately, the biceps has two attachments at the shoulder. The short head of the biceps rarely tears and because of the second attachment, many people can still function and only need simple treatments to relieve symptoms. If symptoms cannot be relieved by nonsurgical treatments, or if the client requires complete recovery of strength for a sport or work, surgery to repair the torn tendon might be required.
Can you think of anyone that would want to deliberately do controlled micro-tears to their fascia? The answer is actually everyone that works out. The most known sports would be bodybuilding for the big hypertrophy effect or a power lifter than is going to compete for lifting the most weight in his class. But it is what happens to all muscles that need to build stamina and endurance. Well, after all, Popeye didn't get that big bicep by not doing micro-tears to his fascia.
The effect of training causes micro-tears to the muscles being trained; this is generally known as a micro-trauma. These micro-tears in the muscle contribute to the soreness felt after exercise, called delayed onset muscle soreness. It is the repair to these small micro-traumas that result in muscle growth and development. Normally, this soreness becomes most apparent a day or two after a workout. However, as muscles become adapted to the exercises, soreness tends to decrease. A micro-trauma can be a cumulative effect from simple acts of daily living over a long period of time or playing a leisure sport such as golf that ultimately leads to pain and dysfunction. The extreme micro-tears are called a macro- trauma where the fascia has been injured by a traumatic event such as a car wreck, fall, or a sports injury.
My client worked out with weights and did bodyweight exercises almost every day. He stated he was just trying to maintain his physique and not trying to do anything over the top. Weight training aims to build muscle by prompting two different types of hypertrophy; sarcoplasmic hypertrophy and myofibrillar hypertrophy. Sarcoplasmic hypertrophy leads to larger muscles and so is favored by bodybuilders more than myofibrillar hypertrophy which builds athletic strength. Sarcoplasmic hypertrophy is triggered by increasing repetitions, whereas myofibrillar hypertrophy is triggered by lifting heavier weights. In either case, there is an increase in the size and strength of the muscles, tendons, bones, and ligaments through a process known as remodeling, the breakdown and growth of new tissue. But when tissue or fascia breaks down (catabolic) faster than it can rebuild (anabolic), injuries occur. Exercising or engaging in a physical activity too intensely, too long, and too often does not allow enough time for the remodeling process. This makes the client more susceptible to an injury.
Once fascia is injured either over stretched or torn the microscopic fibers are disrupted. Now, instead of fibers running parallel to each other in an organized fashion with their normal degree of elasticity and flexibility, the fibers now run every possible direction and have an extremely diminished amount of organization. Fascial injuries often heal in this tangle manner with those injured areas being referred to as microscopic scar tissues or microscopic adhesions. Finding and diagnosing these fascial tears with conventional, high-tech tests can be difficult, to the point of usually being virtually impossible. Advanced imaging techniques such as MRI will not show most fascial injuries because the fascia itself is so thin and microscopic. This is why numerous people that suffer with chronic pain syndromes will be run through test after test, with doctors telling them repeatedly, "We cannot find any reason for your pain." In some cases, they are told it is age related and you will just have to live with it.
Here is a fun quick history lesson. There are two people who have made the awareness of fascia prevalent and the first is Dr. Andrew Taylor Still in 1874, when he walked away from modern medicine to create Osteopathic Medicine. Dr. Andrew Taylor Sill saw that modern medicine at the time used harsh methods and harsh drugs that had more ill effects than good. He believed that problems with the fascia were the root of all sickness and disease. The second, Tom Myers, is quoted saying, "Fascia is the missing element in the movement/stability equation. While every anatomy lists around 600 separate muscles, it is more accurate to say that there is one muscle poured into six hundred pockets of the fascial webbing. The illusion of separate muscles is created by the anatomist's scalpel, dividing tissues along the planes of fascia." Medical professionals are still overlooking the importance of fascia to the detriment of their patients by relying on high tech tests for their diagnosis.
In its healthy state, fascia is smooth, supple and slides easily, allowing you to move and stretch to your full length in any direction, always returning back to its normal state. Unfortunately, it's very unlikely that your fascia maintains its optimal flexibility, shape or texture. Lack of activity or over activity will cement the once-supple fibers into place. Chronic stress causes the fibers to thicken and this is where the muscles start moving as a unit or recruiting muscles in a poor firing order. Fascia needs to be moved in all planes of motion in order for it not to form adhesions and become glued down to the muscle. These repetitive movements pull the fascia into ingrained patterns and once they've formed they are hard for the client to get rid of on their own. Foam roll, foam roll, foam roll is what they are told to do. There are two problems with this, one is that clients rarely use a foam roller properly and second, not all adhesions respond to this form of therapy. In addition, it is hard to form roll a bicep.
How do you help Popeye?
That's it; therapy can really be that simple. This client was better in the first visit during the session by 80%, presented on the return visit 90% improved, after the second and final session he was 100%. He thanked me for the education and was extremely grateful.