resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
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.