resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
Long Thoracic Nerve Injuries in Sports (Part 1)
As youth sports have become more specialized children are not playing multiple sports as much, and with that, I am beginning to see more sprain/strain injuries to muscles and tendons. In this particular case an 11-year-old volleyball player could no longer lift her left arm up in flexion and was limited by both pain and dysfunction.
According to William W. Briner Jr., MD and Robert Gallo, MD on the website Stop Sports Injuries, "Each year, more than 460,000 high school students including more than 410,000 girls participate in interscholastic volleyball. As participation has increased over the past two decades, as such the number of volleyball-related injuries has risen as well. While volleyball injuries rank lowest for all major sports, volleyball players are at risk for both traumatic and overuse injuries. Because volleyball involves repetitive overhead motions, such as spiking and blocking, players are prone to overuse injuries of the shoulder. The types of injuries that are most common in volleyball are rotator cuff tendonitis, finger injuries, ankle sprains, patellar tendonitis, anterior cruciate ligament and low back pain."
Interestingly, they don't mention the trauma that can happen to the nerves exiting the brachial plexus at C5,6,7,8. This would be the possible cause of my volleyball player's long thoracic nerve involvement with serratus anterior muscular weakness.
In the book by Travell & Simons — Myofascial Pain and Dysfunction: The Trigger Point Manual, they studied tennis and serratus anterior and found it essential to each of the three tennis strokes. In my experience volleyball players perform similar overhead repetitive movements.
In The Trigger Point Manual under "Activation and Perpetuation of Trigger Points" it is stated that serratus anterior trigger point may be activated by muscle strain during excessively fast or prolonged running, push-ups, lifting heavy weights overhead, or severe coughing due to respiratory disease.
My client was doing push-ups — an exercise that has become famously prescribed to kids, however this is the worst exercise they can do without first developing proper scapular stabilization. Most of these kids cannot even hold themselves in a plank position let alone a moving parts plank position (push-up) where their full body weight must be supported and moved.
Some days I just shake my head at the training methods used to gain strength in a sport. Have you ever seen a volleyball player solely play their sport from a plank position?
The plank exercise recruits core and shoulder stabilizers, which is a necessary exercise to establish before doing any push-ups. Unfortunately, that is rarely where the coaches begin. That is why it is critical for you as a massage therapist to understand personal training as one of your modalities.
This doesn't mean you have to be a personal trainer, but you do need to have an understanding of the modality, so you can better understand the injuries being presented to you from the various sports/sports training methods.
This 11-year-old presented with pain along the lower medial border of the scapula. Which, if you look in Dr. Travell's book is a trigger point referral for serratus anterior. Her pain had been persistent since September of 2016, I first saw her in January of 2017. She had an MRI of the shoulder and had received six weeks of physical therapy. The MRI revealed supraspinatus tendonitis and subdeltoid bursitis, however she was not told to stop playing volleyball.
In-Gravity Functional Movement Screen
She complained of pain along the left lower medial border of the scapular when she did shoulder flexion or external rotation. Looking at the range of motion of shoulder flexion, she was at best 135 to 140, while normal is 180.
The Manual Muscle (MM) testing of flexion was weak and produced the pain along her scapula. MM testing abduction of the shoulder was weak but not necessarily painful. MM testing of the extension did not cause discomfort or loss of strength. MM testing of internal and external range of motion was weak and there was the same scapular pain on external range of motion. MM testing of supraspinatus was weak but without pain. MM testing of serratus anterior was weak and caused discomfort in her area of complaint.
Looking at her posture I could see a rotation of the pelvis with the right foot forward; rotation in the thoracic region with the left shoulder dropped and the right shoulder high; rotation in the cervical spine with the left ear lobe lower and the right ear lobe higher.
Editor's Note: Part two of this article will resume next month and will begin with the "Table Functional Movement" screen.