resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Muscles as Team Players
Synergistic dominance occurs as "helper" muscles are recruited to take over function when a "prime mover" muscle fails, much like when a football coach calls in the substitute players when a key player is injured. These synergistic stabilizing muscles are designed to help, but not be primary contributors, to a particular movement. Synergistic may be defined as "acting together to enhance the effect of another force." Therefore, if muscles perform the same task at a particular joint, they are termed synergistic.
Altered reciprocal inhibition occurs when a muscle is activated (the agonist), when it should not be. Excessive stress on the agonist decreases the signal strength to the opposing muscle (the antagonist). In altered reciprocal inhibition, the agonist muscle is being activated even though it is not actively contracting. Altered reciprocal inhibition is often the culprit causing synergistic dominance. For example, in forward-head postures, the client's suboccipitals are often maintained in a hypercontracted state as they battle gravity to keep the eyes level with the horizon. As the head cocks back and moves forward on the neck, the antagonist longus capitis muscles - which bind the anterior surface of the upper cervical vertebrae to the occipital base, become overstretched and weak (Figure 1).
Sensing the longus capitis muscles can no longer carry out their duty as primary head-on-neck flexors, the brain calls on the powerful sternocleidomastoids (SCMs) as pinch-hitters. The SCMs are reliable neck flexors when allowed to fire in proper order. However, they serve as poor subs for longus capitis due to their insertion at the mastoid process. When reciprocally weakened from suboccipital hypertonicity, longus capitis muscles give way to the powerful SCMs causing them to fire first in an effort to hold the head upright on the neck. But, instead of holding the head upright, the SCMs "extend" the head on the neck, causing a forward head posture. Neural and vascular structures embedded under the posterior O-A joint aren't happy with this excessive compression.
When the neck's normal firing-order sequence is disrupted, synergistic muscles begin pulling the head in different directions, sending torsional and compressive forces through the facet joints and intervertebral discs. This often results in chronic degenerative conditions such osteoarthritis (spurring), degenerative disc disease and ligamentous laxity. The client may come in complaining of migraines, radicular pain in the arms or thorax, or even an unsightly dowager's hump (Figure 2).
At some point, the brain may get "fed-up" with the flood of noxious mechanoreceptor and possibly chemoreceptor input, and decide to lock the area down with protective spasm. Of course, this may further alter the firing order pattern causing a pain-spasm-pain cycle that's often hard to break. The client's gait may reveal certain body parts that appear frozen in time, as chronically embedded compensations have caused the brain to sacrifice complexity of movement for stability. Fortunately, simple tests help determine if synergistic dominance exists at a particular joint.
Forward bending of the head and neck with the client in a supine position should initiate the following firing-order sequence: longus capitis, longus colli, SCMs and anterior scalenes. The deepest intrinsic muscles must fire first starting with longus capitis (flexing the head on the neck) followed closely by longus colli, which initiates the beginning of neck flexion. Anterior scalenes and SCMs can then join forces to produce smooth head-and-neck flexion.
The most commonly seen substitution pattern (SCMs, anterior scalenes, longus colli and longus capitis) causes the chin to reach toward the ceiling rather than tucking into the chest during the first two inches of flexion efforts (Figure 3).
The neck flexion test alerts the therapist as to which musculofascial tissues need lengthening and which must be strengthened. By performing the head-raise test before and after each neck session, aberrant substitution patterns can be easily identified and corrected. Tension-length imbalances are usually easy to fix once proper assessment is made. The technique demonstrated in Figure 4 is one of my favorites for treating adhesions and contractures in the SCM muscles and accompanying fascia. Please visit http://youtu.be/UmS2pPZIFnw as I perform the neck flexion test and SCM release.