Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
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.