Vaccine Injury? The Autism Debate (Part 2)
As suggested in my first article on this topic [August 2018],1 my impression is that the vaccine authoritarians and radicals have not helped to mold a proper social / political environment for addressing the issue of vaccine injury.
An Update From the Acupuncture Now Foundation
Since launching the Acupuncture Now Foundation (ANF), our volunteer leadership has continued to work to achieve our vision of "Creating a World Where the Benefits of Acupuncture are Known and Available to All.
Depression & The Secondary Vessels
As an acupuncturist I see many people suffering from depression. I often think depression is the major imbalance of our culture. I have a patient I've been working with for several years. Her major challenge is chronic stubborn depression.
Multichannel Access: Software for a Better Customer Experience
It is no secret that today's consumer has high expectations when it comes to how and when they can contact a business. In fact, one of the reasons clinic management software has become so popular with acupuncture practitioners is they allows customers to book appointments and make payments online day or night.
UHC Up to Its Old Tricks With Latest Headache Policy
A decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven and ineligible for reimbursement.
Time-Saving Tips for Your Practice & Life
Of all the finite resources we possess, perhaps the most valuable one is time. There never seems to be enough time to accomplish everything that must be done, and all too often we sacrifice things in our personal life to meet the demands of our practice.
Support Patients With Multi-Channel Customer Service
It's no secret that today's consumers have high expectations when it comes to how and when they can contact a business. In fact, one of the reasons clinic management software has become so popular is that they allow patients to book appointments and make payments online day or night.
The Origin of Blood
The Roman doctor, Galen, (2nd century AD) did pivotal work to prove that blood, which he thought was produced by the liver, and the cardio vascular system existed. He conceived that the arteries and veins were two separate networks.
The international standardization conference was held this year in Shanghai, China (June) - this was the ninth plenary session. Meetings for technical committees, or working groups also took place at the conference.
That's a Wrap: Compression Bands for Contemporary DCs
Over the past decade, compression bands have been increasingly utilized in trainer and manual therapy offices. I was first introduced to the compression band by Kelley Starrett, author of Becoming a Supple Leopard, and have since been using it as a teaching tool.
Food for Thought: An Examination of Diet & Digestion
Even an acute poison can become an excellent drug if it is properly administered. On the other hand even a drug, if not properly administered, becomes an acute poison. — Charaka Samhita
Bringing Acupuncture to Ohio
The jolt of seeing a woman conscious and talking during surgery left a lasting impression in 1971 when acupuncture was on the national news.
X-Ray: To Be or Not to Be - That Is the Question
For the past year, I have been asked by many practicing chiropractors, college presidents, faculty and others what my opinion is on the "Choosing Wisely" guidelines the American Chiropractic Association (ACA) recently adopted for its members.
The Benefits of Going Paperless
The benefits of going paperless in your practice are profound. If you haven't done it yet, here's why you should.
More Access to Chiropractic Instead of Opioids: H.R. 5722
With the opioid epidemic both an ongoing public health crisis and a hot topic extending well beyond the health care industry, Congress continues stepping up to the plate.
A Historic First for Chiropractic Assistants
The New Jersey State Board of Chiropractic Examiners will begin issuing licenses as early as Nov. 1, 2018 to chiropractic assistants who have undergone a 500-hour training course and passed a competency exam.
Lead Patients to the Fountain (and Foundation) of Youth
We're all seeking the fountain of youth and marketers are capitalizing on it. (Global demand for anti-aging products, treatments and services was valued at 140.3 billion in 2015, according to Zion Market Research.)
Neck Pain: Activation Exercises
In observing patients and studying rehab, I have learned that tight muscles are weak muscles and that stretching is sometimes less effective than muscular activation. There is a delicate balance between joints that move too little and joints that are hypermobile.
Working for Someone Else: Know the Rules of the Game
Many of us decide to become acupuncturists because we are healers at heart and want to focus on treating patients, not because we want to own and operate a business. So we work for someone else, which can have great advantages, especially as a new graduate.
"Don't Crack My Neck": What Do You Do Next?
It's Monday morning and your first new patient of the day, a 35-year-old female, presents with chronic headaches and neck pain. The patient was referred by her primary care provider for evaluation and management without the use of cervical manipulation.
Easy, Inexpensive Tools for a Successful Practice (I Promise)
Successful practitioners are the ones who know how to run a business, first and foremost. I became a licensed acupuncturist in 2006. After having worked in chiropractor's offices for nine years, I opened my own office in 2015: four treatment rooms, a back office and a waiting room.
A New NCCIH Director ... One That Backs Acupuncture
The third time is a charm—the National Center for Complementary and Integrative Health (NCCIH), a division of the National Institutes of Health (NIH), announced it's newest director, Dr. Helene Langevin.
The Science Behind the Efficacy of Cosmetic Acupuncture
The beauty industry continues to boom and grow constantly, from topical creams, lotions and potions all the way to cutting edge cosmetic surgeries.
Travel-to-Treat Coverage Finally Becoming a Reality?
Long-awaited legislation poised to hit the president's desk extends liability insurance coverage from one state to another for DCs and other state-licensed health care professionals who care for athletes / athletic teams that cross state lines.
Chiropractic Management of Patellofemoral Arthralgia
Patient reports with pain in the front part of her right knee, especially during and after her weekly Zumba class. She states there has been no injury of which she is aware. No outward sign of injury is observed.
The Importance of the Scapulohumeral Rhythm
The shoulder has the greatest range of motion of any joint in the body. What is often overlooked in shoulder mechanics is that motion in the shoulder is not purely at the glenohumeral joint.
Possession: Blocks to Healing
Before we can approach treatment of a patient's primary elemental imbalance (AKA "Causative Factor" or "CF"), a number of specific energetic blocks must be considered and, if present, removed in order for treatment to be effective. I cannot emphasize this enough.
It's Time to Reward Yourself
An interesting study recently published in the Journal of the American Heart Association (JAHA) confirms what we all learned when we were children – and serves as food for thought as to how you can improve your practice and your personal life.
Your First Impression Always Deserves a Second Chance
Doctor, have you ever had a patient you just couldn't "warm up to"? You know, the kind of patient who "irks" you, who has a hidden agenda to get something you haven't anticipated, perhaps causing you to want to hide in a closet when they come in for treatment.
February, 2011, Vol. 11, Issue 02
The Bike Body
Working With Cyclists
By Erik Dalton, PhD
It's astonishing the money and time many elite and "weekend-warrior" cyclists devote to retrofitting racing bikes to conform to their bodies rather than first restoring function to the most critical piece of racing equipment: the rider's body.When muscle imbalances, faulty movement patterns and joint fixations distort the body's bony framework, the cyclist is led on a never-ending journey searching for that perfect bike fit. (Fig. 1)
My personal mantra: "Fit the body to the bike, stupid!"
Bodyworkers and functional movement trainers whose practices cater to amateur and elite cyclists are keenly aware of the clinical and performance advantages gained by restoring optimal mobility, flexibility and stability to the biker's muscle/joint complex. It makes sense to first get the kinks out before sending the client off for an expensive and sometimes useless bike retrofit. Without hands-on maintenance and functional fine-tuning, cyclists often unknowingly reinforce dysfunctional movement patterns ingrained from long-forgotten micro- or macro-traumatic injuries.
Confusion and controversy over this chicken-or-egg (bike-or-body) thing is primarily due to lack of understanding of the Law of Cause and Effect. For instance, let's say a bike shop performs a retrofit and Bob, the cyclist, smilingly pedals away on his newly reconstructed machine feeling secure and pain-free. Life is good... or is it?
Unfortunately, if Bob is one of many "flexion-addicted" Americans with a sedentary job that keeps him glued to the computer terminal day-after-day, gravitational exposure will gradually drag his body into a big "C" curve. (Fig. 2) In time, Bob's brain relearns this aberrant posture as normal and on weekend outings his "hip-flexed" desk posture morphs into a similarly distorted riding posture. (Fig. 3)
To make matters worse, stubborn pain-spasm-pain cycles often appear as the hip stiffens and the imposed stress destabilizes sacroiliac and low back structures. In the presence of lumbar spine instability, the brain may decide to lock down the low back and ribcage with protective muscle guarding. Thoracic cage rigidity not only inhibits proper diaphragmatic breathing but also sends shock waves through the thoracolumbar and pectoral fascia and into the upper extremity joints where reverberations are met with strong resistance from habitually locked hands, elbows and arms. (Fig. 4) Meantime, compensations from adhesive hip capsules also traverse down through Bob's knees, ankles and feet searching for a weak link in the lower kinetic chain.
Cyclists who opt for a bike retrofit prior to receiving manual therapy to release fibrotic hip capsules and hip flexors, soon notice a loss of endurance and may develop soft tissue or joint sprains associated with lumbopelvic imbalance. Oddly, many flexion-addicted cyclists attempt to work through the injury despite sensing a noticeable reduction of speed, power and efficiency. "No pain, no gain" is an unacceptable working model for those seeking longevity in the cycling sport.
Does decreased hip angle equal less power?
One of the most common bike positions used by "flexiholics" has the hip flexors locked short and the hams and glutes overstretched and weak. This imbalance pattern as described by Vladimir Janda in his lower crossed syndrome, forces the pelvic bowl to be drawn too far forward creating a decrease in hip angle. (Fig. 5)
Cyclists who consistently ride with an anteriorly rotated pelvis and decreased hip angle are subject to capsular and ligamentous adhesions and a subsequent loss of economy and power. To accommodate the loss of hip extension, many recreational and competitive racers compensate by posteriorly tilting their pelvic bowl and rounding their backs into a hyperkyphotic posture just to increase hip angle and power. The famed cyclist Andy Pruitt believes that changing the seat height by a mere inch alters mechanics and motor control patterns of every joint in the lower extremity. By decreasing seat height, excessive force is transferred to the patellofemoral joint, while raising the saddle too much strains the hamstrings, low back and hands.
Stand and try this: Lift one leg with the knee bent about 90 degrees as high as possible without straining or rounding the back and forcing hip flexion. Most people are able to comfortably hip-flex about 90 degrees. Try this maneuver again except this time forward-bend your trunk about 50 - 60 degrees, while raising the knee. Notice a dramatic reduction in the amount of hip flexion? Try both tests again and this time, measure available hip flexion by observing how high your foot raises off the ground. This test illustrates what can happen to hip-impaired cyclists: decreased hip flexion = greater effort = more work = poor performance.
Riding Postures and Rehab
The first order of business when treating adhesive (motion-restricted) hip flexors and capsules is to mobilize the hip in all three cardinal planes. (Fig. 6a) To restore myofascial balance, fast-paced "spindle-stim" maneuvers such as those shown in Fig. 6b help tonify weakened (neurologically inhibited) gluteal and hamstring muscles. Once the therapist manages to increase hip angle and establish proper functional balance and range of motion, the cyclist is free to decide which type of riding posture (he believes) suits him best.
Some cyclists prefer a high seat so they can posteriorly rotate the pelvis to increase hip angle. Other riders find greater mechanical advantage by putting a little curve in the low back, engaging the core, and then slightly backing off the curve to allow a neutral lumbar spine. Either way, both groups should avoid:
The Yin-Yang of Muscles and Joints
To perform well in such a challenging event, cyclists like Bob would greatly benefit from a well-constructed manual and movement therapy program that focuses on restoration and maintenance of proper intrinsic/extrinsic muscle balance and diaphragmatic breathing patterns. Fluid and dynamic body movement during cycling events is dependent on the ability of muscles and fascia to stay strong, yet flexible. A healthy lumbar spine is the driving engine in most athletic endeavors and length/strength balance between muscles, ligaments, joint capsules, and thoracolumbar fascia is essential for providing that stable platform. Any weakness or motor control issues are magnified by traumatic shocks from funky road conditions or recurring bike injuries. Eventually, excessive neurological input cannot be handled at the spinal cord level and the information is "fast-tracked" to the brain for interpretation via pain-signaling nociceptors. If the brain decides to "splint" the vulnerable area to prevent further insult, pain-spasm-pain cycles may ensue.
Ingrained muscle and motor imbalance patterns such as those discussed by Vladimir Janda, Gray Cook, Craig Liebenson and others, often require a concerted team effort to reestablish normal movement behavior. In most cases, the ideal treatment protocol is to first restore lost mobility to impaired structures and then address stability issues via functional movement training.
Like many of America's other popular, but abnormal, athletic endeavors such as golf, tennis, bowling, etc., cyclists bring with them a complex biomechanical downside that's often hard to completely fix. The "arched back" model is generally the most problematic. In an attempt to level the eyes, the rider must hyperextend occiput on atlas. The cervicothoracic junction is also forced to hyperextend (neck-on-shoulders) causing chronically locked intervertebral joints and rib jamming. This area is particularly affected by road vibrations due to the stationary position of arms, shoulders and hands. Additionally, ligamentous laxity may develop from excessive thoracolumbar and lumbosacral bowing which, in time, sets the stage for low back pain and disability.
The good news is that the human body is both adaptable and dynamic; the bad news is that our biker clients often bring along a lot of baggage including flexion-addicted sitting postures, old injuries, compensations, poor training habits, etc. Once the skilled manual and movement therapist makes necessary corrections, the bike can then be retrofitted to conform to the rider's optimally functioning body. A properly fitted bike combined with a revitalized and functionally balanced neuromuscular system allows muscles and joints to work at optimal levels of motor unit recruitment and synchronization. As endurance and performance improve, so does the natural love of cycling.
Click here for previous articles by Erik Dalton, PhD.
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