Supplement Safety: Is It Time to Give Big Pharma a Chance?
Why in the world would I, a chiropractor, consider Big Pharma when I make a vitamin / supplement recommendation to a patient? There are several supplement manufacturers at every chiropractic conference, even at some of our schools.
A Little More Chiropractic, A Lot Less Pain
Why should I visit a doctor of chiropractic when I'm not experiencing pain or other symptoms? That's the question many patients still ask themselves, despite the growing body of research supporting the value of chiropractic maintenance care.
The Carcinogen Most Patients Consume
A known carcinogen is being naively consumed by many, if not most of your patients, who have little to no understanding of how dangerous it really is. Depending on the age of the patient, this carcinogen is a leading, if not the leading, risk factor for death and disability.
Renying-Cunkuo Pulse: The Essential Pulse Method of the Ling Shu
The Ling Shu is a Han Dynasty classic book on the practice of Chinese medicine. It presents five main channel systems: Muscle Channels, Chapter 13; Luo Collaterals, Chapter 10 and others; The Main Channels, Chapter 10 and many more; Separate Channels (Divergent Channels) Chapter 11; and the Eight Extraordinary Channels, referenced in chapters throughout the book (there is very little theory).
A Moment of Silence for Dr. Leon Chaitow (1937-2018)
After months of declining health, Dr. Leon Chaitow – clinician, author and teacher – passed away on Sept. 20, 2018 at the age of 80.
How to Address the Question, "Do You Accept Insurance?"
Do you ever dread getting asked the question, do you accept insurance—when you only accept cash, or when you are out-of-network? As part of my daily practice, mentoring acupuncturists to grow their practices faster and more effectively, I talk to a lot of practitioners.
Pregnancy Health: Looking at the Lower Extremities
When patients tell us they are pregnant, many times we focus on the obvious pregnancy signs and symptoms related to their current trimester of pregnancy, and the biomechanical impact on the spine and pelvis.
Procuring a Place for the Future
As the acceptance of acupuncture continues to grow in the U.S. it is important that the profession be licensed in every state, and nationally board certified.
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.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 1)
In the absence of acute trauma, a usual strength-building session includes concentric, eccentric and isometric exercises. Popular exercise programs typically include concentric movements as the major muscle contraction and should constitute approximately 70-75 percent of the workout time.
Paradise Lost: AWB Relief in Hawaii
In November, 2014, Acupuncturists Without Borders (AWB) was hosting a training seminar on Oahu. A couple of us from the big island (aka "Hawaii" County) contacted AWB because the big island was in the middle of a crisis.
Manual Muscle Testing for Cervical Radiculopathy (Pt. 2)
Dr. John Bandy developed a protocol that associated specific muscles with myotomal nerve root levels. The deltoid is associated with the C6 nerve root; the triceps with the C7 nerve root; and the finger abductors with the C8 nerve root.
World Acupuncture Day: A Meeting in Paris
World Acupuncture Day is an event organized by the World Acupuncture Day Organization (WADO) in response to the eighth anniversary that UNESCO has included acupuncture and moxibustion on it's Representative List of the Intangible Cultural Heritage of Humanity.
Creatine: Muscle Fuel No Longer Just for Athletes!
Erase that image of the 20-year-old, muscle-bound bodybuilder using creatine. Replace it with the image of a lean, strong, fit 80-year-old hiking up a mountain. Creatine, a staple of athletes for more than 50 years, is now being used by athletes and non-athletes alike to help slow normal age-related muscle loss, improve exercise recovery, increase strength, and live a more active lifestyle.
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.
NBCE Exams: Better, Shorter, More Opportunities
The NBCE's Written Exams department, led by Bruce Shotts, DC, developed a solution to computer-based testing on college campuses. Their work has resulted in 11 exam opportunities per year. CBT exams are on schedule to begin January 2019 as follows:
The Husband/Wife Imbalance
The Husband/Wife Imbalance, like Aggressive Energy, is an energetic block that will result in death, unless cleared, as its presence indicates that nature has given up the fight against the internal or external pathogenic factors that have assaulted the body/mind/spirit of the patient.
Case Study: Osteoporosis and the Role of Orthotic Support
The following is the second of three case studies by Dr. Wong on conservative management of lower-extremity complaints. Article #1 (September issue) explored chiropractic management of patellofemoral arthralgia.
Bait & Switch: Are You Guilty?
One of my three sons recently shared a story with me regarding an experience with a chiropractor, which stimulated me to write this ethics article. According to my son, he called a chiropractor's office and asked if his insurance was accepted at the office.
Cyberthreat Checklist: 10 Key Steps to Defend Your Practice
Living in an Internet-connected society brings many conveniences and benefits. The power of the Internet to connect us with customers, store data and find information has opened the door for many small-business owners to grow and flourish.
Vertebral Subluxation: Give Credit Where Credit Is Due
Vertebral subluxation: have any other words caused as much turmoil and controversy in the chiropractic profession? As a chiropractic term, vertebral subluxation did not make its debut until six or seven years after the profession's founding.
Chiropractic Integration a Big Success, Suggests Research
Whether chiropractors should integrate with other health care professionals in medical / multidisciplinary settings remains a contentious issue, depending on whom you ask, but there's no denying two realities.
An Effective Herb for Stress
We all know stress has become a significant factor in the increasing number of reported mental health disabilities and a contributor to various physical health conditions, such as ulcers, high blood pressure, heart disease, and so on.
On Point: Acupuncture Theory & Discussion
Welcome to my new column for Acupuncture Today, which will focus exclusively on the theoretical discussion and clinical application of acupuncture theory and acupuncture points. One of the most common questions I encounter from novice to experienced practitioners is "how do I choose the correct acupuncture point?". I hope this column can help answer some of these questions.
The NCCIH Seeks Participants for Acupuncture RCT
The National Center for Complementary and Integrative Health (NCCIH) is seeking participants for a new Funding Opportunity Announcement (FOA)—a Randomized Control Trial (RCT), which will evaluate the impact of, and strategies to best implement acupuncture treatment of older adults (65 years and older) with chronic low back pain (CLBP).
Checking Your Posture: A Wholistic View From Head to Toe
As you begin reading this article, what position is your body in? Are you sitting down, standing up, lying down, or walking down the street perhaps? Whatever position you are in, stop and observe your posture.
Avoid These New-Patient Turnoffs (Before It's Too Late)
I can't believe this doctor is making me watch this video in a room by myself, your new patient thinks to herself as she texts her best friend.
The Road to TCM, A Talk With Bob Doane
Bob Doane, a veteran acupuncturist, talks about his journey to TCM, the evolution of this medicine, and what he foresees in the future.
Cynicism, Burnout and the Search for the Ideal Patient (Pt. 1)
There is a video on the Internet that has gathered 6 million views as I write this article (so likely millions more by the time you read it). The video is of a doctor in an ER mocking a patient who is extremely weak and distressed.
Placebos, Presence and the Zero Point
We spend a huge amount of time learning the techniques and methods of acupuncture and Chi-nese medicine, and are given professional licenses based on our ability to remember and accu-rately apply them.
A Moment of Silence for Dr. Leon Chaitow (1937 – 2018)
After months of declining health, Dr. Leon Chaitow – clinician, prolific author and teacher – passed away on Sept. 20, 2018 at the age of 80.
News in Brief
The Next Generation of Chiropractic Researchers: Historic NIH Grant; Cleveland University – Kansas City VP Joins CCE Site Accreditation Team; NUHS Opens Second Veterans Clinic; R.I. Chiro. Society Celebrates 100 years.
January, 2012, Vol. 12, Issue 01
A Golfer's Worst Nightmare Rehabilitated Through Massage
By Debbie Roberts, LMT
For many golfers, the only meaningful way to spend a sunny day is out on the links. With 18 holes to look forward to — the sun's rays caressing the greens, blue skies inviting deep breathes, and the warm leather grip of a favored club in hand — nothing much can break their joy of being alive.Until, that is, pain strikes. Pain in the physical sense such as a muscle tear or unstable joint, or the pain they feel from a continually declining game performance. For a die-hard golfer, the two pains are equally worrisome. And, left unresolved, grow to become their worst nightmare: the end of their golfing and no more need for sunny days.
Massage therapists are all well aware that, as the human body ages: muscles atrophy, tissues lose elasticity and overall flexibility declines. What many therapists have yet to fully understand, however, is that static stretching of muscles is rarely enough to correct these affects (Siff and Verkhosansky 1993, Siff 1994, and 1998). And even dynamic stretching is an incomplete course of treatment for many of our clients — especially those who golf.
Kinematic Sequencing and Therapeutic Improvements
To effectively assess and treat the unique needs of a golf client requires that the therapist first acquire an advanced knowledge of body dynamics, namely, the kinematic sequencing of the golfer's body.
Kinematic sequencing refers to the specific order that the body engages its muscles, bones, joints and balance to perform a movement. In our golfing clients, the movement is striking the ball.
For an efficient golf swing to take place, the process of kinematic sequencing looks like this:
Once the ball is struck, the body again engages in a kinematic sequence, this time of deceleration, with the pelvis engaging first, followed by the trunk, followed by the arms, followed by the hands and club. That is good sequencing.
As massage therapists, the better we understand kinematic sequencing — especially in our rotational athletes who play golf, tennis, baseball, bowling and soccer — the the better we become at assessing our clients' pains, restrictions, limitations and frustrations.
And the first step to better assessing our clients is to perform better evaluations. Specifically, how they present when they take a static posture and when they take a dynamic posture as they describe their pains, restrictions and issues.
Static posture is, of course, the position of the body at rest, sitting, standing or lying down. This is typically what we see most often as massage therapists. Our clients sitting or standing before us or perhaps already laying on the table as they describe their pains and wait for us to treat them.
Dynamic posture, on the other hand, has the patient: move, twist, lift, pull, push and balance in order to reveal the likely causes of the client's pain or imbalance. The difference in evaluating your client's condition using dynamic posture as well as a static posture is often the critical and missing step in properly assessing and treating our patients (Doctor Vladimir Janda "Upper and Lower Cross Syndrome" 1979, cited in Lewitt 1999).
To only evaluate your client in a static posture would be missing the holistic nature of human dynamic motion and posture. Sure, you can look at a left hip internal rotation when your client is on the table and find a deficiency of say 15-20 degrees, but that won't give you an accurate picture of what's really affecting the golf swing until you ask your client to stand up and perform the very movement that causes the trouble. So to replicate the golf swing, you must ask your client to do an internal rotation so as to move the trunk over the hip.
Frankenstein on the Golf Course
Here's an example from my own clinic. I recently had the opportunity to work with a golfer who had bilateral hip replacements, a right knee replacement, and a left shoulder injury that was never repaired. I hate to say it, but he walked like Frankenstein and, as you can predict, his traumas lead to a continuing decline in his game performance.
When golfers ready themselves to strike the ball they bend their knees into a semi-squat formation. So to properly assess my client's condition, I asked him to squat, slowly, all the way into a chair. And as he did so, I observed his ankles, knees, hips, trunk and motor control. I then asked him to stand on one leg. His ability to maintain a one-legged posture lasted less than three seconds. I also noted that he could not even begin to touch his toes; and he had limited trunk control, pelvic and spinal rotation. He had a forward head posture, kyphosis, and evaluation of his left shoulder joint presented the arm well in front of his ear instead of the proper placement which is beside or behind the ear. As you might infer, he clearly needed better flexibility. But, because of his hip prosthetics, it would be inadvisable to stretch his hips into internal rotation.
For this client, I began by making a basic golf movement better. Namely, the squat. Simply by teaching him to use his hips better, it allowed him to stay in a golf posture longer which helped with his swing path, tempo and striking distance — and his enjoyment of the game. We always combined our sessions with manual therapy, focusing around the hip rotators, to help him improve his hip hinge.
If you are ever presented with a client suffering with similar impairments, begin by writing down your assessment of how each muscle is affecting the joints in the lower extremities. Look at the flexibility of the feet as they relate to overall stability during weight shifts. Create more ankle mobility by addressing the dorsiflexors and removing myofascial restrictions. Check the client for the ability to do inversion and eversion of the ankles. Attempt to lengthen the quads, hamstrings, adductors, IT band, gluteals and psoas. Your goal is to increase the length of the flexor chain and increase strength to the extensor chain.
Once you've completed all of the above, recheck the client's movement by asking your client to perform another squat or the movement pattern that is causing the concern. If your client has yet to improve, it may indicate that just stretching the lower extremity is not enough. Adding mobility without adding stability may not change the movement pattern. You may need to become a teacher of the squat. Put a chair behind the client, have them do an isometric press into their hands to activate the core, and teach them to hip-hinge back into the chair. Then repeat your manual therapy and re-check your client's range-of-motion. Continue to do this as many times as necessary throughout the session to reveal how much your client's motor control is improving. You will often see minor improvements during the first session and noticeably bigger improvements during subsequent appointments.
This is the protocol I implemented with my own client and he improved dramatically. In just three months, I had him transform his gate from that of a B-movie monster to that of a young man walking with a kick in his step. He also lowered his golf handicap, feels younger, stands taller and more importantly . . . he is now free of his worst fear — that of believing that he'd never again enjoy playing 18 rounds of the great game of golf.
Click here for more information about Debbie Roberts, LMT.
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