A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
When Computers Cause UCS: Adjusting Strategy
With the widespread use of mobile devices such as smartphones and tablets, the incidence of "text neck" has reached almost epidemic proportions. But there is another challenge to the spinal health and well-being of our technology-driven society.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
2018 Gallup-Palmer Report: Key Findings
The fourth annual Gallup – Palmer College report is out; here are some of the key findings excerpted directly from the executive summary regarding Americans' experiences with chiropractic care relative to the management of neck and back pain:
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
February, 2013, Vol. 13, Issue 02
CranioSacral Therapy and the Multiple Therapist Approach
By John Matthew Upledger
One of the qualities of CranioSacral Therapy that has always fascinated me is how well the modality lends itself to multiple therapist work. I have watched, as well as experienced, the coming together of two or more therapists as virtually one set of hands, assessing and responding to areas of restriction within a client's body. Through the process I have seen exponential improvements in a person's health.
The approach always reminds me of a concept I learned while working as a waiter in college. The restaurant brought in a wine expert to teach us about the "synergistic" effect of pairing certain foods with different wines. He explained that, while the food and wine were very good individually, when the right ones were combined they were even better.
I like how Sue Cotta, MSPT, CST, describes it in terms of the practice of CST, "In multi-hands work, one plus one equals more than two. More gets accomplished when two therapists treat for one hour than when one therapist treats for two hours." A longtime proponent of the multiple therapist approach, Cotta regularly joins with fellow CST practitioner Susan Steiner OTR/L, CST-D, to work on each others' clients. While they maintain their own practices in separate locations, Steiner in Providence, R.I., and Cotta in Swansea, Mass., they have developed a partnership of sorts, born of more than 20 years each of practicing and teaching CST.
Two of their most challenging cases on which they collaborate are a boy, now 4, with cerebral palsy (Steiner's client) and a girl, now 10, with microcephaly (Cotta's client). For both of these children, life has been a succession of medical and therapeutic interventions; it will be that way throughout their lives. Yet, in the years that each child has received CST, there have been profound breakthroughs — the kind that can't be attributed to anything but CST Cotta says.
Steiner remembers the first time she saw Robbie (name changed). Six months old at the time, he presented with cerebral palsy and severe brain damage due to anoxia resulting from birth trauma. His behavior was characterized largely by screaming and posturing, particularly when placed in a seated position. Just getting him into a car seat to get to the appointment was almost impossible for his frazzled mother.
Assessment showed that Robbie held a restriction, like a whiplash, in his neck. His dural tube was so tight that his hips curled forward and his back arched, causing him to go into spasms. Through the course of the session, Steiner felt Robbie's neck restrictions begin to release and his dural tube to elongate. By the end of the first session, he was able to sit in the car seat without crying. "That was a huge change in quality of life not just for Robbie, but for his mother, too," Steiner said. "Imagine being able for the first time to drive your child around without him screaming."
In the case of Carla (name changed), the challenges to treatment were just as great. Legally blind and fitted with tracheostomy and gastrostomy tubes, the then 2-year-old reacted to her initial sessions in an unexpected way. "She would go upside down almost every session and wanted to stay that way the whole time," Cotta said. Asking the mother about her daughter's birth, Cotta was told that Carla had gotten stuck in the birthing canal. When the delivery actually occurred, she came out so quickly that her clavicle was broken. By going into the upside down posture during sessions, "It was like she wanted to relive her birth except slow it down this time," Cotta said.
CST treatments with both children over the years have been a combination of individual and dual therapist sessions focused largely on their dural tubes and cranial membranes. "To paraphrase Dr. John E. Upledger," Cotta says, "The cranium is like the foundation of a house. If we can get that foundation corrected, it will help the house to be balanced." In other words, "We'll improve the ability of the brain to function (more efficiently)." Over the course of time, both Robbie and Carla have experienced improvements and reached milestones that no one expected.
With Robbie, there is a visible decrease in his tone and pain, and an increase in his ability to sleep and eat. His facial structure has become symmetric and the quality of his skin is much better. His mother described the effect of CST on her son as being "intensely calming" and helping him to "transition from a traumatized, defensive, clenched being into a more relaxed baby, better able to absorb some of the world around him."
Carla, who started with vision of 20/1200 is now at 20/132 and no longer considered legally blind. Doctors are working to reverse the tracheostomy because the tracheomalasia (softening of the trachea) is no longer an issue. She also has seen improvement in the areas of digestion and communication. Just as significant as these physical and functional improvements are the issues that haven't manifested. For example, Carla hasn't developed scoliosis, which doctors expected to happen because of the severity of her diagnosis. Steiner says, "We may never know all the issues that have been prevented because of the cranial work."
Working In Tandem
When working as a part of a multiple therapist team, Steiner and Cotta emphasize that a key to success lies in letting go of ego. Just as in an individual session, the multiple therapist CST experience is about blending and meeting the client where they are. "If both therapists think of themselves as one therapist with four hands, you treat what you find," Cotta says. "Susan and I don't treat independently. Our hands are an extension of the other person's hands."
By working this way, Steiner says, "There is an increased energy and awareness, and more areas of the body can be addressed in one session. Oftentimes, Sue will have the neck and I'll have the sacrum. Sometimes there's a tension involved, and one will have to stabilize while the other mobilizes. We end up being able to treat the entire structure."
Robbie's mom describes the experience from her vantage: "As an observer, the sessions feel like a dance to me. There is an indescribable energy in the room, something that brings about an emotional fluidity, the same way music can strike your soul. The difference between the individual session and the multi-hands session seems to me like the difference between a dancer dancing alone to swinging with a partner. There is a mutual support between the therapists that both broadens the treatment and heightens the awareness of the client."
"Parents who bring their children to CST feel like their children are being touched and seen in a way that is important," Steiner says. "Sometimes we think of CST as helping those who have a pain or want a better quality of life or wellness. These cases show how CST is valuable for anybody with any challenge. When you meet the individual at the place where they are and treat from there, great things can happen."
So whether you are pairing the right wine with dinner or pairing the right therapists for a treatment, the concept that I learned back in my college days holds true. As these cases attest, CranioSacral Therapy and the multiple therapist approach has a synergistic effect.
John Matthew Upledger is the CEO of Upledger Institute International. For 25 years, he has been actively engaged in all aspects of the organization — from education to clinical services. For more information about CranioSacral Therapy and other modalities offered for study through Upledger Institute International go to www.iahe.com.
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