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.)
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.
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.
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.
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.
"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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
October, 2010, Vol. 10, Issue 10
The Mambo of Golfing
By Erik Dalton, PhD
We see it all the time on sports channels. How do they do it? That golf swing is really a work of art. Requiring such a complex array of finely coordinated movements, it's no wonder a golfer's body is considered a ticking time bomb for acute injury or chronic pain.
Recent stats: 53 percent of male and 45 percent of female golfers suffer low back pain; 30 percent of professional golfers play injured; 33 percent of golfers are over the age of 50; and playing golf and another sport increases chance of injury by 40 percent.1
Researchers agree that a majority of injuries affecting male golfers manifest in the low back and are related to improper swing mechanics and/or the repetitive nature of the game.2,3 The amateur or weekend golfer typically experiences injuries due to improper swing mechanics, whereas the sports professional is more likely to fall victim to overuse injuries from obsessive repetitive movement patterns. When a high velocity rotary force couples with trunk sidebending (the crunch factor), the golfer's spine and deep paravertebral tissues take a beating. No wonder low back pain (LBP) is the most common golfer complaint! (Fig 1)
To hit the ball a great distance, the body must have the ability to rotate into and maintain a wide arc throughout the swing. (Fig 2) Manual therapy techniques that increase range of hip turn allow a decrease in the amount of shoulder turn, thus reducing the amount of trunk flexion and sidebending during the downswing (the most damaging moment of the swing). If golfers lack full range of hip mobility due to an adhesive capsule, powerful torsional forces will travel up the kinetic chain through lumbopelvic ligaments, joint capsules and intervertebral discs. Motion-restricted facets and damaged ligamentous tissue can neurologically inhibit deep spinal groove muscles such as rotatores, multifidus and intertransversarii leading to substitution patterns and low back instability.
Reported in the Journal of Science & Medicine in Sport (2008), University of South Australia researchers found that golfers with LBP were overly dependent on erector spinae muscles for spinal stabilization rather than allowing load transfer to be distributed among more efficient lumbopelvic stabilizers such as quadratus lumborum, transverse abdominus, multifidus, hip extensors, and thoracolumbar fascia.4 They theorized that the brain, sensing weakness, is forced to recruit global muscles (lumbar erectors and obliques) to compensate for the weakened deep spinal stabilizers. The question is, "What mechanism causes the deep lumbopelvic stabilizers to weaken?"
Reconnecting the Disconnect
The body's myofascial system is built from a continuous arrangement of tissues designed to function in organized patterns, not as isolated muscle groups. When operating properly, energy is efficiently transmitted via force-coupling through a reaction chain rooted in the ground. Motor unit recruitment only becomes isolated to a particular muscle group when the brain senses a system disconnect and calls in "the subs." For example, during a golf swing, if a fibrosed hip capsule were blocking energy transfer up the kinetic chain, normal force-coupling would suffer due to lack of mobility of the femoral head in the acetabulum. (Fig 3) The therapist must first mobilize the fixated joint in all three cardinal planes, and then move up the kinetic chain to assess and correct any sacroiliac or lumbar compensation that may be driving the golfer's back pain.
Successful treatment of golf-related injuries not only requires golf swing modifications and functional rehab, but, in most cases, restoration of proper lumbar lordosis. Too much or too little curve results in excessive torsional and compressive loads through the thoracolumbar and lumbosacral junctions. The myoskeletal approach begins by correcting lower crossed muscle imbalance patterns followed by restoration of "joint-play" to fixated low back, sacroiliac and thoracic articulations.
Lower Crossed Syndrome
Developed by the legendary neurologist and rehab specialist Vladimir Janda, MD, the lower crossed syndrome represents a grouping of weak muscles and overactive or tight muscles that, together, produce a predictable low back movement pattern which often leads to injury. (Fig 4) Janda's EMG research recorded a significant number of people developing a distinct pattern of muscle imbalance due to prolonged static posture. He noted that when a muscle is left in a shortened or contracted state for an extended period of time, reciprocal inhibition (reflex weakening of muscles on the opposite side of the body) occurs.
Many "weekend warrior" golfers sit at their job for hours on end in a hip flexed position. Day-by-day the hip flexors tighten and shorten causing reciprocal weakness of glute-max - a crucial hip stabilizer during the golf swing. No longer able to aid in pelvic stabilization, the weakened gluteals force the brain to recruit synergistic muscles like the hamstrings and lumbar erectors to assist in hip extension. When golfers present with a flabby protruding abdomen, flat buttocks and excessive lumbar lordosis, the first order of business is restoring a healthy length to hypertonically shortened hip flexors followed by hands-on fast-paced spindle-stim techniques to wake-up the weak gluteals. (Figs 5 & 6)
It's easy to spot "lower crossed" golfers by observing their set-up posture from down-the-line. The swayed low back forms an anterior curve and, with the head down in set position, the thoracic cage becomes convex. This posture is often referred to in golfing circles as the "S-posture". Oddly, many golfers consciously stick their buttocks out because some golf pro told them they could generate more power on the downswing. In reality, once the thorax is arched and the back is swayed during set-up, the golfer can no longer "hinge" from the hips and is unable to maintain the spine in a stable neutral position. Loss of deep and middle layer core support sets the stage for future damage to lumbar and SI joint ligaments, articular cartilages, and intervertebral discs.
Rarely do humans move one muscle at a time along a single plane. Modern science reveals the brain does not recognize individual muscle activities because there is no need. Instead, the cerebral cortex maps movement patterns and coordinates the neuromyofascial net to meet the specific activity. All is well so long as information entering the central nervous system is not garbled by noxious stimuli from fixated joints, damaged ligaments, trauma or faulty ergonomics. Since the primary function of synovial joints is to transmit stress when stabilized by muscle contraction, anything that disrupts this action prevents muscles and enveloping fascia from achieving maximum leverage to move the body through a desired action such as a smooth golf swing.
The greater control the golfer has over new and diverse movement patterns, the better she will perform with decreased odds of injury. In the presence of a revitalized and functionally balanced neuromyofascial system, joints and muscles operate at optimal levels of motor recruitment and synchronization. As the rate of force production and maximum acceleration improves, so does the golf swing and the natural love of the sport.
Click here for previous articles by Erik Dalton, PhD.
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