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.
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.
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."
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.
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.
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.
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.
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.
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."
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?
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.
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.
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.
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?
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:
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 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.
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.
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).
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.
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.
ACA Champions H.R. 7157; ICA Voices Major Concerns
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
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 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.
A Structural Challenge: Successfully Treating a Morton's Neuroma
Runners, triathletes, dancers, hikers, cyclists, almost all athletes, and even couch potatoes have shown up in my office looking for alternatives to surgery for neuromas. A Morton's neuroma occurs when the tissue in the foot (next to a nerve that leads to a toe) thickens and becomes fibrous. The result is pressure on the nerve causing irritation, usually between the third and fourth toes.
In athletes who run or perform on their feet the repetitive motion of extensive training increases their chances of developing a Morton's neuroma. Shoes are incredibly important. Unfortunately, many of the shoes don't provide proper structural support or cushioning for their feet.
This is also a challenge for women because of high heeled shoes forcing the weight forward onto the balls of their feet. Yet, some women and athletes do not develop Morton's neuromas even with extensive training. Obviously the quality of the shoes is a factor, but the structural support that includes the foot and the entire leg is just as important.
Meghan, a 26-year-old Ironman competitor, developed a neuroma during her training for her second Ironman competition. She first noticed it when the running phase of her training reached approximately 15 miles. The pain was severe—to the point that she couldn't walk at all for several days and felt like there was a nail in her foot. After several trips to the podiatrist, cortisone shots, Botox shot, orthotics, and missed weeks of training, the medical solution for her Morton's neuroma was surgery, which meant missing a minimum of six weeks of training. This would eliminate her ability to participate in the Ironman competition for which she was currently training.
She came in for treatment with a goal of continuing her training and being in shape to better her time from last year's Ironman competition. Since her neuroma had developed in the long distance running phase of her training we examined the shoes that she had been wearing to see if they were contributing to the problem. They were suspect because she had gotten new, supposedly better running shoes just two weeks before the Morton's neuroma appeared.
One of the great things about applied kinesiology is the structural support of shoes, as it affects the structure, can be tested. We tested her new shoes with the orthotics that had been custom made for her and she tested weak. Her body was saying it was obvious that the orthotics were not helping. Her shoes were then tested without the orthotics and they again tested weak. So, not only were the orthotics exacerbating her neuroma, but her shoes were not providing proper support. I taught her how to take a friend to test for appropriate running shoes, which she promised to do.
It was now time for a structural evaluation. She had a left anteriorly rotated ilium, a medially rotated left knee, and the left foot with the neuroma was laterally rotated with a collapsed arch. It was easy to determine this was part of the spiral twist in her body, the core distortion, and changing the lack of structural support by applying Cranial/Structural Core Distortion Releases (CSCDR) was necessary.
After it was applied there was significant improvement in her structure. Her left ilium showed approximately a 15 degree improvement from its anteriorly rotated position—so it was now supporting her sacrum, her functional leg length had evened out, and her left knee was no longer as medially rotated.
Her foot and lower leg were no longer as laterally rotated, and the arch was not as collapsed. There was a more even triangulation of weight distribution in her foot at the calcaneus and ball of the foot, behind the big toe and little toe. Also, there was improved strength and function in her quadriceps, adductors, gastrocnemius, soleus and popliteus, which were evaluated with kinesiology.
There was now a structure for rehabilitation. Specialized myofascial soft tissue protocols were applied to bring the leg further into balance and increased support to the ilium/sacrum relationship. The lower leg was treated to bring the foot further into support and balance. Specific myofascial fiber strokes were then applied to spread and soften the thickened tissue of the Morton's neuroma. This work was sensational, but after each stroke there was a noticeable decrease in her pain.
After the session Meghan was able to walk with minimal pain and asked if she could work out right away. Ideally she should wait until all the pain was gone and then start working out slowly.
However, given her training regimen and her desire to be ready for her Ironman competition, I knew this wasn't going to happen. So, she agreed to ice the foot and not train the day of the session.
Usually, when treating a Morton's neuroma, sessions are scheduled once a week, but since Meghan was going to continue her training she was scheduled twice a week, as the training would continue to irritate the tissue while it was healing. Meghan had a total of six sessions, twice a week while she continued to train. In each session she was evaluated structurally.
Cranial/Structural techniques and specialized myofascial techniques were applied to improve her structure, especially the weight bearing support of her left leg and foot. The work on the neuroma progressed to the point it could no longer be palpated or located. The tension was released in the fibers in her lower leg relating directly to the neuroma, which no longer stood out either by palpation or by sensation. By her sixth session her running had reached the 20-mile mark and the pain and discomfort from the neuroma was gone.
Meghan competed in the Ironman competition and posted her best time. The key to Meghan's recovery from her neuroma was correcting the structural collapse that went down her body into her foot.