tag:typepad.com,2003:weblog-1250480 2008-07-10T09:25:32-07:00 Focus on hardware and diagnostics. TypePad tag:mpamedia.com,2008:post-54418 2010-01-15T12:00:32-07:00 2010-01-15T12:00:07-07:00

This article was inspired by a recent article by Robert Cooperstein, MA, DC. I find that I often end up being the physician of last resort, seeing patients who have not responded to previous chiropractic care, PT or medical management. I have realized that my model of what goes wrong in the lower back has really changed over the years. I used to think that my job was finding fixations and correcting them. I now have a broader understanding that often includes hypermobility as a primary issue. Once you recognize that functional instability has to be addressed, you know you have to both correct fixated joints and stabilize unstable joints.

By Marc Heller, DC This article was inspired by a recent article by Robert Cooperstein, MA, DC. I find that I often end up being the physician of last resort, seeing patients who have not responded to previous chiropractic care, PT or medical management. I have realized that my model of what goes wrong in the lower back has really changed over the years. I used to think that my job was finding fixations and correcting them. I now have a broader understanding that often includes hypermobility as a primary issue. Once you recognize that functional instability has to be addressed, you know you have to both correct fixated joints and stabilize unstable joints. tag:mpamedia.com,2008:post-54422 2010-01-15T12:00:32-07:00 2010-01-15T12:00:07-07:00

At a recent seminar, I was teaching how to correct the adductors. As I circumducted the supine patient's left hip joint, she experienced pain at the pubic ramus when the thigh was adducted medially and moved from superior to inferior. One of the doctors standing nearby blurted out that the patient had a labral tear. This opened the opportunity for discussion about acetabular labral tear signs and symptoms.

By Todd Turnbull, DC, CCSP At a recent seminar, I was teaching how to correct the adductors. As I circumducted the supine patient's left hip joint, she experienced pain at the pubic ramus when the thigh was adducted medially and moved from superior to inferior. One of the doctors standing nearby blurted out that the patient had a labral tear. This opened the opportunity for discussion about acetabular labral tear signs and symptoms. tag:mpamedia.com,2008:post-54404 2010-01-01T12:00:32-07:00 2010-01-01T12:00:07-07:00

It often appears that when the author of a particular test states high accuracy for the test, other scientists down the line, using MRI or other tests, reach opposite conclusions regarding its validity. This is certainly true for shoulder labral tests. If you've read my previous few articles, you realize this is also probably true for muscle testing. Thus, no matter how logical and accurate any test seems, we must always question it. That is one reason why it pays to use a number of tests to reach any conclusion.

By Warren Hammer, MS, DC, DABCO It often appears that when the author of a particular test states high accuracy for the test, other scientists down the line, using MRI or other tests, reach opposite conclusions regarding its validity. This is certainly true for shoulder labral tests. If you've read my previous few articles, you realize this is also probably true for muscle testing. Thus, no matter how logical and accurate any test seems, we must always question it. That is one reason why it pays to use a number of tests to reach any conclusion. tag:mpamedia.com,2008:post-54373 2009-12-16T12:00:32-07:00 2009-12-16T12:00:07-07:00

I've had a recent series of tough thoracic cases. Most of them failed previous medical management, physical therapy and chiropractic care. I've found that if the patient does not begin to respond within two or three adjustments to the local area of pain, they probably will not respond to the fourth, fifth or sixth adjustment. Spinal pain is often referred pain. The thoracic spine is no different. Pain is a liar. The painful area may continue to feel restricted and tender, but that does not mean you should continue to aggravate it.

By Marc Heller, DC I've had a recent series of tough thoracic cases. Most of them failed previous medical management, physical therapy and chiropractic care. I've found that if the patient does not begin to respond within two or three adjustments to the local area of pain, they probably will not respond to the fourth, fifth or sixth adjustment. Spinal pain is often referred pain. The thoracic spine is no different. Pain is a liar. The painful area may continue to feel restricted and tender, but that does not mean you should continue to aggravate it. tag:mpamedia.com,2008:post-54326 2009-12-02T12:00:32-07:00 2009-12-02T12:00:07-07:00

Recently the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released another best-practices chapter for review and comment: a literature synthesis of chiropractic management of thoracic spine conditions. After reviewing this chapter, I've concluded that there are a number of interesting findings that can improve the way we practice and that support current clinical procedures and decision-making processes.

By David N. Taylor, DC, DABCN Recently the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released another best-practices chapter for review and comment: a literature synthesis of chiropractic management of thoracic spine conditions. After reviewing this chapter, I've concluded that there are a number of interesting findings that can improve the way we practice and that support current clinical procedures and decision-making processes. tag:mpamedia.com,2008:post-54348 2009-12-02T12:00:32-07:00 2009-12-02T12:00:07-07:00

An anatomic study that appeared recently in the American Journal of Sports Medicine1 identified – for the first time – the cross-sectional anatomy of the iliopsoas tendon at the level of the labrum. Several authors have implicated iliopsoas impingement on the anterior labrum as a cause of labral tears. They have stated that a tight iliopsoas tendon could cause compression over the anterior capsulolabral complex, leading to labral lesions. Labral tears at the 2 o’clock to 3 o’clock position of the acetabulum (see image on page 20) are directly under the iliopsoas tendon. This labral tear is considered an anterior tear, while most labral tears caused by trauma, femoroacetabular impingement, capsular laxity/hip mobility, dyspla

By Warren Hammer, MS, DC, DABCO An anatomic study that appeared recently in the American Journal of Sports Medicine1 identified – for the first time – the cross-sectional anatomy of the iliopsoas tendon at the level of the labrum. Several authors have implicated iliopsoas impingement on the anterior labrum as a cause of labral tears. They have stated that a tight iliopsoas tendon could cause compression over the anterior capsulolabral complex, leading to labral lesions. Labral tears at the 2 o’clock to 3 o’clock position of the acetabulum (see image on page 20) are directly under the iliopsoas tendon. This labral tear is considered an anterior tear, while most labral tears caused by trauma, femoroacetabular impingement, capsular laxity/hip mobility, dyspla tag:mpamedia.com,2008:post-54310 2009-11-18T12:00:32-07:00 2009-11-18T12:00:07-07:00

As discussed previously, most orthopedic and neurological tests are taught as individual entities and are then grouped into regions and/or categories of pathology, rather than being taught in patterns or sequences that consider efficiency in performance or clinical use. In the first two articles in this series, we discussed test sequencing and testing for the same pathology, respectively. The third method of combining tests is testing by indirect method. This method involves obtaining clinical information without actually having to perform a test.

By K. Jeffrey Miller, DC, DABCO As discussed previously, most orthopedic and neurological tests are taught as individual entities and are then grouped into regions and/or categories of pathology, rather than being taught in patterns or sequences that consider efficiency in performance or clinical use. In the first two articles in this series, we discussed test sequencing and testing for the same pathology, respectively. The third method of combining tests is testing by indirect method. This method involves obtaining clinical information without actually having to perform a test.