tag:typepad.com,2003:weblog-1250480 2008-07-10T09:25:32-07:00 Focus on hardware and diagnostics. TypePad tag:mpamedia.com,2008:post-54530 2010-03-12T12:00:32-07:00 2010-03-12T12:00:07-07:00

When performing a posture assessment, be as accurate as you can and keep chart notes to make your posture evaluation a reproducible measurement. Posture evaluations become an objective measurement that can drive treatment decisions.

By Jeffrey Tucker, DC, DACRB When performing a posture assessment, be as accurate as you can and keep chart notes to make your posture evaluation a reproducible measurement. Posture evaluations become an objective measurement that can drive treatment decisions. tag:mpamedia.com,2008:post-54495 2010-02-26T12:00:32-07:00 2010-02-26T12:00:07-07:00

The patient was a 63-year-old female who presented with pain about the low back, hip and an inability to place her right heel on the ground. The patient was walking with a cane. Prior to attending care, the patient had seen her PCP, a neurologist and an orthopedic surgeon. She had been under some form of care or consultation regarding this issue for the seven months.

By Richard Beck, DC The patient was a 63-year-old female who presented with pain about the low back, hip and an inability to place her right heel on the ground. The patient was walking with a cane. Prior to attending care, the patient had seen her PCP, a neurologist and an orthopedic surgeon. She had been under some form of care or consultation regarding this issue for the seven months. tag:mpamedia.com,2008:post-54497 2010-02-26T12:00:32-07:00 2010-02-26T12:00:07-07:00

Laboratory reference ranges are not synonymous with normal. Most physicians have the misconception that the reference range provided by the testing laboratory is the same as the normal range. Many chiropractors don't even order laboratory work-ups on their patients, despite the fact that in most states, chiropractors are licensed as primary care physicians. How can you be a primary care physician and not use laboratory analysis as one of your diagnostic tools?

By Daniel Hough, DC Laboratory reference ranges are not synonymous with normal. Most physicians have the misconception that the reference range provided by the testing laboratory is the same as the normal range. Many chiropractors don't even order laboratory work-ups on their patients, despite the fact that in most states, chiropractors are licensed as primary care physicians. How can you be a primary care physician and not use laboratory analysis as one of your diagnostic tools? tag:mpamedia.com,2008:post-54501 2010-02-26T12:00:32-07:00 2010-02-26T12:00:07-07:00

As I've said previously, most orthopedic tests for the shoulder cannot truly isolate a particular structure, since when we use tests that compress or stretch an area, adjacent structures also have to be compressed, stretched or contracted. While there is definite truth in this statement, most of us arrive at a diagnosis by using as many credible tests in the literature as possible. There is a test that, while not that specific in determining the exact lesion source, has the ability to determine whether the problem is located in a particular area, which can then be followed by other specific tests. The test is called the internal rotation resistance strength test (IRRST). This test, as discussed by Zaslav, helps to differentiate between an outlet impingement and a non-outlet impingement.

By Warren Hammer, MS, DC, DABCO As I've said previously, most orthopedic tests for the shoulder cannot truly isolate a particular structure, since when we use tests that compress or stretch an area, adjacent structures also have to be compressed, stretched or contracted. While there is definite truth in this statement, most of us arrive at a diagnosis by using as many credible tests in the literature as possible. There is a test that, while not that specific in determining the exact lesion source, has the ability to determine whether the problem is located in a particular area, which can then be followed by other specific tests. The test is called the internal rotation resistance strength test (IRRST). This test, as discussed by Zaslav, helps to differentiate between an outlet impingement and a non-outlet impingement. tag:mpamedia.com,2008:post-54513 2010-02-26T12:00:32-07:00 2010-02-26T12:00:07-07:00

My first article on the coccyx, written back in 2004, changed my life and my practice. It was one of the first articles published on internal coccyx procedures. I did not invent the procedure; I just had the chutzpah (a Yiddish term for nerve) to write about it. Since then, patients from all over the country have e-mailed me about how to get their coccyx corrected. Most of them have tried external chiropractic and PT approaches, and have nearly exhausted their medical options as well. (Coccyx removal surgery is tricky, and does not always work.) I usually have no idea where to send patients, as there is no list of who is competent at treating the coccyx, and no standardized training.

By Marc Heller, DC My first article on the coccyx, written back in 2004, changed my life and my practice. It was one of the first articles published on internal coccyx procedures. I did not invent the procedure; I just had the chutzpah (a Yiddish term for nerve) to write about it. Since then, patients from all over the country have e-mailed me about how to get their coccyx corrected. Most of them have tried external chiropractic and PT approaches, and have nearly exhausted their medical options as well. (Coccyx removal surgery is tricky, and does not always work.) I usually have no idea where to send patients, as there is no list of who is competent at treating the coccyx, and no standardized training. tag:mpamedia.com,2008:post-54516 2010-02-26T12:00:32-07:00 2010-02-26T12:00:07-07:00

The patient was referred for a consultation regarding his consideration for cervical disc surgery and his upper extremity pain. The patient was accepted for treatment for chiropractic care. His referring provider was informed in writing of my consultation findings and was provided information on the condition as evidenced below.

By Nancy M. Molina, DC, QME, MBA The patient was referred for a consultation regarding his consideration for cervical disc surgery and his upper extremity pain. The patient was accepted for treatment for chiropractic care. His referring provider was informed in writing of my consultation findings and was provided information on the condition as evidenced below. tag:mpamedia.com,2008:post-54517 2010-02-26T12:00:32-07:00 2010-02-26T12:00:07-07:00

Recent guidelines and other research have shed light on some of the effective treatment strategies for chronic neck pain. In addition to spinal manipulation, exercise is a key recommendation; however, it appears that exercise for chronic neck pain is being underutilized by the chiropractic profession. Traditional rehabilitation strategies have focused primarily on muscle strength and endurance through high loads.

By Jasper Sidhu, BSc, DC Recent guidelines and other research have shed light on some of the effective treatment strategies for chronic neck pain. In addition to spinal manipulation, exercise is a key recommendation; however, it appears that exercise for chronic neck pain is being underutilized by the chiropractic profession. Traditional rehabilitation strategies have focused primarily on muscle strength and endurance through high loads. 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.