Some tough pain cases are getting better (fast)!

Here is the link to Podia. My new course just went live.

https://richardhazel.podia.com

I saw a new patient this week with posterior knee pain and his leg would internally rotate when he had been playing golf for a while.

Online Courses: https://richardhazel.podia.com

Most likely your doctor looks at your pain as a structural issue. i.e. Joint inflammation needs an anti-inflammatory. 

Unless you need a surgical intervention, Janda would have seen your pain as a functional problem. Your sensorimotor system is having problems. 

This is why I'm 100% in the Janda camp and why it gets such great, lasting results.

If you are an acupuncturist and are wanting to learn motor points, come to Amsterdam in June:

https://integrative-acu-seminars.com/2nd-european-orthopaedic-and-sports-acupuncture-congress/

There are some new devices for Restless Leg Syndrome that use electric stimulation to stimulate the afferent nerves of the low leg.

What's the connection to the Superficial Peroneal Nerve and Restless Leg? I'm not sure, but I'm willing to start treating patients with this in mind.

Also, some updates on tough nerve entrapment cases.

If you are an acupuncturist and are wanting to learn motor points, come to Amsterdam in June:

https://integrative-acu-seminars.com/2nd-european-orthopaedic-and-sports-acupuncture-congress/

My online courses are here: https://richardhazel.podia.com

Recognizing symptoms of peripheral nerve entrapment is critical for chronic pain patients who have gotten no relief from the usual standard of care and diagnostic exams. 

When you know the symptoms, you can rule in or out a peripheral nerve entrapment and then palpate the typical entrapment zones to confirm you are on the right track. 

If you are an acupuncturist and are wanting to learn motor points, come to Amsterdam in June:

https://integrative-acu-seminars.com/2nd-european-orthopaedic-and-sports-acupuncture-congress/

My online courses are here: https://richardhazel.podia.com

People often ask questions about how to use electric stimulation of an acupuncture needle in the motor point of a muscle. They want to know why and how and for how long. 

I attempt to give some answers based on what I have seen. There are so many opinions about it that I thought it would be best to give you the basic explanation that has worked well for me. If you're happy with your results, that's what you should do. 

I leave it to others to dispute the minutiae of frequencies and points and length of treatment. 

If you are an acupuncturist and are wanting to learn motor points, come to Amsterdam in June:

https://integrative-acu-seminars.com/2nd-european-orthopaedic-and-sports-acupuncture-congress/

My online courses are here: https://richardhazel.podia.com

Some updates about Amsterdam and the recordings on Podia and the Mentorship Membership on Podia.

Here's the registration link for Amsterdam in June: https://integrative-acu-seminars.com/2nd-european-orthopaedic-and-sports-acupuncture-congress/

Here's the Podia link:

https://richardhazel.podia.com

This episode is about a recent patient with SIJ pain and it was due to the psoas being tight. 

Coracobrachialis issues that are often missed for pain and mobility and cutaneous nerve symptoms.

Here's the Amsterdam Link:

https://integrative-acu-seminars.com/2nd-european-orthopaedic-and-sports-acupuncture-congress/

Podia Online Courses Here:  https://richardhazel.podia.com

I had a rough week trying to sleep with terrible neck pain that was giving me a right-sided headache almost like a migraine.

https://chinesemedicineeducation.com/event/motor-point-acupuncture-mastery-using-jandas-crossed-syndromes-as-a-roadmap-to-success-plus-advanced-treatments-for-nerve-entrapment-syndrome/

https://integrative-acu-seminars.com/2nd-european-orthopaedic-and-sports-acupuncture-congress/

For the month of March 2024 everything on Podia is 20% off with the discount code MARCH20 at checkout. You can use it as many times as you want.

https://richardhazel.podia.com

Know the signs of issues with these intrinsic foot muscles.

They will help with plantar fasciitis and other foot pain.

Also, here are the live seminar links I mentioned:

https://chinesemedicineeducation.com/event/motor-point-acupuncture-mastery-using-jandas-crossed-syndromes-as-a-roadmap-to-success-plus-advanced-treatments-for-nerve-entrapment-syndrome/

https://integrative-acu-seminars.com/2nd-european-orthopaedic-and-sports-acupuncture-congress/

For the month of March 2024 everything on Podia is 20% off with the discount code MARCH20 at checkout. You can use it as many times as you want.

https://richardhazel.podia.com

Sometimes that low leg pain and numbness is an entrapment of the superficial peroneal nerve. It's not always an L5-S1 radiculopathy. 

Pain on plantar flexion and inversion can be a sign of superficial peroneal nerve entrapment.

https://linktr.ee/richhazel

Everything on Podia is 20% off until the end of March. Use the discount code MARCH20 as many times as you want until March 31. 

Everyone who uses motor points and trigger points in their acupuncture treatments owes their thanks to these MDs.

https://richardhazel.podia.com

It's not easy to treat a pain that the patient only feels at times when they are not in the clinic with you.

You have to go on their memory of where it hurts and what they are doing at that time.

On palpation there was no pain to reproduce. Length testing and muscle testing showed nothing. 

I had to rely on Dr. Travell to figure it out.

Online Courses: https://richardhazel.podia.com

Why should we care about the Upper and Lower Crossed Patterns?

How does it help to know the difference between a tonic and a phasic muscle?

https://richardhazel.podia.com

https://www.richhazel.com

Some people say that posture has no connection to pain. I disagree. 

Happy New Year!! 

https://richardhazel.podia.com

Dr. Vladimir Janda and Karel Lewit were pioneers of musculoskeletal medicine who have given us a roadmap to understand assessment and treatment of pain.

Assessment and Treatment of Muscle Imbalance: The Janda Approach https://a.co/d/0JCe9vt

https://richardhazel.podia.com

I'm really happy to see a daily migraine patient cancelling appointments because they have gone a month without a migraine!

I've updated how I treat migraines. It's always a work in progress. I have to learn from clinical experience and doctors like Dr. Andrea Trescott so I'm sharing what I have learned so far in hopes it will help others.

https://RichardHazel.podia.com

I see patients in their 70s 80s and 90s that I don't run through a range of manual muscle testing for their pain.

This is how I prefer to assess and treat. And it works very well.

https://richardhazel.podia.com

Two interesting cases this week to share.

Here's my website link for the Seminar in Italy: https://richhazel.com/live-seminars/

https://richardhazel.podia.com

There are some key considerations that have helped me with foot numbness, tingling, hot/cold sensations.

Online Courses and Mentorship Community

https://richardhazel.podia.com

Isn't it likely that osteoarthritis is due to unaddressed muscle imbalances?

It seems to be the case clinically. This is a case from this past week of an 87 year old woman with constant knee pain that has her now in a wheelchair.

I think that learning a subject from the source material, research, science has been the key to getting excellent results for me.

I think when you learn a "system" from someone, you are limited by their system, especially if they don't share their source material so that you can keep learning.

https://richardhazel.podia.com

Gua Sha is soft tissue manipulation but all not all soft tissue manipulation is Gua Sha.

There is a difference and here's what it is.

https://richardhazel.podia.com

Just a review of how I usually treat a leg length discrepancy and some of my tough cases. Foot neuropathies, Cauda Equina Syndrome, Migraines

Online Courses: https://richardhazel.podia.com

A patient with a diagnosis of Plantar Fasciitis will have different symptoms from the last one you saw with the same diagnosis and different from the next as well.

We need to think about foot biomechanics, nerves, the plantar aponeurosis and we need to know specifically where the patient is having pain.

https://richardhazel.podia.com

Entrapment of the superior cluneal nerve can be a source of chronic low back pain, especially after lumbar disc surgery. 

It can be a source of psuedo-sciatica as well.

https://kangfu.eu/european-orthopaedic-and-sports-acupuncture-congress/

https://richardhazel.podia.com

I'll be in Amsterdam teaching at the 1st European Orthopedic and Sports Acupuncture Conference.

NCCAOM CEUs available.

You should come!

I'll be covering Sciatica, Meralgia Paresthetica, Ilioinguinal Nerve Entrapment, Obturator Tunnel Syndrome, 2 Peudo-Sciaticas: Superior Cluneal Nerve Entrapment and Superior Gluteal Nerve Entrapment

And also Migraines and their nerve entrapments

https://kangfu.eu/european-orthopaedic-and-sports-acupuncture-congress/

Ever resolve sciatica (or what you thought was sciatica) by treating the gluteus medius or by releasing trigger points in the gluteus medius?

Now I know what was likely happening. 

https://richardhazel.podia.com

Join The Acupuncture Outsiders Mentorship Membership for Group Zoom Meetings each month to discuss tough cases and other things of interest.

Double Crush Syndrome: It might be controversial but I believe.

And Thank You to all who have sent me messages of support!

https://richardhazel.podia.com

Can we improve our results for migraines by addressing the Upper and Lower Crossed patterns for patients?

Let's walk through it.

Correction : I said the Millennial Tower is tilting 24 degrees. I meant inches. And when I looked it up it's actually tilting 29 inches. 😮

https://richardhazel.podia.com

New Mentorship Program on Podia. Look for the Acupuncture Outsider Community. 

Future Courses, Mentorship Subscription on Podia and 2 Cases that I'm struggling with but learning from.

https://richardhazel.podia.com

I don't always trust muscle testing, especially if the symptoms don't match with a strong test where I think there's some over-use injury.

I want to put my fingers or thumb on a muscle to feel for hypertonicity before I rule it out as a part of the problem. 

It's easy to miss a hypertonic muscle if the manual muscle tests seem normal and you don't palpate to confirm. 

https://richardhazel.podia.com

Reciprocal Inhibition is an interesting thing and I think I think a lot about treating antagonists muscles but maybe I don't always consider reciprocal inhibition for every case. I'm going to be thinking more about reciprocal inhibition for some cases in case it can help me improve my results for muscle activation once someone is pain-free. 

Here's the article I mentioned:

https://journals.physiology.org/doi/epdf/10.1152/jn.00424.2017

My Podia Online Courses are here: https://richardhazel.podia.com

I was just thinking about how the infraspinatus can help shoulder flexion. The fiber orientation is a clue. It's an external rotator, so how does it get involved in shoulder flexion?

How does the Pectoralis Major flex the shoulder? Look at the fiber orientation.

How does Gluteus Minimus (abducts and internally rotates the hip) which doesn't flex the hip, cause an anterior pelvic tilt? Fiber orientation. 

https://richardhazel.podia.com

If you're sticking needles into the site of pain you're waving the flag of surrender.

If you know the cause of the pain, you should be getting good/great results in your first treatment and have it resolved or greatly improved very quickly soon after, in most cases.

If you are sticking needles into things where they hurt, you're likely missing the real cause of the problem. 

Yes, I'm going to piss people off. But Janda and Lewit were right. "He who treats the site of pain is often lost"!

Online courses: https://richardhazel.podia.com

Sometimes patients have not done well even after trying Physical Therapy for their pain.

Once we have gotten them out of pain and restored their mobility, do they really need Physical Therapy? Are we a replacement for Physical Therapy?

Also, I mentioned in the podcast that I would be interested in doing some podcasts in German and/or French if there's an audience that you think doesn't listen in English.

If you think it would help me reach more people, please let me know. rich@richhazel.com

Thanks!

https://richardhazel.podia.com

There's more to the SI Joint than just nutation and the pain some people get there.

Many issues like back pain, hip pain, hamstring pain, even shoulder pain can be due to dysfunction at the SIJ. 

Movement, Stability & Lumbopelvic Pain: Integration of research and therapy https://a.co/d/cuyLspO

https://richardhazel.podia.com

"The perfect is the enemy of the good." - Voltaire

Here's an imperfect protocol that gets great results a high percentage of the time.

If you're new to Contemporary Acupuncture or just feeling overwhelmed by all the possibilities, try this protocol.

It covers a lot of the basics and I get great results with it most of the time. 

I know I'll get perfectionists complaining but the goal is to help more people help more people. Too many outliers to knee pain can make people doubt themselves.

Try this protocol and when the patient feels better you have time to think about the underlying segmental, postural, ankle or hip or core issues that led to the pain.

https://richardhazel.podia.com

Gracilis is the only hip adductor that can flex the knee.

It often gets short after a knee replacement surgery.

Quads glutes  TFL and glute minimis are usually my go-to for knee pain but gracilis is usually part of the solution as well. 

https://richardhazel.podia.com

Skeletal Muscle is Elastic, Excitable and Contractile. Does Electric Stimulation Acupuncture at the Motor Points of the muscle restore those qualities after injury has made the muscle short, weak and inhibited?

The German word for "numb" is "taub". I think muscle inhibition may be due to the muscle being deaf, not listening to the nerve signals. What if it's not the nerve, but the muscle that is causing muscle inhibition?

https://richardhazel.podia.com

You and I have probably already seen it daily in the clinic. Gluteus medius and minimus get very tight and they restrict the hip and cause pain. 

We have always heard that the glutes get inhibited. But when it comes to the glute medius and minimus, while they might be inhibited they are also short and tight like other postural muscles.

Research backs up that the glute med and minimus are primarily Type 1 slow twitch fibers like other postural muscles. 

https://dergipark.org.tr/en/pub/anatomy/issue/68435/1152716

https://richardhazel.podia.com

These little muscles can cause a lot of big pain and dizziness (and other things that I talk about here).

https://richardhazel.podia.com

This is a very effective technique I use for muscles that feel restricted and that don't release with just motor point acupuncture or IASTM.

https://richardhazel.podia.com

Some good results on the first visit for 2 different migraine patients.

https://richardhazel.podia.com

I got some feedback from several people about the Sydney course and wanted to share that.

Also, I want to give my opinion about how Janda influences my thoughts about adding or not adding extra needles for local inflammation. 

https://richardhazel.podia.com

I recently saw a discussion about treating the psoas with acupuncture techniques like fascial pecking on the abdomen, treating the segment, addressing other issues like the abdominals and core, distal points.

What should we do and why? 

All of the above are good, but there are times when the motor point is essential. Here's my take.

Hint: it's a matter of muscle tone vs muscle shortening.

Online Courses: https://richardhazel.podia.com

I probably don't assess hips the way you were taught to assess hips.

I organize my thoughts around the assumption that the glutes are weak and don't need me to muscle test them. If they were firing, the patient wouldn't be in my office with hip issues.

https://richardhazel.podia.com

Are you forgetting to test the lats for shoulder flexion and abduction issues? What about for low back issues? Inhibited abs and serratus anterior? QL injury?

A very reliable approach for most sciatica patients that I have had a lot of success with.

New videos will be added to the Motor Point Location Guide

richardhazel.podia.com

4 Day Seminar in Sydney in February

chinesemedicineeducation.com