Archive for tag: adjusting

Intern Skills - Physical Therapies and Manual Manipulations

Hi, everyone!

I thought that, starting this week, I would share a bit about the therapies and skills required of each Intern before graduation.

This week, since we here at NUHS are historically a chiropractic school, I will start with the obvious requirements of physical therapies and manual manipulation (or adjustments) skills.

Physical therapies are any therapy for the body including soft tissue (muscle, tendon, fascial) therapies, ultrasound, cold laser, phonophoresis, or massage. These therapies can range from treating ganglion cysts, scars, sprains, strains, swelling or tissue damage.

Manual manipulations (adjusting the skeletal structure) include manual adjustments of the spine and extremities (arms and legs). We are taught a tremendous amount of physical medicine while here at NUHS and the training came in handy as one of my first patients as a ND intern required both physical medicine and manual adjustments.

I have been fortunate to complete all of my physical medicine and manual manipulation requirements after only fours weeks into 9th trimester. The opportunity to get this much practice with physical medicine prepares me thoroughly for understanding the proper feel of a patient's musculoskeletal structure, based upon their age, activity level and level of injury. I feel that this will give me a competitive advantage versus other NDs in the marketplace, based upon the scope of practice in the state where I settle.


I have shared another pic of the swan and duck families who have grown and thrived on Lake Janse this past summer. Soon, the ducks will migrate south and the swans will return to their winter lodgings to rest and get ready for another year of scaring away the flocks of geese that attempt to invade our little campus on their migrations.

Next week, I'll share more about the skills that naturopathic interns need to master prior to graduation. Until then, enjoy the newly birthed autumn season

Another Trimester in the Books

This morning, I sit at my spot by Lake Janse and watch my classmates walk into their last few exams as I do a small walkthrough of my last final for the trimester, Minor Surgery.

I think of all the preparation, stress, notes, charts, diagrams, decision trees, memorizing, practicals, dissecting, adjusting lab...ahhh!  Adjusting?!?! I'm going to be a ND, why in the world do I need to know how to adjust somebody?!?! This was something I heard, and even said, early in my education here at NUHS, a historically chiropractic school.

Well, as things turned out, adjusting was highly important for me to remember in my first trimester as an intern. Three of my patients required manual adjustments along with physiotherapeutic treatments (ultrasound, etc.) and soft tissue (i.e. muscle, tendon, etc.) manipulation. As a result, I was forced both to remember and to go back to dig through old notes on modalities I thought I would rarely, if ever, use in my practice.

The extensive therapy that these patients each needed to return them to a basis for health included physical medicine, part of the naturopathic therapeutic order, as well as some supplements and analgesics specific to their needs.

My patients, through their needs, visits and therapies, helped me to complete my physical medicine and manipulation requirements for graduation in my first trimester in clinic! These are modalities that are typically completed much later in the naturopathic internship. My physical medicine patients this trimester have taught me a number of invaluable lessons.

  1. Pay attention in the early manual adjusting classes here at NUHS.
  2. Keep your notes and procedures from the early manual adjusting classes.
  3. Work with a chiropractic student when studying for adjusting practicals (and offer to study with the chiros for Botanical Medicine classes, where ND students are more engaged).
  4. Mostly, in your early career here at NUHS, remind yourself to be prepared for ANY patient that walks through the door. You may not know the specifics, yet you can get a good foothold on the complaint and be prepared to take it on if you apply a "big picture" view, even when the classes are information specific.

My experience with the physical medicine aspect of our training here has given me a bit to think about over this coming break and in the coming months. I am now considering, considering mind you, pursuing a chiropractic degree upon completing my naturopathic training here at NUHS. I feel that having both degrees will give me a more complete tool kit to offer patients as a Natural Medicine Primary Care Provider. Of course, time and financial resources are considerations in that "consideration."

2013-08-19_tim _president

Finally, I feel it's important to mention that this past week was President Joseph Stiefel's first graduation ceremony at NUHS. I enjoy sharing a "Good Morning" and short conversation with Dr. Stiefel as we pass on his walk from his home to his office each morning. In the photo, each of us is getting a "dry run" on the graduation portrait--his for about 200 graduate photos at the ceremony and mine for roughly 8 months from now. I enjoyed seeing him speak to our graduates and their families and am proud to have Dr. Stiefel as our new President. (Small trivia fact: Dr. Stiefel's wife, Dr. Holly Furlong, was the very first blogger for NUHS.)

So, with only two trimesters to go (or possibly more if I return for the chiropractic doctorate), I am looking back at what I have learned, what I need to brush up on and explore new skills for my future practice. This is what I will think about when traipsing over the mountain trails back home over the next two weeks. Until then, may the rest of your summer be relaxing, fulfilling, and help you make the decisions you need to guide your future in the proper direction for you.