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Silver Spring, MD
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Notes from the Practice of Harold Goodman, D.O.

Update.  Saturday, September 20, 2008

Update.

I am now accepting new patients.

The initial appointment is 9:15 am and the last one in the early afternoon.

Patients of all ages are welcome; neonatal, pediatric, adolescent, adults, older patients and those who are ageless, as well.

Just contact me if you have any questions about my practice. See the e mail contact below.

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It all started with a sprained ankle  Saturday, April 21, 2007

Sprained ankles are very common. You step the wrong way and twist the ankle. Then it swells up, may get warm ( both signs of inflammation), and is painful to stand or walk on. So far, nothing unusual. What all of us know or have heard is that once you have sprained an ankle it is likely that you will sprain it again.

The typical medical advice is to keep the ankle raised, iced, wrapped or compressed and to rest it, keep off of it. Hence, the large number of people hobbling around on crutches.

Why is it that the same ankle is prone to further sprain?

To be very blunt, the reason is that the original trauma, the sprain or strained connective tissues, ligaments, tendons, fascia ( a type of connective tissue) has never been treated. The above mentioned measures do not treat the trauma. They treat the symptoms of the trauma, the inflammation.

In order to treat the trauma the actual strain pattern in the tissues must be diagnosed and removed. Only osteopathy does this.

I have had people limp into my office on crutches from a recent strain (often young men) and walk out pain free without crutches and not prone to future restraining of the tissues. I have learned how to identify and remove the strain in the tissues.

If I were present at a football game and one of the players sprained their ankle I could have them back in the game, playing within 20 minutes. This is rarely the case with team physicians or sports medicine doctors. Also, the player would be less likely to resprain the same ankle.

I mention this because someone recently told me that a car ran over their foot. They have been receiving acupuncture for some time ( I am a licensed medical acupuncturist, so I believe I am qualified to speak about acupuncture) but were still in quite a bit of pain.

I told them that I often treat such problems with a lot of success. I treat the strain and the symptoms ( read: pain) go away. It is really quite simple and logical. Strains will not show up on imaging studies ( X rays, MRI, CT, etc.). The patient is given the same instructions mentioned above, anti inflammatory medications, and, if they are still complaining, sent to a physical therapist. The problem, the strain, is never treated.

I treat strains. I find them in almost every patient including babies. They result from traumas to the system. How can a new born have a trauma? Being born is quite traumatic. The neonate must travel through a passage which is not large enough to accomodate the body.They have to twist around to get through, their head gets squished which is why it is still soft in parts when the child is born. This is natures way of dealing with the trauma of birth. If the child is large the birth can be even more traumatic. Many obstetricians routinely do an episiotomy where they will cut the muscles so that there will be more give in the mother's tissues to accomodate the child. If this were not done then the muscles might be torn as the large mass ( the neonate) emerges from the relatively small canal. Labor is not called labor for nothing.

People come in with back pain, neck pain, numbness, tingling in their arms or legs, headaches, eye problems, jaw pain, infections, asthma, and so many other problems. In every case I find strains. The strains are removed and the symptoms disappear. It's a no brainer but, unfortunately, something which is not taught and virtually unappreciated outside the community of osteopathic physicians who practice osteopathy in the cranial field.

Incidentally, this is not taught to cranio-sacral therapists, chiropractors and message therapists all of whom receive good training and help many people in need. How do I know they don't receive this training? Because I treat them and they are fascinated to learn what I am doing.

If you have a question on this or anything related to my work, don't hesitate to contact me. I am always happy to answer questions.

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Chronic ear infections in children  Saturday, March 24, 2007

About 30% of my patients are children. Since I treat a lot of pregnant women to get them through pregnancy with a minimum or absence of problems ( back pain, morning sickness, premature labor, etc.) I have long offered a free first visit for the newborn to get the child started off on the right foot. Often this first visit reveals many structural and functional problems ( feeding issues, irritability, reflux and spitting up, asymmetrically shaped heads, asthma and other respiratory problems, etc. etc.) which can be easily treated and quickly reversed.

As the children age they may display delayed development, frequent infections and other common pediatric problems which osteopathic and homeopathic treatment can solve. There are two local pediatricians who have been referring such children to me for many years. Also, word of mouth among moms has been one of my best means of letting people know what osteopathy has to offer these young ones.

By far, the most common pediatric issue I see is the child who suffers from serous otitis media or ear infections. These children receive many rounds of antibiotics and may or may not improve but inevitably come down with yet another infection. At some point the parents are told that the child must receive tubes. This is often when I see the child.

Usually I find that the base of the cranium and especially one or more of the temporal bone are malfunctioning. This impairs normal drainage of the inner ear via the eustachian tube which, in turn, renders the child vulnerable to infections. Hence the ineffectiveness of antibiotics. This is a structural problem which must be treated structurally and will not be cured with a biochemical ( antibiotic) approach.

Often it takes just a few treatments for the pediatrician to notice that the ears look clear. The parents, especially if the child has been in pain, pulling or boring its ear or complaining, will notice earlier. I am able to then discharge these patients. They usually don't require much further treatment unless there is an additional problem.

In 2003 The Archives of Pediatric and Adolescent Medicine, an MD journal published by the AMA, did a study on osteopathic treatment of ear infections.
This is the link which you can paste into your browser to examine:
http://archpedi.ama-assn.org/cgi/content/extract/157/9/852
The authors concluded that there was a significant positive correlation between children who received osteopathic treatment for ear infections and the subsequent improvement in their health. This was welcome news indeed since I realize many people rely on such sources for their knowledge of medicine.

It was also reassuring that such a study appeared in a prominent MD specialty journal. This lends additional credibility to what many osteopathic physicians witness on a daily basis; osteopathy ( and, I would add, homeopathy) are a veritable God-send to a sick child.

What I regularly have witnessed over the years is that children treated in this way are healthier overall, develop better than their peers, and need far fewer doctor visits. It is the most valuable foundation that can be given them for future health.

We have a saying in osteopathy. As the twig is bent so grows the tree. Imagine a small sapling that is bent over. When the twig is small there is not much to notice. When it grows into a tall tree its "bentness" becomes more obvious. However, then it is harder to reverse what formerly could be treated in just a few visits. The earlier we can get to these bent twigs the easier will their lives be. There are few investments with such enormous and long term benefits.


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Learning and Relearning Osteopathy  Saturday, March 03, 2007

I recently returned from Orlando,Florida where I helped teach a five day course in Cranial Osteopathy for 21 physicians, residents and medical students. I have helped teach this course before and will be helping to teach a similar course in Tucson, Arizona in June, 2007.

Maybe you have had the experience of reading the same book more than once. I have done this several times. Each time, it seems, it is like reading a totally new book. Of course, it is me that has changed, not the book. It is not the same person reading the book.

It is the same thing with teaching and medical practice in general. Every time I help teach a course I experience it differently. This last time I was taking a lot of notes. Most of the students I had around me were sitting and quietly listening. Few were taking notes. When they were it was somewhat sparingly.

One of them leaned over and asked why I was taking so many notes. " I am so excited by what I am learning. I want to write down enough to jog my memory so that I can carry this back to my practice," I told him. He was surprised, he said, that someone who has been in practice for 17 years doing this work full-time would have so much to learn from what was billed as an introductory 40 - hour course. I explained to him that it is precisely because I do this on a daily basis that I find these lectures and presentations by my colleagues to be so valuable. They are sharing what they do. We are all supposedly doing the same thing but we are all doing it in our own unique ways. I find this amazingly creative and inspiring.

When I returned to the office I thought, My patients are in for a real treat! And, indeed, patient after patient related to me how satisfying these treatments were. I told them that I had learned things which enabled me to go deeper with what I was doing.

The human skull (cranium) is formed in cartilage and membrane. The base ( bottom) is formed by compressive forces in utero in cartilage. The rest (the vault) is formed in membrane. All of the 12 cranial nerves that come from the brain and which essentially control the rest of the body function exit the bottom of the skull via the membrane. The same goes for the blood supply to and from the brain.

Because the base of the skull is formed by compressive forces it can become very hard. Osteopaths can feel the relative hardness of the bones of the skull. The harder they are, especially in the base, the more problems that patient will have in many areas of life and body function. Using very gentle cranial manipulation I am able to get these areas of the skull to soften enough so that the patient can finally begin to really feel like a human being instead of someone who is trapped in an unyielding box.

Besides compressive in utero ( before birth) forces such hardness and jamming of cranial bones can also come about from traumas both physical and emotional. The release of this tension brings tremendous relief.

When I returned to my office I found several new patients both adult and children who had extremely hard heads. The work that I was able to do was immediately noticed by the patients. I know that these people will go on to do well.

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