resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
June, 2004, Vol. 04, Issue 06
Setting the Record Straight: Massage Gets a Bad Rap in National Report
By Rebecca J. Razo
Over the years, the massage profession has been no stranger to adversity. Many battles have been fought, and won, to protect the reputations of the profession and massage professionals throughout the country.Fortunately, an increasing number of studies and news reports have helped validate massage and other forms of complementary and alternative medicine (CAM) in treating pain and dysfunction. (See the top story in this issue: "Newsweek Validates Complementary and Alternative Therapies for Back Pain" www.massagetoday.com/archives/2004/06/01.html) With all of the positive aspects of the advancing massage profession, it can be disheartening when media reports indict massage as a harmful practice with little or no supporting evidence.
Such was the case in April 2004, when a short segment ran on national television suggesting that massage can be dangerous. The segment, which was written, produced and distributed by Ivanhoe Broadcast News - a health news-gathering service that produces daily media reports - was subsequently posted on several Web sites.1 One report, "Massages Could Cause More Pain Than Relief," ran on a major Southern California network with the following introduction: "People often feel better right after a relaxing massage, but many people leave the table feeling even worse. Experts say what you don't know about massage may cause more pain than relief."2
The feature discussed the case of Mary Schreiner, who had sought massage after suffering injuries in two major accidents. Schreiner claimed she felt fine during and immediately following massage, but that the treatments ultimately aggravated her injuries; in the end, Schreiner received cortisone injections to manage her pain.1,2
The piece quoted only one expert, Dr. Robert Gotlin, a physical rehabilitation specialist with Beth Israel Medical Center in New York City, who made three blanket statements in relation to massage, including that 15 percent of massage patients need corrective treatment following massage; thin people should avoid deep-tissue massage because of potential injury; and a client's likelihood of receiving a safe massage is better from a "therapist with credentials from the American Massage Therapy Association."1,2
In an initial phone interview, Dr. Gotlin told Massage Today that his true message was not made clear in the television segment, and that he was not given the opportunity to proofread the piece before it went to production3 -- a statement Stacie Overton, Director of Medical Programming for Ivanhoe, vehemently denies. "We fact-check everything we do," Overton said. "If he had a problem, I wish he had said something ... if [he thought the piece] was presented poorly."4
Dr. Gotlin indicated that the segment was originally intended to address what he perceives is a problem in the massage profession. "The impetus for this piece is the recent increase in storefront 'pay-by-the-minute' massage centers," he said. "For the hundreds of patients seen monthly for complaints of musculoskeletal pain ... [an] increasingly common modality tied to pain symptoms is storefront 'pay-by-the-minute' massages."5 But Overton denies the piece was ever intended to cover massage mishaps in storefront-type operations. "I would have never accepted that story," she said.4
When queried about his claim that 15 percent of massage patients need corrective treatment, Dr. Gotlin told Massage Today that his statistic was derived from unofficial, nonscientific assessments of thousands of patients from his private practice over the past two to three years. "This was a practice comment," he said.
However, transcripts of Ivanhoe's original interview, which were fact-checked and approved by Dr. Gotlin prior to production, show-- although he openly admits his conclusions are based on "trial and error" evaluations of his own patients -- that Dr. Gotlin never clarifies his statistical assessment is based on those same in-office patient evaluations; consequently, this omission resulted in an innacurate depiction of massage injuries.6,7,8
Moreover, Dr. Gotlin, who claims to see roughly five to six patients a week for injuries following massage, agreed that his patients usually have pre-existing injuries that are merely exacerbated -- not caused by -- massage.3 The feature never makes this point clear.
In reality, it is "rare for a well-trained massage therapist to give a bad massage," remarked AMTA President Laurel Freeman. "There are very few malpractice claims filed against massage therapists for injury."9 Moreover, the number of documented injuries is extremely low.
According to a study conducted by massage educator Keith Eric Grant, PhD, and published in the October 2003 issue of the Journal of Bodywork and Movement Therapies: "There are extremely few reported cases of injury related to massage within the indexed health care literature. While statements have occurred in newspapers that would seem to indicate that massage has a high potential and probability for causing injury, such anecdotal statements have no support in the medical literature or in insurance statistics."10
And a study published late last year in Rheumatolgy indicates that although "massage is not entirely risk free ... serious adverse events are probably true rarities."11
"I seriously question the judgment if not the ethics of [Gotlin's] pronouncements to the media," Dr. Grant said. "If Dr. Gotlin had clinical observations to report, doing so by a journal article or letter to the editor would have been a fully appropriate and useful contribution to the ongoing professional dialogue and development of the massage profession." Dr. Grant further noted that Dr. Gotlin's statements were made "in a manner potentially misleading to the public."12
Still, Dr. Gotlin stressed his support of massage therapy when properly indicated, and affirmed that his concern is for those who self-treat with massage prior to seeking appropriate medical care for pre-existing injuries. "For those who are without pain and wish the comforts of soft-tissue massage ... this is not the population I am speaking of," he said. "It is those who have complaints of neck or back pain accompanied by arm and/or leg pain, which manifests at night, or pain along with muscle weakness ... conditions which should undergo a medical evaluation before embarking on any therapy.
"Massage therapy may be an excellent modality choice if not contraindicated," he continued. "Many patients are not [told] to seek medical advice by the storefront massage therapist. In fact, there is usually no discussion of any related symptoms."5 Yet, Dr. Gotlin's support of massage therapy was not a point made central to the feature that aired.
James Waslaski, international lecturer on orthopedic massage, chronic pain and sports injuries, believes that massage often receives negative press because of ongoing "turf wars" between health care professionals, and affirms that "many advanced disciplines within [the massage] profession have a very low chance of making an existing injury worse.
"I do recommend that people become certified in advanced [massage] disciplines ... to assure that proper assessment is done prior to treatment. By referring out [to other qualified therapists], certain complicated conditions ... would not become exacerbated by massage treatments. In fact, many times for soft tissue injuries, muscle relaxants and cortisone injections will only mask the patient's symptoms instead of treating the underlying structural imbalance causing the pain," Waslaski said.13
Another of Dr. Gotlin's claims was that thin people should not receive deep-tissue massage. "The most common body habitus seen with complaints of increased symptoms with deep massage is the ectomorph. Those who are thin may suffer the greatest ill effects of deep-tissue massage, likely due to the close proximity of the massaging hands to inflamed nerves and muscles," he said.5
But according to Waslaski, "deep tissue massage can indeed be performed safely on thin individuals." Waslaski affirms that most orthopedic massage instruction stresses the importance in teaching massage to remain "always pain free," which may involve "superficial to deep, myofascial spreading routine, avoiding bony landmarks to increase blood flow to ischemic areas ... gentle trigger point techniques to referral pain patterns in short muscle groups and gentle stretching ... to assist the body back to a state of balance.
"In my opinion, muscle groups shorten because of repetitive use or poor postures," he continued. "It is our role to lengthen those short muscle groups in a pain free fashion. We should never cause pain in our treatments, and [must conduct] a thorough assessment of [the] patient prior to doing the treatment," Waslaski added.13
Freeman agrees. "Thin people have skin and muscles just like people who are heavier. The more important question is: 'What is the person's sensitivity level?'"9
Although Dr. Gotlin is on record saying that those seeking massage should ask if "the therapist [is] certified by the AMTA,"7 he amended his statement to Massage Today, stating instead that consumers should seek a massage therapist "who is certified/licensed by an organization such as the AMTA."5
He also wants the public to know that his intentions were noble: "The intent of ... my media pieces is to 'advise' consumers ... to increase awareness of the indications/contraindications and risk/benefit ratios for the many therapeutic options available," he said. "I am an advocate and believer in massage therapy."5
Although some may construe this report as a setback to the massage industry, Freeman emphasizes how far the profession has come over the past several years. "Massage has been growing at an incredible rate," she said. "In the last seven years, AMTA's consumer surveys have shown the percentage of American adults receiving massage jump from 8 percent to 21 percent; the number of articles written about massage have gone from 3,700 per year to over 15,000; and the massage profession is listed in the American Medical Association's Health Professions Career & Education Directory."9
Editor's note: Due to the transient nature of the Internet, some links may no longer be accessible.
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