resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
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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