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Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
January, 2001, Vol. 01, Issue 01
By Kate Jordan, NCTMB
Many massage therapists are confused and uncertain about the appropriateness of accepting pregnant clients who are in high-risk pregnancies. Who can be harmed? Can massage therapy and bodywork be useful and beneficial in a high-risk pregnancy? Are there techniques to avoid?
A high-risk pregnancy is one in which the mother or baby has a greater chance of injury or death.About 5-10% of all pregnancies in the U.S. fit in this category.
Prenatal care for women in this situation may include more extensive testing, more frequent prenatal visits, medications, and bed rest.
A woman may be identified as high risk because of her age (under 15 or over 35), family history, medical condition, or complications that develop in her pregnancy. Therapists should include a question about risk status in intake forms for pregnant clients, or in initial phone contacts. If a client indicates that she is considered to be high risk, it is essential to communicate with, and secure a release from, her prenatal health care provider, who will be a doctor, nurse-midwife, or lay midwife. Such a release asks the health care provider to approve massage therapy, and also list any precautions or limitations in massage procedures. I find it easiest to fax a release form to the doctor's office, or ask my client to hand-deliver it on her next prenatal visit.
When working with a high-risk pregnant client, it becomes even more important to observe basic precautions and contraindications for bodywork in pregnancy. Some clients may have been restricted by their health care providers in the positions they are allowed to take. This can include no sitting or prone or supine positioning, or lying on either the left or right sides. When no specific restrictions have been given, side-lying positioning is the safest, offers the greatest comfort, and increases blood flow to the heart. Side-lying is also the most common position a high-risk client on bed rest will be asked to assume.
Therapists should also modify bodywork modalities used on the legs in pregnancy. Fibrinolytic changes in pregnant women's blood makes blood clots more likely to develop. These clots can develop in both superficial and deep veins in the legs, and are not always detected by common tests. Therapists should avoid using techniques that involve deep pressure and friction on the legs. This includes, but is not limited to, deep acupressure, shiatsu, cross-fiber friction, deep tissue massage, and all percussive movement. In addition, all techniques on the legs, except for the lightest effleurage, should be directed toward the heart, since hormonal changes in pregnancy weaken the valves in veins.
Therapists should restrict abdominal massage with high-risk pregnancies to light touch, and should avoid touching the abdomen entirely in the first trimester. Since 80% of miscarriages occur in the first trimester (1-13 weeks), it is wise for a therapist to avoid even the appearance of possible contribution to the loss of a baby.
When a mother knows that her pregnancy is high risk, or develops a complication that puts her in that category, she may experience anxiety, fear, and guilt. This increased stress can further endanger the successful outcome of her pregnancy.
Massage therapy is especially appropriate for the high-risk mother, since it promotes relaxation, reduces anxiety, supports the physiology of the pregnancy, and can relieve the discomfort and muscle strain that develop when a mother is placed on bed rest. Recent research has shown that massage in pregnancy decreases the incidence of prematurity or other complications in labor.
When in doubt about the appropriateness of specific techniques for a high-risk pregnancy, therapists should consult experts in that modality, or err on the side of caution. Observing guidelines on client positioning and use of modalities will enable the therapist to provide the high-risk pregnancy client with a safe, enjoyable, and therapeutic bodywork experience.
There is a need to understand and address the unique health concerns of women. This column will continue to explore issues of particular interest in massage therapy and bodywork for women, including reproductive health, sexuality, body image and eating disorders, pain syndromes, osteoporosis, and aging.
Click here for previous articles by Kate Jordan, NCTMB.
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