resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
March, 2001, Vol. 01, Issue 03
A Comparison of the Somatosensory Effects of Therapeutic and Medical Massage, Part I
By Gregory T. Lawton, DN, DC
There are many different kinds of massage therapy and massage therapy techniques. This article reviews two systems of massage therapy: therapeutic massage and medical massage, as they relate to their clinical effects on the somatosensory system, specifically, mechanoreceptors, nociceptors and the joint complex.
Medical massage is composed of a strictly delineated clinical protocol, and therapeutic massage is commonly practiced as recreational, relaxation; energy; fringe or spa massage, and is most often based on the system developed by Per Henrik Ling.Massage therapy is a form of manual therapy and may be considered to have two categories of physiological considered to have two categories of physiological effect: generalized effects and specific effects. All modes and methods of manual therapy have some degree of generalized physiological effect, whether the massage therapy is employed for medical or relaxation purposes.
However, it is in the area of specific clinical effect that systems of massage separate into different categories: medical and non-medical. Medical massage claims to be a specific system of manual therapy that facilitates connective healing relative to the pathophysiology of the condition to which it is applied and is therefore a system of medical treatment. Therapeutic massage, which is most commonly practiced as relaxation or spa massage, has numerous documented clinical effects. To date, most studies on massage therapy have employed the general techniques of therapeutic massage. Perhaps the greatest strength of therapeutic massage is its effect on the stress cycle.
Therapeutic massage may be broken down into two categories of techniques: those techniques originally developed by Ling and represented by the "Swedish massage" system, and ancillary techniques added to the Ling system by various therapists and utilized by therapeutic massage practitioners as adjunctive techniques. Examples of this latter category would include trigger point therapy, skin rolling, proprioceptive neuromuscular facilitation (PNF), and neuromuscular and muscle energy technique.
To make the issue of definition between medical and non-medical technique even more confusing, some practitioners of medical massage, and authors of medical massage articles and books, utilize therapeutic massage (Swedish massage) technique and simply label it medical massage. Some therapeutic massage therapists do this because they do not practice therapeutic massage for relaxation massage purposes, but rather general clinical objectives. Some practitioners of therapeutic massage consider themselves to be medical massage therapists if they use therapeutic massage in a hospital or medical environment, or if they add muscle testing and range of motion techniques to their therapy.
Medical massage therapy contends that any system of manual therapy that claims a specific clinical effect must demonstrate that its techniques can achieve clinical outcomes identical to those measured in other clinical systems, or techniques that have been scrutinized in research studies and clinical settings. One example would be the ability of a series of techniques or a massage treatment protocol to effectively address chronic pain through stimulation of mechanoreceptors and inhibition of nociceptor activity, while also reducing acute and chronic inflammation and restoring normal joint range of motion. Any system of massage therapy that systematically obtains these clinical objectives is a form of medical massage. Currently, any clinical claims made by the medical massage therapist are based on "borrowing" the observations and findings of studies from other disciplines, such as histiology, chiropractic, orthopedics, physical therapy, and biomechanics. It should be noted, however, that a review of the current research in these areas offers the medical massage therapist a wealth of information. This information at least suggests the effectiveness of certain techniques, and further defines the application of certain techniques. Missing are specific studies that measure the outcome of medical massage techniques and protocols.
The massage profession at large has not seriously engaged in the labor of defining many of the issues addressed in this article because of a lack of general consensus within the massage community of the definition of medical massage; because of a lack of standardized educational curriculums in massage schools; and because of an historic rejection, by the massage community, of research-based technique and medical methodology. In addition, many schools of massage therapy teach very elementary and introductory massage therapy technique, basic anatomy, almost no pathology, and no clinically based internship programs. Indeed, the level of education in most massage schools is currently at a low level as compared to other allied medicine and professional training programs in health care.
This article does not propose to define medical massage for all practicing massage therapists, but rather to offer some insights into possible future directions and development for medical massage. Certainly, there is a wide diversity of massage therapy practice that ranges from esoteric forms of fringe massage to clinically focused manual therapy.
Studies on massage to date have been performed utilizing generalized therapeutic massage, not the controlled clinical techniques used by some medical massage therapists. As this article emphasizes, technique should not determine studies, but studies should indicate or suggest technique, or even lead to the development of new treatment approaches. When research, technique, and outcome-based clinical rehabilitation collide, medical massage is born.
One of the problems in the general practice of massage therapy is the use of theories, techniques and concepts that are not based on valid scientific knowledge or accepted clinical practice. Within the fields of histology, pathology and biomechanics, there already exists a vast body of scientific research on connective tissue that validates massage and manual therapy techniques. Rather than waiting for future studies, massage therapy can adapt current research to clinical practice. Significant current examples are the research that exists on the physiology of ligaments, the joint complex and mechanoreceptors and nociceptors.
An example of a universally accepted misconception within the massage community involves the concepts regarding the "proprioceptor." Currently, within the general massage culture, the term proprioceptor is used to describe a type of neural receptor that transmits biological impulses related to a sense of position of a body part or area. Various massage techniques and exercises have been developed by different massage therapists that claim to "reprogram" or "normalize" proprioceptor function. In medical research and scientific circles, the term "proprioceptor" is and has been recognized as an inaccurate and non-scientific term. Although first entered into use by Sherrington (1906), the term was used to describe a specific type of biological sensor, and was not accepted by the legitimate scientific community since 1926. The term is listed in Gray's Anatomy, 37th edition, as "arbitrary." Scientific literature related to the use of the word proprioceptor dismisses the term for the following reasons:
Most, if not all massage textbooks, refer to and teach treatment and technique based on the concept of the proprioceptor. Almost all massage schools and their instructors teach the concept of the proprioceptor. Several methods of manual technique and therapeutic exercise are based on the erroneous concept of a proprioceptor. If this is not a physiological term, then what terms are physiologically and scientifically correct?
References and suggested reading:
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