resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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:
Detoxification Demystified and the Crucifers that Help
"Let food be your medicine and medicine be your food," is a quote often attributed to Hippocrates, a philosopher of the 5th century BC.
When I started to think about what I wanted to do, I toured different schools to choose where to pursue my original chiropractic education.
Yo San University Receives $1 Million Gift
Long-time Yo San University supporter Thomas S. Blount recently gave a $1 million dollar gift to the University, it's largest charitable gift to date. Mr. Blount was a retired naval officer, aerospace consultant and philanthropist.
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.
Suffering Makes Us Human
It is possible that suffering, instead of being something negative, can be one of the greatest gifts to bring out one's humanity — if we allow it to be.
Create Community and Grow Your Practice
Many healthcare providers are fortunate to enjoy the freedom and independence of owning their own businesses. However, the constant demands can lead to a lonely and isolating experience unless you make an effort to get out of your office.
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.
Breech Baby: A Scientific Approach
You learned a classic cookbook style treatment strategy in college for treating breech baby presentation. I'm sure you've used it. The main ingredient: moxa at Urinary Bladder 67.
Cold and Flu Season: Expanding the Repertoire
As we move into the winter months, it is important for clinicians to have a solid working knowledge of effective herbal protocols for treating and managing clinical cold and flu presentations.
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.
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.
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.
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.
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."
How to Market to the Medical Profession
The world of health care is changing dramatically. When situations occur that cause expenses to increase, it is time for you to develop strategies that maintain and grow revenue.
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?
The 2015 Nobel Prize Shines a Spotlight on TCM Research
Traditional Chinese Medicine continues to make it's presence felt on the world stage as the 2015 Nobel Prize in Physiology or Medicine was jointly awarded to William C. Campbell and Satoshi Omura for their work on combating parasites and YouYou Tu for her discoveries in combating Malaria.
Are You a Stakeholder?
In today's world many new things are occurring, especially in the world of information technology. With these changes, comes an entire new set of vocabulary words and definitions.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
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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