resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
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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