resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
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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