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Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
April, 2001, Vol. 01, Issue 04
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Hello readers, and thank you for your wonderful responses to the first article of my Dealing with Pathologies column in the January 2001 edition of Massage Today!
Several people wrote in with interesting questions that they wanted to bring to public discussion.Some of these were fairly simple, like, "Is shingles contagious?" (Not if you've ever had chicken pox, but shingles can be extraordinarily painful, so take care!), and "What are the rules for working with high blood pressure?" (If it is manageable with diet and exercise, go to town; if it requires medication, use more caution with circulatory massage).
One of the most complex questions was raised by a massage therapist from the South, who wrote that she had worked for a short time in a salon. Her employer made all her appointments and controlled all the initial contact with her clients. The owner of the salon, not understanding the profound impact massage can have on health and disease, expected her to work with clients with a variety of conditions that could contraindicate Swedish massage: advanced atherosclerosis patients, clients with unexplained dizziness, and clients with unregulated diabetes. When the therapist repeatedly voiced her concerns, her employer didn't seem to grasp the seriousness of the problem. The working relationship was short-lived, and the therapist found another situation in which she could have more control over her choices.
How could this problem have been avoided? I see a need for three related areas of education:
1) Therapist-Employer Education
Any therapist who works as an employee has an obligation to meet the commitments outlined in that relationship, but those commitments need to be clearly stated from the beginning. This is obviously true for financial matters, but it also applies to how the therapist manages clients. In other words, massage therapists need to make clear that they may refuse to do circulatory massage with any client if they feel it is not in the client's best interest - regardless of whether the client or employer agrees. (And of course, therapists should also be able to refuse to give service to any client who abuses the client-therapist relationship; this is a safety issue.)
Many employers of massage therapists, especially those working in the "relaxation" aspect of the profession rather than in "clinical" settings, don't know the risks that circulatory massage may have. It is the therapist's job to educate these employers for the benefit of all their clients. For this purpose, it might be useful to make up a brief list outlining cautions and concerns for Swedish massage; circulatory and sensory disorders, contagious diseases, certain medications, and undiagnosed problems are all cause for concern. Of course, any such list needs a disclaimer explaining that decisions must be made on a case-by-case basis.
Other client management issues include being able to interview clients before they come for a first appointment; being able to take a thorough health history; and being able, when necessary, to consult with other members of a client's health care team.
The better we become at educating massage therapy employers about the risks and benefits of massage, the safer the profession will be for therapists and clients.2) Therapist-Client Education
Another front-line education target is our clientele. Swedish massage is our industry standard. It is what most people expect when they pay money to receive massage. The vast majority of massage therapists use Swedish massage with most or all of their clients. However, we all know that whole worlds of bodywork have been developed that lack the circulatory impact Swedish massage has. When we, the therapists, are better able to educate our clientele about alternatives to Swedish massage that can yield outstanding benefits with minimal risks, we will have more options when people come to us with conditions that contraindicate Swedish massage.
I have found that when I discuss bodywork choices with clients, in terms of their own health and safety, they are usually open-minded about receiving work outside of their expectations. Not all clients will enjoy non-circulatory bodywork, however. Some may leave to find therapists who will do Swedish massage, regardless of their medical conditions. But every therapist needs to define boundaries for keeping clients safe. Beyond legalities and the threat of litigation, we need to keep the health and well being of our clientele first and foremost in our judgment.
3) Therapist Education
Finally, we ourselves have an obligation to be continually learning and adding to our skills. An old saying goes, "if all you have is a hammer, everything looks like a nail." If all you know is Swedish massage, every client looks like a good candidate for circulatory work! But if we have, in addition to our Swedish hammer, a craniosacral screwdriver, reflexology pliers, a Bowen technique drill... you get the picture. The more tools we have in our tool belt, the more versatile we can be. This benefits not only ourselves, keeping lively and interested in our work as we incorporate new skills, but also our clients, who will have therapists with skills that apply even when medical situations preclude circulatory massage.
This whole issue of making decisions about bodywork when our clients are not completely healthy, brings up a few more questions I'd like to put to you:
How do you talk to your clients about their health? When you see or notice something that requires attention from a medical professional, what do you say or do? Have you ever had to send a client away because his or her medical situation was too precarious? How did you convey your concerns? Did you feel you did a good job?
Send me your feedback, along with any other questions about massage and pathology, and I'll discuss it in a future article in Massage Today! Until then, good health and happiness.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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