resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
April, 2001, Vol. 01, Issue 04
A Comparison of the Somatosensory Effects of Therapeutic vs. Medical Massage, Part II
By Gregory T. Lawton, DN, DC
Editor's note: Part I of this article appeared in the March 2001 issue of Massage Today.
Mechanoreceptors and nociceptors are somatic receptors that act as biological sensors in response to physiological stimuli.The nociceptors respond to abnormal stimuli and transmit this information, most often as pain signals to the higher neurological centers. Mechanoreceptors respond to normal stimuli and transmit this information. Each of these two types of biological sensors tends to dampen or inhibit the other.
Nociceptors are found in the skin and throughout the musculoskeletal system. Nociceptors have been found in almost all connective tissue, with the exception of joint cartilage, synovial membranes, and certain parts of the inner vertebral disc. Nociceptive stimulation due to noxious stimuli has dramatic effects on the nervous system, and has been shown to promote segmental responses such as muscle spasm and increased sympathetic activity. Nociceptor stimulation can also stimulate suprasegmental activity that affects the hypothalamus and can cause sweating, nausea, weakness, pallor and dizziness. A commonly recognized problem in chronic pain is the continuing stimulation of nociceptors.
Mechanoreceptors respond to normal tissue environment and report this homeostatic activity to the central nervous system. Mechanoreceptors appear to respond to weak mechanical signals, gentle movement and pressure, and normal range of motion activities of the joints. Mechanoreceptors do not respond to noxious stimuli and are in fact inhibited by nociceptive input.
The two previous paragraphs, regarding nociceptors and mechanoreceptors are vitally important in understanding what constitutes effective medical massage therapy. Rather than basing our understanding and application of massage therapy technique simply on the theories or pet techniques of a few massage therapists, or upon inaccurate models of physiological function, we should seek to understand the scientific literature that reveals the deeper secrets of physiological function as it pertains to connective tissue therapy.
Based on what is scientifically known about mechanoreceptors and nociceptors, we can suggest the following principles as applied to medical massage therapy:
The above eight principles provide the medical massage therapist with both a mandate and an outline for delivering medical massage therapy. In addition, the medical massage therapist can use the scientific evidence from studies on mechanoreceptors and nociceptors to judge and evaluate massage therapy technique. Clearly, the scientific literature supports manual therapy technique that promotes responses in mechanoreceptors and any technique or activity that dampens or inhibits nociceptors. Four aspects of clinically effective treatment can be identified from the eight principles outlined above:
Therapeutic massage techniques (or any system of massage therapy) that stimulates nociceptor activity via painful and improper technique, will retard and delay the healing of injured connective tissues. Specifically, techniques that are improperly applied such as trigger point therapy and periosteal or deep tissue techniques will stimulate nonciceptive input, muscle spasm, pain, sympathetic hyperactivity, and supra-segmental physiological responses.
It should now be clear that the proper application of medical massage technique should include the avoidance of technique that stimulates nociceptive responses in the nervous system. This stimulation has a negative effect on the outcome of the treatment and the patient's healing process. From this viewpoint, pain is not gain. The massage therapist who wishes to apply the principles presented here in the clinical application of massage therapy technique probably needs to make subtle changes in manual technique. These changes include the following:
Medical massage therapy is a scientifically based method of manual therapy. Medical massage seeks a clear understanding of the scientific principles of physiology that affect connective tissue healing and treatment. Many currently utilized therapeutic massage techniques unnecessarily inflict patient pain and exacerbate the patient's condition, due to a faulty and erroneous viewpoint regarding biological sensory input and "proproceptors." This material is offered to all massage therapists, to clarify this issue and to offer more effective treatment methods. The next time you see an article showing (r a massage instructor demonstrating) trigger point therapy with the elbow buried an inch into the levator scapula and trapezius, consider the nociceptive stimulation this technique is provoking and reconsider the value of this type of technique.
Regardless of what we call or label the manual therapy techniques that we apply to clinical cases, we must, as massage professionals, recognize the need to thoroughly investigate current scientific research regarding connective tissue pathophysiology and reconsider our technique and treatment protocol based on this knowledge. For those massage therapists who prefer to practice general relaxation massage in recreational settings, while they may voluntarily choose not to practice medical massage, they must also recognize and understand the higher mechanisms of connective tissue rehabilitation and the ability of the medical massage therapist to treat connective tissue pathology.
The pet techniques of the massage therapist should not determine the patient's treatment. Treatment should be based on the findings, diagnosis, causation and symptoms of the patient's presenting problem or condition.
The allied medical professions and the chiropractic profession can also benefit from a detailed education in medical massage technique and protocol. The application of non-exacerbating technique directed at the primary area of pathology in most musculoskeletal disorders, the joint complex, is of profound value to medical massage therapists, chiropractors, physical therapists, occupational therapists, nurses and physicians who treat connective tissue disorders. Medical massage therapy may effectively become the pivot point where many of these health care practitioners come together in a common understanding of massage therapy.
References and suggested reading:
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