resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
October, 2001, Vol. 01, Issue 10
Reflex Mechanisms of Massage Therapy, Part I
By Ross Turchaninov, MD
Editor's note: Dr. Ross Turchaninov graduated from Odessa Medical School in the Ukraine in 1983. He supervised the rehabilitation program at the Ministry of Public Health of Ukraine, and later served as chief scientific researcher at the Kiev Orthopedic Institute.Dr. Turchaninov is the author of more then 25 articles in Ukrainian, European and American medical and massage journals. He is also the author of two textbooks published in the USA: Medical Massage, Volume 1 and Therapeutic Massage: A Scientific Approach. Dr. Turchaninov currently resides in Phoenix, Arizona. In the past several years, massage therapy has developed with great speed in the United States as a form of alternative medicine. According to a statistical survey conducted by Eisenberg, et al. and published by the Journal of the American Medical Association in 1998, the probability of a patient visiting an alternative health practitioner increased from 36.3% in 1991 to 46.3% in 1998. Among these patients, massage therapy was second only to chiropractic care in terms of popularity.
The work of scientific institutions such as the Touch Research Institute in Florida has created a scientific background for the clinical application of massage therapy. More and more insurance companies cover the cost of massage therapy, and more and more doctors refer their patients to massage practitioners. Unfortunately, most insurance companies do not cover methods of preventive therapy; their major concern is the clinical effects of treatment. This is also a major expectation of patients and other health practitioners who recommended massage therapy. Consequently, it seems apparent that the further development of massage therapy may lead in the direction of its medical benefits.
Therapeutic massage alone does not necessarily deliver stable clinical results. This type of massage therapy was originally created for healthy people, to enhance their health and improve their well being. Some of the methods of medical massage therapy are already widely (e.g., lymph drainage massage) or partially (e.g., connective tissue massage) incorporated into the arsenal of American massage therapy; some methods remain to be rediscovered or more fully explored (e.g., segment-reflex massage or periostal massage).
The medical massage practitioner occupies a special place in massage therapy. What distinguishes a massage therapist from a medical massage practitioner? First of all, medical massage demands more education and, perhaps more importantly, a commitment to permanent self-improvement. Second, the massage therapist who studies and practices for example, lymph drainage massage, cannot be considered a medical massage practitioner, but rather a lymph drainage massage practitioner. The uniqueness of medical massage therapy is in its integrative approach. In other words, the medical massage therapist has to know all major methods of medical massage therapy, and be able to blend them together to create the unique treatment protocol of the treatment for each patient. Only in such a case can stable clinical results be achieved. We do not expect surgeons to conduct an operation by knife only; they utilize a wide set of different tools. The methods of medical massage therapy are tools massage therapists use for the health benefits of their patients. With such an integrative approach, the medical massage practitioner can treat different somatic or visceral disorders using the local and reflex mechanisms of massage therapy.
The local mechanisms of massage therapy are widely known -- they play an important role in the formation of the clinical effects of massage treatment. However, in this article I will discuss the theoretical foundation of reflex mechanisms of massage therapy. These mechanisms are key elements of the major methods of medical massage therapy: segment-reflex massage; connective tissue massage; periostal massage; and neuromuscular therapy.
The human body has two major anatomo-physiological components: soma and viscera. Soma includes skeletal system and all soft tissue structures: skin, fascia, muscles, etc. Viscera includes the inner organs and systems of our body. The soma provides our locomotion, interaction with environment and also serves as a protective envelope for the viscera. Somatic and visceral structures are perfectly united together by the nervous system. The different somatic structures also interconnect with each other through the nervous system. This interconnection can be seen between different visceral structures or systems of the body. These interconnections are possible because of several principal reflexes:
The medical massage practitioner is able to use soma-somatic, viscero-somatic and viscero-motor reflexes for the treatment of various somatic and visceral disorders. The reflex mechanism of massage therapy allows the practitioner to dramatically increase the results of the treatment of somatic abnormalities, and to participate in the treatment of visceral disorders. Soma-somatic, viscero-somatic and viscero-motor reflexes are responsible for the formation of local abnormalities in the areas of soft tissues, innervated by the same segment of the spinal cord as the original somatic or visceral disorder. These areas in the soft tissues are called reflex zones. The reflex zones do not form as soon as clinical picture of original disorder is established. In cases of somatic abnormalities, the formation of reflex zones may take an average of two-to-three weeks. In cases of visceral disorders, the reflex zones are formed after approximately three months. Thus, the reflex zones in the skin, connective tissue, skeletal muscles and periosteum are formed secondarily, as the body's response to chronic various somatic or visceral abnormalities.
The concept of reflex zones was first proposed by Prof. A. Sherbak, MD, in works published between 1910 and 1936. He developed one of the most effective methods of medical massage therapy: segment-reflex massage. The conception of reflex massage therapy continued to develop in different countries. In Austria, E. Dickle and Prof. W. Kohlrausch proposed connective tissue massage in the 1930s. In Germany, Dr. P. Vogler and Dr. H. Krauss developed the concept of periostal massage in 1950s. In 1955, Drs. O. Glezer and V.A. Dalicho reshaped segment-reflex massage by publishing maps of reflex zones in cases of different somatic and visceral disorders. In Russia, Prof. O.F. Kuznetsov developed asymmetric segment-reflex massage in 1977 for the treatment of patients with pulmonary disorders.
After World War II, reflex zones were intensively studied by American scientists (Beal, 1985). Experimental studies conducted by Prof. I. Korr in 1940s allowed scientists to more deeply understand the intimate mechanisms of reflex zone formation.
What mechanism is responsible for the formation of reflex zones in the skin, connective tissue (e.g. fascia, aponeurosis), skeletal muscles and periosteum (i.e., thin connective tissue membrane which covers bones and supports their metabolism)? Let's discuss this matter with the help of figure1.
Take as example a patient suffering from a chronic gastric ulcer. The patient complains of pain in the epigastric area, heartburn, gas, belching, etc. The symptoms worsen with stress and consumption of spicy or fatty foods. The flow of these pathological impulses (solid arrows in figure 1) travels from the peripheral receptors in the stomach, through the afferent sensory neurons, to the posterior horns of the spinal cord, where all sensory information arriving at the spinal cord is primarily processed. As soon as ascending sensory information reaches the spinal neurons in the corresponding segments of spinal cord, these neurons are stimulated. The posterior horns of the spinal cord act as a computer to analyze sensory input, then transfer it to the brain. Simultaneously, these sensory impulses from the stomach are conducted to the lower motor centers, located in the anterior horns of the spinal cord. As a result of stimulation of lower motor centers, the motor commands are sent to the area with original pathological processes in the stomach, causing changes in gastric function such as increased peristalsis, decreased gastric juice production, etc.
The stimulation of lower motor centers also produces the flow of motor impulses to the areas of the skin, connective tissue, skeletal muscles or periosteum, which are innervated by the same segments of the spinal cord as the stomach. Reflex zones start to form in these soft tissues, as a result of their permanent bombardment by motor impulses. However, these motor impulses were not produced originally by the stimulation of peripheral receptors in soft tissues. They are a radiation of sensory impulses from the stomach to somatic areas innervated by the same segment of the spinal cord as the stomach. The constant flow of unnecessary motor commands to the somatic areas causes the increased tension in these areas, and reflex zone formation.
Pathological changes in the reflex zones appear in different clinical forms. As soon as the reflex zones are formed, they start to emit their own pathological impulses through the afferent sensory neurons to the posterior horns of the spinal cord (dashed arrows in figure 1). These stimuli also activate the spinal neurons, which transfer sensory information up to the brain and stimulate the lower motor centers in the anterior horns of the spinal cord. Stimulation of the lower motor centers elicits the flow of motor stimuli back to the areas of reflex zones and, at the same time, the flow of motor stimuli to the stomach. This unnecessary flow of motor impulses to the stomach accelerates the original process of ulcer formation by increasing vasoconstriction, cellular edema, and abnormalities in the gastric secretion. Thus, a vicious circle is formed which supports further development of the chronic gastric ulcer.
Segmental-reflex massage, connective tissue massage, and periostal massage can interrupt this vicious circle - by eliminating local abnormalities in the areas of reflex zones, and by blocking a reverse flow of pathological impulses from the reflex zones to the spinal cord, brain and stomach. Essentially, this is the primary goal of medical massage therapy: to evaluate, then eliminate reflex zones.
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