resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
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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