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State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
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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