resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Treating the Lower Pelvis (Pt. 2): Midline Structures and Fascia
My previous article [October 2016 issue] outlined evaluation and treatment of pelvic issues involving the sacrotuberous ligament and the pubic symphysis. Now let's discuss two case studies that illustrate how to address additional problematic areas of the pelvis.
Helping Patients With Parkinson's Disease
Parkinson's disease (PD), a long-term degenerative disorder of the central nervous system that mainly affects motor function, has a slow onset over time.
The Large Intestine Official
The large intestine (AKA colon) is the great eliminator, or as J.R. Worsley called it, "The Drainer of the Dregs." Dregs are defined as the remnants of liquid with its sediment left in a container, or the basest, least valuable portion of anything.
Near-Infrared Therapy for Diabetic Neuropathy
The pain experienced by people with diabetes is a symptom of diabetic neuropathy. The impact on quality of life is significant. Pain makes walking difficult, sleep troublesome, and eventually contributes to a decrease in social interaction.
ICA Goes on the Vaccine Offensive
Have you watched the vaccination documentary, "Vaxxed: From Cover-Up to Catastrophe," by Andrew Wakefield MD, director, and Del Bigtree, producer? This is the documentary Robert DeNiro was pressured to remove from his Tribeca Film Festival.
VF Works / DMX Works Epilogue: Almost Two Decades Later, the Lawsuits Continue
An article in the March 8, 1999 edition of Dynamic Chiropractic examined whether then-VF Works / Nu-Best Franchising was selling its franchises illegally to doctors of chiropractic.
Chiropractic in Texas Is Under Attack
The profession of chiropractic faces an unprecedented challenge in Texas, an attack that is more aggressive, sustained and dangerous than anything previously seen. The medical lobby has launched a coordinated, multi-front assault.
News in Brief
The American Association of Acupuncture and Oriental Medicine (AAAOM) board members recently met with the Korean Customs Service, which is similar to the FDA, to discuss herbal safety and importation issues.
Reader Beware: Consider the Source
The aftermath of last year's presidential elections brought a running conversation on the role played by "fake news" that was largely presented via social media.
Latest Cassidy Study on Stroke Risk Published
The latest study to investigate whether a unique association between chiropractic manipulation and risk of cervical artery dissection / stroke exists has yielded similar encouraging findings, with the authors noting "no excess risk of carotid artery stroke after chiropractic care" and no significant risk difference between patients receiving care from a DC or a primary care medical provider.
Advancing the "Whole Organ" Spine Model
Historically, the human spine has been organized by body region utilizing specific anatomical landmarks and transition zones.
Paperwork Done Wrong, Done Right
I was visiting a doctor's office recently and a member of his staff brought a stack of forms to his private office and laid them on the doctor's desk. She informed him he needed to complete the forms for patients and a few third parties.
House Calls With Dad
My father was a chiropractor and he did house calls. On Wednesday nights, while my mother attended the weekly women's meeting at the Odd Fellows and Rebekahs hall in our small town, dad loaded up the portable adjusting table, fired up the Pontiac and drove off to treat a few patients in their homes. I went with him.
Getting Unstuck: Healing From Trauma With TCM, Qigong & Movement
We all come into this world vulnerable, with seeds to grow into our strength. Some of us — through a combination of good fortune (i.e., family and culture we are born into, constitutional inheritance, or ability to learn) grow with minimal interruption from traumatic injuries and experiences.
4 Things Every DC Should Know About Levels of Care & Prevention
As health practitioners, we help people with their health problems and assist them with health promotion and disease prevention.
Spiritual Initiation: Opening Your Higher Healing Abilities
People drawn to the field of acupuncture and Oriental Medicine tend to be those who march to the beat of a different drummer.
TCM & the Caregiving Population: Treatment Considerations & Our Vital Role
Informal caregiving is increasingly a reality for many Americans who find themselves providing unpaid care for a loved one or a family member with a long-term, terminal, or chronic illness.
Gather & Grow
I recently attended a faculty seminar held by one of the acupuncture schools. There was a facilitator who led us through some very interesting experiences. The attendees were a diverse group with varying opinions.
Correcting Rib Dysfunction: Improve Patients' Pain, Posture and Breathing
As chiropractors, we tend to focus on the spine, and rightly so. Many problems our patients face can be corrected by manipulating the correct spinal level.
The Acupuncture Channel System (Part 2)
The primary channels (main channels) are introduced in chapter 10 of the Ling Shu, these channels are referenced in many chapters throughout the Su Wen and the Ling Shu. The primary channels have become the main channel system used in TCM.
AOM Residency at NUNM
Imagine you're a recent acupuncture graduate, worried about making enough income as you forge your new career and seek more in-depth training in a particular treatment style.
A Brief History of Acupuncture and Oriental Medicine Doctoral Programs
A doctorate in acupuncture and Oriental medicine has been a goal of the profession since its beginnings in the late 1970s. At that time, however, the maturity of the educational institutions and the regulatory environment made it a goal with only a distant completion date.
November, 2001, Vol. 01, Issue 11
Reflex Mechanisms of Massage Therapy, Part II
By Ross Turchaninov, MD
Editor's note: Part I of this article appeared in the October 2001 issue of Massage Today, available on line at www.massagetoday.com/archives/2001/10/05.html.
Why do stimuli from the stomach that are delivered to the central nervous system (CNS) radiate to somatic structures, and why in turn are the stimuli from reflex zones activated by the flow of motor impulses to the stomach? The phenomenon of convergence is responsible for this effect. The number of afferent sensory neurons delivering information from peripheral receptors to the spinal cord is greater than the amount of spinal neurons in the posterior horns of the spinal cord. The posterior horns accept and primarily process this information (see figure 2).
In other words, there is more than one sensory neuron in contact with each spinal neuron in the posterior horns of the spinal cord. In this instance, the information brought to CNS by sensory neurons from the stomach excites the entire neural plate of the spinal neuron. The sensory information delivered by sensory neurons from the peripheral receptors in the skin or skeletal muscles also excites the entire neural plate of the same spinal neuron. This stimulation by sensory stimuli from the stomach or reflex zones activates the lower motor cells in the anterior horns of the spinal cord. They generate motor input not only to the location of the original abnormality (the stomach, in our example), but also to the somatic structures innervated by the same segment of the spinal cord.
Simpler mechanisms of reflex zone formation are applied in cases of somatic abnormalities. This mechanism is responsible for the reflex zones' formation along the pathway of irritated or compressed peripheral nerves. For example, the chronic irritation of the sciatic nerve by overtensed piriformis muscle will produce pathological symptoms through the entire lower limbs. In this manner, irritation of peripheral nerves in the upper part of the body will cause the formation of reflex zones in the lower extremities, supported by the affected peripheral nerve.
Finally, reflex zone formation can be caused by direct compression of the spinal nerve by a herniated disc. As a result of irritation or compression of the spinal nerve, various areas of pathological excitement develop in the spinal cord, especially in the lower motor centers in the anterior horns. Abnormal impulses flow from the spinal cord to the inner organs, and to other parts of the body that are innervated by the affected spinal nerve. Further development follows the same pattern of relation between reflex zones and inner organs or parts of the body as mentioned previously.
Let's now look at another important issue, and ask another important question: "What local events lead to the formation of reflex zones?" First, let's briefly review the physiology of excitation and the conduction of nerve impulses. A nerve impulse or "action potential" is a propagated electrical disturbance originating in the peripheral receptors or in the upper nervous centers; it is conducted through afferent, ascending sensory or efferent, descending motor neurons. Both ascending information to the central nervous system about any kind of peripheral receptors activation, and descending motor commands from the central nervous system, are delivered as a series of action potentials. Any single action potential is the result of changes in the conductance of sodium and potassium through the membrane of the nervous cells. Every action potential has a threshold. A threshold is the firing level of the action potential. This means that if applied stimuli are weak, they are unable to evoke an action potential. In this case, full action potential is replaced by a local response.
A local response is a weak electric excitement that stays within the stimulated receptor, rather than propagating along the neuron. As soon as the stimuli are strong enough, the action potential is generated and conducted through the neuron. This mechanism protects the nervous system from overflow with useless information. Normally, the threshold activation of peripheral receptors has stable electrical magnitude. The continuous radiation of motor impulses to the reflex zones in skin, connective tissue, muscles, or periosteum evokes unusual phenomena in these tissues. The magnitude of the threshold is reduced in all receptors located in these areas. As a result, receptors start to generate action potentials as a response to even the weakest stimulus, even those that normally had subthreshold levels and have never produced action potentials. (Korr, 1947). This phenomenon is called hyperirritability. The affected soft tissues respond by building up tension, especially in contractile elements. Vasoconstriction and local edema are formed, further diminishing blood circulation and decreasing tissue metabolism.
The decrease of the threshold of peripheral receptors, i.e. the condition of hyperirritability, is the starting point of reflex zone formation (Korr, 1947; Glezer, Dalicho, 1955; Kunichev, 1985; Shterngertz, Belaya, 1994; Loginova, 2000). Figure 3 shows how the action potentials are generated, both in the receptors of the normal parts of the body and in the areas of reflex zones.
In 1947, in a series of brilliant clinical experiments, Prof. I. Korr showed that hyperirritability is a key to understanding reflex zone formation. In his experiments, Korr inserted microelectrodes in muscles with clinical symptoms of hypertonic abnormalities, then exposed his subjects to different types of stimulation: physical activity, decreased and increased temperature, loud sounds, bright light, etc. When subjects were exposed to each of these stimuli (even visual and auditory) the skeletal muscles in the area of reflex zones reacted with increased tension, which was detected by electromyography. This caused the additional decrease of peripheral circulation in already-affected areas. Thus, as Prof. I. Korr showed, any type of sensory stimulation of the CNS causes the further development of reflex zones in the tissue which are no longer protected from theactivation of peripheral receptors by subthreshold stimuli.
A number of clinical abnormalities can be found found in the areas of reflex zones in the skin, connective tissue, skeletal muscles and periosteum. During diagnostic examination, the practitioner should detect all abnormalities and record them on prepared diagrams of the body. At the end of the diagnostic examination, the practitioner will have a complete picture of somatic abnormalities for the patient. Such an approach to diagnostic examination allows the practitioner to formulate the optimal treatment protocol.
I. Cutaneous Reflex Zones
II. Connective Tissue Zones (CTZ)
Connective tissue zones are also examined by palpation. Several diagnostic techniques target the CTZ in the each level. In general, the practitoner is looking for following abnormalities in the areas of CTZ:
III. Reflex Zones in Skeletal Muscles
Reflex zones in the skeletal muscles are examined by palpation and direct compression. The moderate compression of muscular tissue elicits sharp pain in the area of hypertonic muscular abnormalities. Patients show the so-called "jump symptom." Sharp pain elicited during moderate compression is another example of hyperalgesia.
IV. Periostal Reflex Zones
The periosteum is the thin connective tissue membrane covering all bones. It supports bone metabolism and remodeling. The periostal reflex zones are available for diagnostic examination only in the areas at which bone structures are covered by skin only. Examination of periostal reflex zones is conducted by palpation and direct compression.
Following diagnostic examination, the practitioner will able to formulate the proper protocol of medical massage therapy. The formulation of a correct protocol is of course key to successful treatment. As mentioned, this protocol is a combination of different methods and techniques. For example, connective tissue massage is the best way to work on the connective tissue zones, but it is useless in the areas of periostal reflex zones, where periostal massage is the most effective therapy. The practitioner must utilize the particular methods and techniques created for the treatment of particular type of reflex zones. For example, if the patient does not have abnormalities in the periosteum, periostal massage techniques must be excluded from the protocol. However, if one measures the clinical validity of different methods of medical massage, I believe that segment-reflex massage is as appropriate as all known methods of Western medical massage therapy. The major advantage of segment-reflex massage is its integrative approach to treatment.The modern protocol of segment-reflex massage includes therapeutic massage, connective tissue massage and periostal massage, as well as its own therapeutic techniques and approaches. This unique combination allows the practitioner to target the reflex zones precisely and deliver an effective therapeutic impact to the affected areas of the body. In any case, the protocol of medical massage therapy must be individually adjusted to each new patient, because there are no two identical cases.
In conclusion, I want to emphasize that reflex mechanisms of massage therapy allow the massage practitioner reach a completely new level of professional expertise. At first, the clinical application of reflex mechanisms of massage therapy is a challenge. However, the professional benefits are far more rewarding than the time spent by the practitioner to achieve this level of expertise.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.