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Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
January, 2002, Vol. 02, Issue 01
Medical Massage Therapy: The Search for Definition
By Gregory T. Lawton, DN, DC
Attempts to present and to define medical massage therapy vary from teacher to teacher and author to author. This article presents concepts related to medical massage therapy, a form of manual therapy routinely practiced by medical physicians and medical personnel during the 19th century.Medical massage therapy lost popularity in medical circles with the advent of the "drug era," along with many traditional forms of health care, such as midwifery and herbal medicine. State and national laws were developed which prohibited the legal practice of medical massage or natural health care for medical purposes. This government action resulted in the current condition of massage therapy as a lay practice based on esoteric principles and theory.
Currently, there is a movement within the massage profession to restore the historic medical applications of massage and manual therapy. Currently, most schools of massage therapy teach Swedish massage (also referred to as therapeutic massage) and/or variations of Swedish massage technique, or specialized systems of manual therapy such as shiatsu. Most of the western systems of conventional massage therapy, especially techniques taught in the United States, are based on the work of Per Henrik Ling, who formulated the general and relaxation techniques of Swedish massage (also referred to as therapeutic massage). In 1892, Emil Kleen, MD, PhD, author of Handbook of Massage commented on Ling and Swedish massage:
This "unfortunate defect" still plagues massage therapy, as there are very few studies that presently substantiate the medical claims of massage therapy. In addition, there are few massage therapists that have the doctoral or scientific credentials needed to study and present findings related to massage therapy research. In a research paper written by Justus J. Fiechtner, MD, MPH and Raymond R. Brocheur, DC, PhD ("Manual and manipulation techniques for rheumatic disease," published in Rheumatic Disease Clinics of North America, Volume 26, Number 1, February 2000), the authors state:
Conclusions regarding the effectiveness of massage therapy in the treatment of musculoskeletal disorders or disease are largely based on subjective and empirical evidence presented by massage therapists over hundreds of years. While this collection of empirical evidence is large and impressive, it does not address the more scientifically refined questions regarding specific modalities of treatment directly applied to particular disease states.
Conventional medicine likes to offer the supposition that its therapies are all scientifically validated. On the contrary, much of standard medical practice, including commonly performed invasive techniques and drug therapies, are not well studied, and/or the mechanisms of their activity, effectiveness and safety are unknown. We can all recall "routine" medical practices and procedures that, although practiced for many years, are now either no longer performed or discouraged. New drugs are brought to the market place with studies that involved small trial groups; when approved and utilized by larger groups, their side effects lead to death, disease and removal from the market.
While massage therapy as a profession lacks the kind of scientific studies called for by medicine, massage therapy technique and treatment enjoy a long history -- over 11,000 years worldwide -- which allows for another kind of scientific evidence, based on the collective clinical observation of thousands of massage therapy practitioners from many global cultures. Clinical observation with the systematic collection of clinical data has long been a tool of science; indeed, it resulted in Edison's invention of the light bulb. In addition, studies on massage therapy usually involve the general and superficial techniques of Swedish massage. For example, a study might indicate in its abstract that patients with back pain received a "back massage." Medicine remains in this new millennium largely ignorant of the various techniques, school of techniques, and variety of treatment protocols that exist in the many forms that massage therapy is practiced. Most massage therapy professionals employ several different techniques, exercises and modalities in a typical patient treatment session, making it difficult to quantify the effects of a single technique. Future studies need to identify the specific techniques of different manual therapy systems, and study the exact clinical effects of those techniques.
Medical massage therapy, by the adoption of the qualifying word, "medical," should be able to demonstrate clinical results when placed under scientific scrutiny. This supposition is as yet unproven by conventional research. While limited studies do exist, and the data continues to increase regarding the generalized effects of Swedish massage, there are almost no studies on medical massage technique and protocol. The medical massage therapist must borrow from research data that has been performed in other manual therapy disciplines, such as orthopedic medicine, physical therapy, chiropractic and acupuncture, and studies on the biochemistry, physiology and histology of soft tissue structures of the body.
Medical training and research in the United States is largely subsidized by the pharmaceutical industry. The awarding of research grants is heavily influenced by the drug industry and medical bias. This situation has resulted in money being directed at finding the most profitable therapies rather than the most effective ones.
Massage therapy is experiencing a slow and gradual movement within the profession toward higher levels of academic standards, longer periods of study, entry into the profession by allied medical personnel, and acceptance into colleges, hospitals and medical clinics. However, there are few training programs in massage therapy schools that meet the needs of students of higher capacity and allied medical credentials.
The highly generalized format and techniques of Swedish massage, fringe massage and relaxation massage therapy do not meet the clinical needs of a medical or rehabilitation therapy environment. Lengthening the period of study within a training program does not address the need for a higher level of technique, clinical protocol, knowledge of the pathophysiological processes of connective tissue disease and disorders, and the application, formulation and delivery of sophisticated rehabilitation programs.
Medical massage therapy is emerging as a manual medicine system of treatment that does address the needs of a rehabilitation therapy environment. Medical massage therapy achieves this clinical criteria because:
Swedish or therapeutic massage employs generalized manual techniques such as gliding, kneading, striking, shaking, and friction. Medical massage utilizes these same movements as soft tissue pre-treatment preparation for the primary deep tissue and joint complex protocols that follow this general preparation. Medical massage deep tissue technique employs a relaxed hand technique referred to as the "soft hand." This hand technique allows deep tissue penetration without patient discomfort and without exacerbating the patient's condition. In addition, medical massage therapy utilizes patient anatomical positioning and soft tissue folding in order to reduce postural soft tissue tension and muscle contraction. Medical massage techniques combine manual therapy techniques directed at all connective tissue structures with joint mobilization techniques that "exercise" the deep internal joint complex tissues. These mobilization techniques, based on the normal physics of joint motion, include torque, shearing, accommodation and traction. The techniques of Cassel (osteopath) and Smith (naprapath) are also employed. The Cassel techniques include extremity shaking and release techniques; the Smith techniques involve the use of a bony lever and hand contact that move the joint and gently exercise and stimulate the ligaments of the joint.
Medical massage therapy is a highly specialized system of connective tissue rehabilitation based on theories and research regarding connective tissue healing and remodeling. This system of massage therapy recognizes that the joint complex and its attendant soft tissue structures, especially ligaments, are the primary sites of chronic pain and dysfunction, and that treatment of these structures must be directed at the soft tissue findings that result from diagnostic palpation. Treatment must be provided for the purpose of soft tissue and joint rehabilitation. In addition, therapeutic exercise, physiotherapeutic modalities, and patient education are combined in a treatment plan that identifies the appropriate frequency and duration of a therapy program. Medical massage therapy recognizes that clinical treatment for the goal of connective tissue rehabilitation must identify the cause of a problem and utilize direct manual technique to correct the cause of the problem.
All systems of manual and massage therapy share a common historical heritage. They are more than the mere sum of their parts - not simply "technique," but a synthesis of education, training, experience, dedication, humility, and intuition, expressed through the miraculous instrument, the human hand. Medical massage therapy is not so much a "new" approach to massage therapy as it is a "renewal" of the manual medicine practiced by many of the early European and Western medical pioneers of massage therapy.
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