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News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
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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