resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
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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