resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
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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