Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
April, 2002, Vol. 02, Issue 04
Scope (Not the Mouthwash)
By Cliff Korn, BS, LMT, NCTMB
"Scope of Practice" is a term that, like many others, seems obvious, but means different things to different people. Strictly speaking, a scope of practice is the legal limit of practice options available to a regulated practitioner.However, in common usage, associations develop scope-of-practice guidelines for professionals in a field independent of regulation. A practitioner's scope of practice is predominantly measured by definition, and definitions change depending on who is doing the defining. Laypersons and regulators may define terms we use internal to our work differently than we do.
An example of this can be found with the term "massotherapy." From a school website comes this definition: "Massotherapy is a scientific method for treating disorders of the human body through manipulating the soft tissue, by hand or other modality, to affect relaxation, relieve pain, increase range and mobility of joints and ligaments, reduce certain types of edemas, affect blood and nutrition, improve metabolism, promote circulation, and beneficially influence the nervous system." Another school's site defines the same term as: "Massotherapy is a hands-on application that consists of a number of techniques executed on living tissue with the objective of promoting a general well-being. This type of therapy has an effect on the skin, muscles, tendons and ligaments (referred to sometimes as soft tissue) and aims for a physical as well as a psychic well-being since the last two are closely related." Yet a third defines it as the following: "Massotherapy is massage therapy or a systematic and scientific manipulation of the soft tissues of the body."
They all make the term seem pretty synonymous with "massage," don't they? My favorite choice for definitions is Webster's New World College Dictionary, Fourth Edition. My copy defines massotherapy as "a physical therapy by means of massage." My guess is that individuals looking to initiate state regulation/licensing of massage would get fewer objections from the physical therapists if they studiously avoided Webster's definition!
Individual state regulators can and do choose how they wish to define terms and scopes of practice. This can drastically affect a scope of practice from one jurisdiction to another. A classic example of this is colon hydrotherapy, which until recently was (in one state) not allowed in a licensed massage establishment, while in a different state required those performing colon hydrotherapy to also be licensed massage therapists. In another state, a practitioner of massage may treat temporomandibular joint dysfunction only if a physician has directly referred the patient in writing for such treatment. One state allows the application of non-prescription topical substances on the body within its scope of practice. This has led massage therapists there to offer facial massage, which really irritates the estheticians, who consider the word "facial" to be theirs alone.
Certainly massage therapists deal with overlapping scopes of practice all the time, but regulatory definitions, scope limitations and educational requirements make it particularly difficult within the broad umbrella of massage therapy. Many well-meaning massage boards have developed broad massage definitions so that other professions aren't able to exclude massage therapists from the conduct of emerging advances in the field. A side-effect of this is that many people get swept up in the regulations that feel like they don't fit a definition of massage. Reiki practitioners in all but the most hard-nosed jurisdictions have been able to exempt themselves from most massage definitions. Other methodologies, which frequently wish to opt out of massage regulation, are reflexology and polarity. They make strong cases for not fitting the definitions of massage in many instances, but my trusty Webster's defines reflexology as "a practice involving the use of acupressure or massage of the hands or feet to relieve pain in other parts of the body, reduce tension, etc." The International Institute of Reflexology also lists itself as approved for continuing education by both the Florida Board of Massage and the NCBTMB. Do you think a regulator or layperson reading that definition and noting those approvals would see the merit in granting reflexology an "out"?
Similar difficulty with structural integration, Bowen technique, Asian bodywork, Trager, watsu, CranioSacral Therapy, etc., stems from differences in definition. One I found humorous was Webster's definition of Rolfing. It states, "service mark for a form of painful massage intended to relieve emotional tensions by relaxing and repositioning the muscles." My guess is that the Rolf Institute's public relations team will soon be petitioning Webster's publisher for a definition change!
The differences in state-by-state definitions and scopes of practice are particularly stressing to massage therapists. As a group massage therapists tend to be a mobile lot and the ability to cross state borders relatively seamlessly should be a boon. An organization had been in place to attempt to find common ground in regulatory language. Unfortunately, the National Alliance of State Massage Therapy Boards is all but dead. It has no leadership and no plans to meet again. Perhaps there can be a grassroots effort to get it re-established.
Thoughts on scope of practice are always affected by definitions. Here are a few (from Webster's, of course!) to ruminate on when next you are discussing the benefits of accepting or rejecting regulation, embracing or delaying continuing education, or contemplating whether you are a professional or a hobbyist in massage:
My high-school biology teacher used to use a phrase that still stays with me: "Ontogeny recapitulates Phylogeny." It refers to life cycles of individual organisms affecting the life cycles of groups of organisms. When we choose to define our scopes of practice, we affect more than just ourselves. As that teacher was alluding to with his jargon, what happens to one is indicative of what happens to many!
Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be published in a future issue of Massage Today. Please send all correspondence by e-mail to , or by regular mail to the address listed below:
Former editor of Massage Today, Cliff is owner of Windham Health Center Neuromuscular Therapy LLC. He is nationally certified in therapeutic massage & bodywork and is licensed as a massage therapist by the states of New Hampshire and Florida. Cliff is a member of the International Association of Healthcare Practitioners; a professional member and past president of the New Hampshire chapter of the American Massage Therapy Association; a certified member of the Associated Bodywork & Massage Professionals, Inc.; and a past chairman of the board of directors of the National Certification Board for Therapeutic Massage & Bodywork.
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