resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
June, 2002, Vol. 02, Issue 06
We Get Letters & E-Mail
By Editorial Staff
"Much of the public is still not convinced..."
I would like to respond to the letter from Sybille Murphy in the October 2001 issue.(Editor's note: Ms. Murphy's letter to the editor appears on line at www.massagetoday.com/archives/2001/10/17.html.)
I would question Ms. Murphy to be more exact about what she means by "so much incompetence" before slamming licensure as ineffective, either in protecting the integrity of the profession or protecting the public. As a licensed occupational therapist and a licensed massage therapist, I see great benefit in both areas for licensure. Of course, I recognize that there will always be some cases of incompetence in any field. We do live in an imperfect world.
As Massage Today Editor Cliff Korn pointed out in his column (that prompted Ms. Murphy's response), we have an opportunity to limit incompetence and unethical practitioners under licensure that we do not without it. Whether people contact you depends upon their confidence, not just in you, but in the profession as a whole, before they ever call you or lay eyes on you. Your assertion that "if we're incompetent, no one will ask for our services." is only partially correct. The truth is, if the public perceives we are incompetent or of questionable ethics, they will not call. (Editor's note: Cliff Korn's article, "Should We or Shouldn't We?" appeared in the June 2001 issue and is available on line at www.massagetoday.com/archives/2001/06/09.html.)
I get many calls from people who say they picked me out of all the other MTs in the Yellow Pages because I have a "health background" (occupational therapy). This clearly indicates that much of the public is still not convinced of our competence, and perhaps also of our ethics. As Mr. Korn stated in his article, "Many of us don't see ourselves as part of the greater health care field."
This leads me to my major complaint as an LMT: the ludicrous requirement in most massage job applications that we give away a free hour of our time and skill "proving" our competency. What other (accepted) health care profession experiences this? I know of none. I reiterate Mr Korn's own words to express my feeling on this practice: "How ludicrous. How demeaning. Occupational therapists, physical therapists, dental hygienists, psychologists, nurses, opticians, etc., would never put up with such nonsense, but many massage therapists accept this situation as customary and normal."
Thanks for the opportunity to express my point of view.
Bonnie Clancy, OTR, LMT
Editor's note: The following letter was submitted as commentary on Ben Benjamin's article, "The Dangers of Biking," which appeared in the January 2002 issue of MT. The letter is followed by a response from Dr. Benjamin.
"I submit myself as an expert in the field..."
Dear Ben, I just read your article in the January 2002 issue of Massage Today.
From your opening paragraph, it is obvious that you have not set foot in a bike shop in 10 years! Or at least not a shop that caters to "every person." Or perhaps our industry's ad campaigns gave you a wrong impression; they are still (unfortunately) aimed at the 20-something gonzo male.
Have you heard of the category called "comfort bikes"? They are the fastest growing and most popular category of bike. They address all the concerns of the average person: performance, ease of braking and shifting, comfort and an upright position, shocks, cushy seat, big tires, you name it!
The popular "bikes of 30 years ago" (that was 1972, the beginning of the "Bike Boom") were Schwinn Varsity 10 Speeds. They provided a very bent-over position and made the mountain bike an even better success because of its relative upright position. All the stresses your talk about are 'undone' by the comfort bike.
Recumbent bikes are indeed comfortable, but they have dangers and disadvantages also. Being less visible in traffic is one disadvantage, climbing ability is another, maneuverability is a third.
The bicycle industry woke up to the needs of real people about five years ago. The trend started about 15 years ago in 1988 with the introduction of hybrid bikes. Comfort bikes take it a step further. After 150 years, the bicycle industry is finally agreeing on "fit." Fit is a compromise between comfort and performance. We help our customers find that balance. Please see my website, linked below for more info and many links from other experts.
I suggest you contact experts in the bicycle industry before you give us such bad press in the future. I demand that you do your homework and print a more accurate article! I submit myself as an expert in the field if you have any further questions.
"I have done my homework"
Dear Aaron Goss,
I don't mean to give the bike industry bad press, but I have done my homework. I visited many bike shops over the past year in the Boston and New Hampshire areas, looking for a bike for myself. I wanted a bike that was comfortable and healthy for my body. It took many months and many bicycle shops to find a so-called "comfort" bike that was actually reasonably comfortable.
Biking can be a wonderful activity, but it seems that some bike shops and their "experts" still have ideas about biking that encourage injury instead of protecting the rider against it. They all advised me to ride in a forward-bent position that puts excessive strain on the neck, lower back, shoulders and wrists. There were no exceptions.
It sounds like you are motivated to offer a healthy bike to the public and I can only commend you on that. But it seems the bike retailers aren't yet tuned in to the knowledge expansion you describe. Since salespeople assume the role of educating the public on their product, it clearly matters that they may be uninformed about the advances you describe, and the injuries with which I am concerned.
After receiving your e-mail, I went out again today to see what the most well-thought-of bike shop in my area had to say while recommending a bike for me. I specifically asked for a bike that would not place undue stress on my neck, low back, shoulders and wrists. The salesperson discouraged me from sitting upright on any bike; he said it was actually bad for my low back. I was shown several comfort and hybrid bikes and put in positions that I was told were optimal for my back and my wrists. In each case, I was told that leaning forward was better for me and that this would not put pressure on my wrists. I also asked which type of bike the majority of recreational bikers used. The salesperson said that most bikers chose to buy bikes that gave them optimal power by having an even greater forward lean than the bikes in which I was interested.
Nothing in this particular conversation was different from what I have been told over the past year. I decided to question myself further after your e-mail and called an expert I know on alignment and movement. The discipline I respect most in this regard is the Alexander Technique, a method of teaching healthy posture, alignment and movement. According to Tommy Thompson, former chair of Alexander Technique International, "Sitting totally erect while riding a bicycle is the healthiest position for the neck and back. Most recreational bikers ride in a racers position which strains the body and makes it vulnerable to pain problems."
In addition to seeing injured bikers, it was the information I received in bike shops that convinced me that biking can be a dangerous activity for the neck, the low back, the shoulders and wrists. I frequently treat clients with biking injuries caused by this type of uninformed thinking about body mechanics and good health.
You might suggest to the trade magazines in your industry that they publish more about the dangers of injury associated with the "forward leaning posture" of contemporary bike riding. The body of a healthy 20-something-year-old may better tolerate this prolonged unnatural posture, but unfortunately I see too many bikers who have severely injured themselves because they believe this posture is best for their performance.
Ben Benjamin, PhD
Author's note: What follows are some helpful responses that Aaron Goss gave me in response to my questions in our e-mail correspondence.
Q: What exactly should a consumer say to a bike salesperson in order to find a bike that will not cause injury?
A: The first thing that should be discussed when shopping for a bike is the fit. Fit is a compromise between comfort and performance. Consumers should think about where they want to ride, on what kind of surfaces they will be riding, and how often, how far and how long they want to ride. These elements all play a roll in the fit process. Factors that may cause pain when leaning forward while sitting on a bike seat or that limit reaching the bars should be discussed with the bike fitting professional. Previous back injury, shoulder problems, lower back pain, tennis elbow, vaginal yeast infection, hernia, etc., are important considerations when choosing the most appropriate bike.
It is hard to find someone who understands fit and can answer all these questions. If the salesperson tries to size you by just having you stand over the bike, get someone else or go to another shop, because that person doesn't have a clue about bike fit. Most bike "salespeople" are simply trying to sell a bike. Bike industry wages are not high, so it's best to find someone who does this work for more than just money.
Q: Are there specific kinds of bikes (not just the descriptives "comfort" or "hybrid") that the casual/recreational rider should ask for?
A: Those terms are well known in the bike world, and bike shop professionals will know what you mean. They are also sometimes referred to as "cross" bikes or "cross training bikes" (not the same as Cyclocross). "Comfort" or "hybrid" bikes generally have a cushy seat, high handlebars in relation to the seat (generally two to six inches higher), and wide tires. Other features are low mountain bike gearing, seatpost shock, and a front fork shock.
Hybrids have 700 C (aprox. 27") wheels, and comfort bikes have 26" mountain bike-size wheels. Comfort bikes usually have higher handlebars than hybrid bikes. Both types usually have the straight handlebar like a mountain bike. Some may curve up to give more rise and some may curve back.
A really comfortable bike (although usually-custom installed) has the cruiser handlebar, (the names North Road, Priest, Upright and Girls have been given to the same bar). They put the rider's hand in a more natural position. Stand with your hands at your side, and raise them as if to grab a handlebar, but do not turn your wrist. Notice your hand position. This is the hand position of the cruiser bar. Straight mountain bike bars force you to turn your wrist 90 degrees - good for control, but not as comfortable. This is why mountain bike bar end extensions are popular. They give you the cruiser position.
Hope this helps.
"Why are we letting this happen?"
As I read your article about yet another state considering licensure for MTs, I had to ask myself, "Why?" As a massage therapist who has had to go through all the requirements for a license, I can only say that the process is flawed and meaningless in the end. (Editor's note: See "Arizona Massage Therapists Press for Licensure" in the February 2002 issue.)
In 1996, South Carolina passed, with great enthusiasm from the AMTA, licensing for MTs, plus passing requirements such as continuing education, course-hour minimums, etc. The reasons given were that the industry needed to legitimize itself through government intervention and and to ensure that MTs were being trained properly before working with the public. This rationale is ludicrous at best.
First of all, I have yet to see any compelling evidence that anyone ever died from a massage. The whole safety issue is moot, with the exception of wear and tear on the therapist. Here in South Carolina, it's obvious that the "legitimacy" issue is a joke as well. In fact, here in my town of Myrtle Beach, we've had an increase in "massage parlors" since the law was passed. Law enforcement has made a few token arrests, but no one even acknowledges the massage laws on the books.
Another point to make is this: A large portion of licensed therapists engage in inappropriate behavior. The dirty little secret is discussed by therapists who hear about it directly from the therapists themselves, or in my case, hearing from their clients about sexual encounters from other therapists. Of course, these clients aren't complaining, nor or they going to press charges against the therapist. There is no way anything can be done to discourage this. Two consenting adults in a private setting cannot be regulated by legislation.
This takes me back to the original question: Why do we allow (or even encourage) ourselves to be regulated? I think the answers are as follows:
As many industries are asking for self-regulation these days and less government regulation, we need to ask ourselves why we are letting this happen. Can you imagine the film industry (or any other industry, for that matter) asking the government to mandate regulations and guidelines to keep less legitimate elements at bay? Of course not! As business people, we need to start thinking like professionals, instead of worrying about prostitutes and the like.
"Obviously Massage Today is being read"
I wanted to thank you for publishing my article. (Editor's note: See "Medical Massage Therapy: The Search for Definition" by Gregory Lawton in the January 2002 issue.) Since the article came out, we have received 87 telephone calls to our school requesting educational materials or seminar information. In addition, our e-mail requests for catalogs are up more than 30 percent. This is remarkable because the article did not indicate exactly how to contact us. Many of the requests have come from nurses and physical therapists who are also massage therapists. This is the group we are attempting to target with our training. Obviously Massage Today is being read.
Greg Lawton, DC
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