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Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
December, 2002, Vol. 02, Issue 12
Flushing Out Myths
By Keith Eric Grant, PhD, NCTMB
There's a statement, seemingly pervasive throughout massage education and massage books, that unspecified toxins accumulate in the body, and that these toxins can be flushed out by massage.I believe this is yet another myth that continues to be passed on as misinformation to massage students. This is not to dispute that there are very real toxins that accumulate in the body, notably persistent organic pollutants (POPs) in fatty tissues and heavy metals in skeletal tissues. [7,8] However, these toxins are too chemically bound to their target tissues to be significantly liberated by the mechanical motions of massage.
A more significant issue is whether metabolic wastes and cellular debris can significantly accumulate and be flushed out by massage. To elucidate a negative response to this, I turn to consideration of the circulation of blood and lymph. If the tissue is to accumulate wastes in a static manner, i.e. not as an instantaneous balance between production and removal, the tissue must be isolated. If we assume that the tissue is isolated from blood circulation, then necrosis (cellular death) is the rapid consequence. Such gangrene is, for example, one of the results of the vascular pathology of diabetes. We have to conclude that non-gangrenous tissue must be receiving oxygen and nutrients via circulation and that, for this to continue, venous return flow must also be occurring. If the toxins are accumulating, they cannot be doing so within the reach of the circulatory system. Perhaps we should look instead in the interstitial spaces served by the lymphatic system.
As noted by Bruno Chikly, the lymphatic system is a second pathway back to the heart, parallel to the blood system [2, pg. 27]. Chikly further notes that "about 1.5 to 3.5 liters of lymph per day circulate through the thoracic duct, although the total volume of the flow of lymph has yet to be precisely measured" [2, pg. 51] and expands on the process of lymphatic circulation.
What arises is a picture of tissue far from being in static isolation. If neither necrosis nor severe edema is to result, the tissue environment must be continually bathed in the fluid circulations of blood and lymph, ruling out the accumulation of free toxins. Where there are restrictions, such as adhesions between fascial planes, they must be of a more macroscopic nature, still allowing for the microscopic flow of circulation, just as water can flow through cheesecloth.
Based on the above considerations, I can only conclude that the flushing of toxins is yet another persistent myth. However, this does not imply that massage is powerless to benefit the body. While massage does not appear to directly increase overall blood flow , it can be used to relax muscle hypertonicity. Lowering the level of muscle activity will locally reduce the need for energy and oxygen and the rate of production of metabolic wastes. It will also reduce the muscular pressure on surrounding tissues, effectively improving circulation and recovery from use. This, however, is not massage moving out toxins, but massage facilitating a better homeostasis. It is just this improvement in homeostasis by which, I believe, massage facilitates recovery from exercise and allows a higher level of training to occur.
In cases of excess lymphatic fluid production (overloading a normally functioning lymphatic system), or partial lymphatic system compromise, lymphatic drainage massage may be helpful in promoting the process of lymphatic filtering. The key sign here is the existence of edema. Normally, local muscle contractions promote sufficient lymph drainage. A notable exception exists with breast tissue. Since there is no contractile tissue within the breast to assist lymphatic drainage, overall tissue movement becomes important [3, pg. 101].
There remains a consideration that some clients respond to a massage with reactions of flu-like aches and malaise. Such symptoms have often been attributed to the toxins released. Dispelling with the concept of toxins means that we must seek other explanations for such post-massage malaise. Chaitow notes that fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS) are the distant end of spectrums of dysfunction that can include aches, malaise, and flu-like symptoms [1, pg. 6]. He believes that a great many people are somewhere on those spectrums. Some of the models of dysfunction that Chaitow presents include a sort of systemic allergic reaction characterized by a great deal of pain, either muscular and/or joint-related [1, pg. 33]. Chaitow also notes the hypothesis that the inability to produce an adequate cortisol response to a stress can result in symptoms: "Deficiency in cortisol is characterised by fatigue, weakness, muscle and joint pain, bowel symptoms, nausea, increased allergic reactions, mood disturbance" [1, pg. 68]. I tend to think of a body's neurochemical system on the edge of its ability to adapt being pushed temporarily beyond the edge by accommodating to the work being done. This reaction may be exacerbated by effects of athletic overtraining or by a genetic metabolic predisposition [5,6].
To explain the effects of massage, think not of flushing out toxins, but flushing out tensions - not just in the sense of emotional holding, but in the basic sense of muscles "idling" with the throttle open. As with good mechanics, we're simply readjusting the throttle to a reasonable idle rate. Underlying this way of looking at things, however, is a fundamental shift in orientation from mechanically moving something that accumulates to changing a dynamic balance within the living human body. It is, I believe, an important shift away from mythology and toward better understanding of our work.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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