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.
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.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
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.
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.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
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.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
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!
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
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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