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The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
January, 2003, Vol. 03, Issue 01
Introduction, With a Response to AMMA
By James "Doc" Clay, MMH, NCTMB
Clinical massage therapy has been around a comparatively long time.(Ben Benjamin has certainly been practicing it quite a while.) The various schools of myofascial release are clinical in intent. Bonnie Prudden, after being treated by Dr. Janet Travell, published a number of books and established her system of myotherapy. The Rolfers, Hellerworkers, and CORE myofascial therapists, with their approaches to structural alignment, practice what has to be considered a type of clinical bodywork.
Clinical massage therapy/bodywork is the product of a number of converging streams. The psychiatrist and psychoanalyst Wilhelm Reich, who began as a disciple of Freud, postulated the expression of character in body structure, and was certainly one of the first to develop an approach to treating mind and body together. Dr. Reich's system lives on in bioenergetics, an approach developed by his student, Alexander Lowen. Ida Rolf pioneered the manual treatment of the fascia to restructure the body. Traditional massage therapy began to expand to address specific pain problems. Travell and Simons explored myofascial trigger points and pain. Osteopaths such as Leon Chaitow contributed many procedures and techniques from the osteopathic tradition. We are heirs to all these ideas and practices that came before us, and are putting them together in a "bodywork synthesis"called clinical massage therapy.
But the perceptions of the public in general, and the medical profession in particular, have been limited largely to relaxation massage. I recently talked with Dr. Kathi Kemper, a pediatrician and the author of The Holistic Pediatrician, about massage therapy and pediatrics. She's quite interested in the topic, and thoroughly familiar with the work of Dr. Tiffany Field at the Touch Research Institute of the University of Miami Medical Center, but I found it nearly impossible to interest her in the effects of clinical massage therapy in the treatment of specific problems of myofascial pain and dysfunction (I haven't stopped trying!). Neonatologists know how effective massage is for helping premature babies gain weight, but pediatricians in general are utterly ignorant of the effectiveness of clinical massage therapy for treating headaches, earaches, and other childhood problems with myofascial components.
There are signs that the situation is changing. Recent articles have reported favorably on the effectiveness of clinical massage therapy for such problems as low back pain and neck pain, one even appearing in Reader's Digest. (I strongly recommend that anyone interested in keeping up with such studies subscribe to the newsletters from WebMD.com - they report such items on a regular basis.) Perhaps we needed some time for the public to become comfortable with massage therapy in general, before they were ready to accept clinical massage therapy as an option for pain treatment.
The purpose of this column is not to deal with clinical issues themselves - that's what we have Ben Benjamin for - but to address the variety of issues confronting clinical massage therapy as it develops and evolves. I want to do this in an interactive way, by soliciting your input. What do you think the issues are? What are your opinions about various aspects of the discipline we will have to deal with as therapists? How does clinical massage therapy differ from traditional relaxation massage in such areas as:
My decision to write a column on clinical massage therapy was well-timed, as it followed the publication of the American Medical/Manual Massage Association's (AMMA) guidelines for a medical massage curriculum in the September 2002 issue of Massage Today. This first column is an ideal place to reflect on that article. I find much in it to agree with, such as the recommendation for more thorough training in anatomy, physiology, and pathology, more intensive clinical exposure during training, internships in clinical settings, and a greater emphasis on problem-oriented therapy. However, I also found a number of points to take issue with.
1) I've heard the term "medical massage" used for several years, and have never been quite comfortable with it, for a variety of reasons. In Basic Clinical Massage Therapy: Integrating Anatomy and Treatment, I wrote:
Not only has our field rediscovered and revived a number of therapeutic techniques from the distant past and borrowed many techniques from other disciplines, we have taken advantage of our independence from traditional health care to explore and develop new techniques and new ways of understanding and applying old techniques. I can't help feeling that the use of the word "medical" in designating our profession betrays a desire to enhance our prestige by diving headlong into the medical field. We have seen what has happened to physical therapy as a result of just such a merger: the stifling of creativity and imagination. Although there are many outstanding and creative physical therapists in practice, the vast majority have been inexorably absorbed into the black hole of insurance and managed care, and have succumbed to the pressure to work "by the book." If we are to continue to explore and discover, and increase our effectiveness through creativity, we would do well to maintain our independence from more traditional disciplines.
2) AMMA may have already crossed that line. The article suggests that the training proceed from one body part to the next, learning the anatomy and typical pathology of each area before proceeding to the next area. The examples used are first the hand, then the elbow. Surely the authors are aware that most problems of the wrist and hand are traceable to muscles in the forearm, some of which cross the elbow - not to mention the common possibility of pain in the hand referred from the shoulder or chest! Yet we find the statement, "The medical massage treatment model is, however, neither a 'medical model,' nor is it 'allopathic.' Since it is massage therapy, the medical model is based on a natural and holistic philosophy of care." But the description we are given of a suggested curriculum is entirely reductionistic. Massage is not inherently holistic, and calling something holistic does not make it so. I see no reference anywhere in the article to posture as a causative or aggravating factor in myofascial pain, yet even the most authoritative physicians in the field of myofascial pain and dysfunction, Janet Travell, David Simons, and Robert Gerwin attribute a great deal of responsibility in this area to posture. I believe that most massage therapists are committed to a holistic view of health and the body, but such a view is not apparent in the AMMA statement.
3) The article says that, "Currently, massage education is fixated on 'hours in training,'" and later that "Time in training is not the central factor in developing good medical massage therapists; it is simply one factor." I certainly agree with that concept. However, a quick trip to AMMA's Web site (www.americanmedicalmassage.com), reveals that graduation from a 600-hour program is a requirement for membership in AMMA. Why 600 hours? Most programs I have come across span 500 to 600 hours, and I'm quite certain that most therapists practicing clinically are essentially self-taught, having gained the necessary knowledge and experience after massage school by attending workshops, reading books, watching videos, and working with clients. Among them are probably outstanding clinicians, but they would be ineligible for membership in AMMA.
4) AMMA tells us that, "It is important that the techniques and treatment protocols being taught conform to current and correct applications of medical massage therapy." What are those techniques and protocols? Is the jury already in? Am I to understand that all the research is done, all the exploration finished, our knowledge complete, and we now have a set of "techniques and treatment protocols" that are not only current, but even "correct?" Why wasn't I told? Since I'm just beginning work on my textbook on advanced clinical massage therapy, I hope someone will let me know about this. I'd hate to suggest incorrect approaches.
I find this statement from AMMA frightening. It suggests that we are in a great hurry to become frozen, petrified, closed-minded and institutionalized as a profession. And we should be duly warned that, if "correct" clinical techniques are established beyond question, we are not professionals, but technicians.
5) Finally, I can't overlook the article's reference to a "sore bicep [sic] muscle." Whether on the arm (biceps brachii) or the leg (biceps femoris), the singular of the word is "biceps" (the plural, in the unlikely event you should ever need it, is "bicipites") - there is no such word as "bicep." Perhaps that seems niggling and pedantic, but words are important, and for a group that emphasizes technical education, it's a point worth making.
It really isn't my intention to start a fight with AMMA. I encourage them, and I wish them well. But it is my intention to start (and maintain) an open conversation, because what we are doing is far too important to be left to a single individual or group to dominate or dictate. Having offered my criticisms this month, I will devote my next column to my own thoughts and ideas about clinical massage therapy education and standards, and welcome any feedback. Meanwhile, primum non nocere, and keep an open mind.
Click here for more information about James "Doc" Clay, MMH, NCTMB.
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