resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Acupuncture Points: Broadening Our Scope and Diagnostic Work
As every practitioner knows, the correct diagnosis is everything. Most healing disciplines rely on the use of symptomatology for their treatment implementation. Beyond symptomatology, we have clinical tests to provide more objective findings.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.